Health Department

Asthma

Asthma is a chronic disease that involves inflammation of airways in the lungs. There is no cure, but it can be treated and controlled. During an asthma attack three basic things occur in the lungs - the inside of the airways swell, airways muscle spasms occur and mucous builds up. Asthma affects all age groups from infants to senior adults. There are many different theories on why asthma occurs, but no definite explanation.

Asthma is characterized by excessive sensitivity of the lungs to various stimuli. Asthma episodes can be triggered by a variety of factors including pollen, cigarette smoke, mold, animals, cockroaches, dust, weather, exercise, respiratory infections and colds, emotions, strong smells, etc. Over 80% of those with asthma also have allergies. Each person reacts differently to the factors that may trigger asthma.

Common symptoms include:

  • Coughing, especially at night
  • A wheezing or whistling sound, especially when breathing out
  • Trouble breathing or fast breathing that causes the skin around the ribs or neck to pull in tightly
  • Frequent colds that settle in the chest

Treatment for asthma includes avoiding the factors that can start an attack and taking medication to control the inflammation in the airways. The treatment will depend on the severity and frequency of the symptoms. To deal with childhood asthma, the doctor may prescribe two types of medicines:

  • Quick relief: Any child who has asthma needs a quick-relief medicine to treat the noisy part of the disease — the coughing, wheezing and shortness of breath that occur with symptoms or an asthma attack. This medicine (typically an inhaler) should be with the child at all times for use at the first sign of symptoms.
  • Long-term control: This type of medicine is needed by some children to treat the quiet part of asthma — the inflammation of the airways. It is taken daily to prevent asthma symptoms and attacks.

Approximately 18% of the students in the Independence School District have asthma, and it is the most common reason children miss school. Symptoms vary per person, but some common symptoms include a cough with or without mucus, wheezing, difficulty breathing, and/or chest tightness. If you are experiencing any of these symptoms you should see your physician.

Asthma Resources

If you would like more information about asthma, contact Dee Hampton at (816) 325-7320 or DHampton@indepmo.org.

The Independence Health Department takes an active role in working with children with asthma. Children in the Independence School District are presented the American Lung Association's Open Airways program. This program helps the students understand their asthma and learn to take charge of their asthma. Classes are also presented to adults, bus drivers, childcare workers, teachers, after-school workers and caretakers.

The American Lung Association’s Open Airways For Schools is a school-based curriculum that educates and empowers children through a fun and interactive approach to asthma self-management. It teaches children with asthma ages 8-11 how to detect the warning signs of asthma, avoid their triggers and make decisions about their health. Children who complete the Open Airways for Schools program should be able to:

  • Take steps to prevent asthma symptoms
  • Recognize the symptoms of asthma when they first occur, and carry out appropriate management steps
  • Discuss and solve problems related to asthma with parents, medical professionals, teachers, and friends
  • Feel more confident about taking care of their asthma on a daily basis

Watch this video from an Open Airways For Schools facilitator on why the program is so important to young asthma sufferers.

The Story Behind Open Airways For Schools

Open Airways For Schools was developed over a decade ago by researchers at Columbia University, in collaboration with the American Lung Association. The decision was made to design the program for delivery in schools because that is the surest way to reach all children, regardless of their family situation or access to health care. Children who completed the program took more steps to manage their asthma, improved their school performance, and had fewer and less severe asthma episodes. Parents of children participating in Open Airways For Schools reported taking more steps to help manage their children’s asthma. And the school environment became more supportive: children without asthma were more willing to help children with asthma, and children with asthma were able to give support to one another.

How the Program Works

The Open Airways For Schools curriculum consists of six 40-minute group lessons for children with asthma held during the school day. The curriculum incorporates an interactive teaching approach – using group discussion, stories, games and role play – to promote students’ active involvement in the learning process. Topics covered include basic information about asthma, recognizing and managing asthma symptoms, using medication, avoiding asthma triggers, getting enough exercise, and doing well at school.

Open Airways For Schools classes are led by trained instructors, who might be the school nurse or other school personnel, parents, community volunteers, or anyone with an asthma background that has an interest in working with children.

The Open Airways For Schools classroom kits contain easy-to-use teaching materials including a detailed curriculum guide, posters and activity handouts. Each lesson also includes materials for the children to take home and share with their parents. All curriculum materials are available in English and Spanish.

More Information

Asthma is one of the most common chronic disorders in childhood, currently affecting an estimated 7.1 million children under 18 years; of which 4.1 million suffered from an asthma attack or episode in 2011. Asthma is a reversible obstructive lung disease, caused by increased reaction of the airways to various stimuli. It is a chronic inflammatory condition with acute exacerbations.Determining whether a child has asthma can be difficult.

