What causes asthma attacks?

Understanding the most common causes of asthma could help reduce severity of symptoms

Asthma causes are not the same as the factors that can trigger an asthma attack. The causes are usually the underlying reasons why some people develop the disease which is marked by shortness of breath, wheezing and coughing. Triggers, on the other hand, include things like pollen which can lead to coughing in asthmatics.

 

Asthma is commonly defined as an inflammation of the airways and affects around 300 million people worldwide. There are different types of asthma and causes vary accordingly.

 

Types of asthma

Differentiating between different types of asthma helps to determine their causes and find the best treatments. 

 

  •  Allergic asthma
  •  Non-allergic asthma
  • Occupational asthma
  • Pediatric asthma
  • Obesity asthma
  • Late-onset asthma or asthma in the elderly
  • Severe asthma

 

Some types of asthma run in families. That means you are more likely to get asthma if one or both of your parents already have asthma. But other types of the disease may be avoidable. By understanding the causes, you can minimise your risk of developing asthma in the future.

 

Asthma causes

 

Allergies

Asthma is referred to as an allergic disease because symptoms are often triggered in response to an irritant. Allergens that can cause asthma include:

 

  • Dust mites
  • Pollen
  • Mold spores
  • Cockroaches
  • Pets and rodents

 

Sometimes, allergens can cause mild asthma, but mold spores, pet dander, cockroaches and food-based inhaled allergens are associated with severe forms of asthma.

 

Smoking

Non-allergic asthma has been associated with cigarette smoke. Around 25% of adult asthma patients are smokers. Cigarette smoke can worsen the inflammation caused by asthma and may also hamper the body’s own repair mechanisms.

 

A study following 4,000 adults found that lung function in smokers with asthma declined more rapidly over 10 years than that in non-smoking asthmatics.

 

Smoking whilst pregnant also raises the risk of childhood asthma.

 

Environmental and occupational irritants

Asthma can also be caused by prolonged exposure to certain irritants in the environment and specifically the air we breathe. Environmental and occupational asthma causes include:

 

  • Air pollution and dust in the air
  • Wood fire or grill smoke
  • Chemical fumes, e.g. from paint, perfumes, flour, laboratory chemicals

 

It’s important to limit your exposure to these