  • An asthma episode is a series of events that results in narrowed airways. These include: swelling of the lining, tightening of the muscle, and increased secretion of mucus in the airway. The narrowed airway is responsible for the difficulty in breathing with the familiar “wheeze”.
  • Secondhand smoke can cause serious harm to children. An estimated 400,000 to one million children with asthma have their condition worsened by exposure to secondhand smoke.2
  • Asthma is the third leading cause of hospitalization among children under the age of 15. Approximately 29 percent of all asthma hospital discharges in 2010 were in those under 15, however only 20% of the U.S. population was less than 15 years old.
  • Asthma is one of the leading causes of school absenteeism;in 2008, asthma accounted for an estimated 14.4 million lost school days in children with an asthma attack in the previous year.

Answers to Commonly Asked Questions

Will my child outgrow his/her asthma?

Many babies who wheeze with viral respiratory illnesses will stop wheezing as they grow older. If your child has atopic dermatitis (eczema), allergies or if there is smoking in the home or a strong family history of allergies or asthma, there is a greater chance that asthma symptoms will persist.

Can asthma be cured?

Not yet. However, for most children and adults, asthma can be controlled throughout life with appropriate diagnosis, education and treatment.

Should my child exercise?

Once a child's asthma is controlled, (usually with the help of proper medications) exercise should become part of his or her daily activities. Children with asthma certainly can and do excel in athletics. Many Olympic athletes have asthma.

How can symptoms be controlled at school?

You, your family, physician and school personnel can work together to prevent and/or control asthma. Share your child's asthma management plan with the school nurse and any coaches who oversee your child. With the approval of physicians and parents, school-age children with asthma should be allowed to carry metered-dose inhalers with them and use them as appropriate.

The most important part of managing asthma is for you and your child to be very knowledgeable about how and when asthma causes problems and how to use medications.

Asthma Resources for Children

Millions of teenagers around the world have asthma – you’re not alone. You know best how you feel about having asthma. These tips may help you be in control of your asthma and can make managing asthma as a teen a bit easier:

  • With your doctor or asthma educator, make an Asthma Action Plan that fits your life.
  • Ask to be actively included in all discussions and treatment choices because you’re the one who has to take the medicine regularly.
  • Ask your doctor if your rescue medicine can be taken at home in the morning and evening. This can make taking asthma medicine part of a morning or night time routine, just like brushing teeth or showering.
  • Always take your controller medicines as prescribed by your doctor. Not taking long-term control medicines when needed can be dangerous and even fatal.
  • Live as normal a life as possible with the help of medicines and thoughtful limitations. You can still play sports or go to dances and partake in most normal activities. Following your asthma action plan will let you do just about anything.
  • Keep your quick-relief inhaler with you, and use it when you need it.
  • Watch for early warning signs of an asthma attack, and get help if you need it.
  • It is okay to ask for help if symptoms do not improve despite following the action plan and taking the medication as prescribed.
  • Schedule doctor visits. Don’t forget routine visits to the doctor for monitoring.
  • Know your asthma warning signs and do your best to avoid things that trigger your asthma.

Asthma Resources for Teens

Many people develop asthma in childhood. However, asthma symptoms can appear at any time in life. Individuals who develop asthma as adults are said to have adult onset asthma. It is possible to first develop asthma at age 50, 60 or even later in life.

Adult onset asthma may or may not be caused by allergies. Some individuals who had allergies as children or young adults with no asthma symptoms could develop asthma as older adults. Other times, adults become sensitized to everyday substances found in their homes or food and suddenly begin to experience asthma symptoms. About 50 percent of older adults who have asthma are allergic.

Who Gets Adult Onset Asthma?

We do not know what causes asthma. There is evidence that asthma and allergy are in part determined by heredity.

Several factors may make a person more likely to get adult onset asthma. Women are more likely to develop asthma after age 20. For others, obesity appears to significantly increase the risk of developing asthma as an adult. At least 30 percent of adult asthma cases are triggered by allergies.

Different illnesses, viruses or infections can be a factor in adult onset asthma. Many adults first experience asthma symptoms after a bad cold or a bout with the flu.

Adult onset asthma is not caused by smoking. However, if you smoke or are exposed to cigarette smoke (secondhand smoke), it may provoke asthma symptoms.

Asthma symptoms can include:

  • Dry cough, especially at night or in response to specific "triggers"
  • Tightness or pressure in the chest
  • Difficulty breathing
  • Wheezing—a whistling sound—when exhaling
  • Shortness of breath after exercise
  • Colds that go to the chest or "hang on" for 10 days or more

How Does Adult Onset Asthma Compare with Childhood Asthma?

Unlike children who often experience intermittent asthma symptoms in response to allergy triggers or respiratory infections, adults with newly diagnosed asthma generally have persistent symptoms. Daily medications may be required to keep asthma under control.

After middle age, most adults experience a decrease in their lung capacity. These changes in lung function may lead some physicians to overlook asthma as a possible diagnosis.

How can adult onset asthma be managed?

There are four key steps to successfully managing asthma:

  • Learn about asthma and stay up-to-date on new developments.
  • Take prescribed medications. Don't make any changes until you check with your doctor. Don't use over-the-counter medications unless prescribed by your doctor!
  • Check your lungs daily at home with a peak flow meter. You often can detect changes in your lungs with a flow meter before you actually feel your symptoms increasing. Visit your doctor regularly for further in-office tests. These lung tests are painless and provide valuable data that help your physician make adjustments in your medications.
  • Make an asthma management plan with your health care provider. A plan establishes guidelines that tell you what to do if your asthma symptoms get worse.

How can Asthma Symptoms be Controlled or Reduced?

If your asthma symptoms are caused by allergies, take steps to control known or potential triggers in your environment. Allergy-proof your house for dust, mold, cockroaches and other common indoor allergens to which you are allergic. Reduce your outdoor activities when pollen counts or ozone levels are high. Choose foods that don't contribute to your asthma or allergy symptoms. Evaluate your workplace for possible allergens and take the necessary steps to reduce your exposure to them.

Can Asthma Reappear in Adults After Disappearing Years Ago?

Asthma is usually diagnosed in childhood. In many patients, however, the symptoms will disappear or be significantly reduced after puberty. Around age 20, symptoms may begin to reappear. Researchers have tracked this tendency for reappearing asthma and found that people with childhood asthma tend to experience reappearing symptoms through their 30s and 40s at various levels of severity. Regardless of whether your asthma is active, continue to avoid your known triggers and keep your rescue medications or prescriptions up-to-date and handy in case you need them.

Are There any Special Considerations for Adults with Asthma?

Many adults take several medications and/or use over-the counter medications, such as ibuprofen or aspirin, regularly. Work with your doctor to simplify your medication program as much as possible. Explore the possibility of combining medications or using alternate ones that will have the same desired effect. Be sure to discuss potential drug interactions with anything you take, including vitamins.

Some asthma medications increase heart rate. If you have a heart condition, discuss those side effects with your health care provider. Older "first generation" antihistamines can cause men with enlarged prostates to retain urine. Oral steroids can make symptoms of glaucoma, cataracts and osteoporosis worse.

Adults with arthritis may need special inhalers that are easier to operate. Anyone with asthma should consider getting an annual flu shot. Older adults also should talk with their doctor about getting a pneumonia vaccination. People with multiple medical conditions need to be aware of how their illnesses may affect one another.

Asthma Resources for Adults

You probably think about your child's asthma every day. When you care for a child with asthma, it's important to know what his or her asthma triggers are and to work with your child's health care provider to create an Asthma Action Plan so you will know what to do if your child's asthma symptoms worsen. It's also important to make sure that you know about your child's medication and how to use the devices prescribed or recommended by your child's provider. Be sure to stay informed, and work closely with your child's health care provider to help control your child's asthma symptoms and work toward his or her asthma management goals.

Five important things you can do to help your child manage his or her asthma

  • If your child is 4-11 years old, have them take the Childhood Asthma Control Test* periodically to help determine whether your child’s asthma symptoms are well controlled, and share the results with your child’s health care provider. If your child is 12 years or older, have them take the Asthma Control Test™.
  • Know what your child's asthma triggers are and how to minimize exposure to them.
  • Make sure your child is using the right medication at the right time. Know which medicines are for long-term control and which are for quick relief of sudden symptoms.
  • Work with your child’s health care provider to create an Asthma Action Plan that explains what steps to take if asthma symptoms worsen. Share it with your child's school and other caregivers.
  • Make sure that other caregivers — sitters, teachers, school nurses, camp counselors, coaches, and so on — understand your child's condition, what his or her triggers are, which medications he or she needs and when, and how the medications should be given.

If your child is old enough to take part in his or her care, it's important to help your child understand:

  • His or her asthma triggers and how to minimize exposure to them.
  • How to take prescribed asthma medicines and the differences between them.
  • His or her Asthma Action Plan and steps to take if asthma symptoms worsen.

Watch the videos in the following link to learn how to properly use an inhaler to get the most out of your child's medicine: http://www.cdc.gov/asthma/inhaler_video/default.htm

Asthma Resources for Parents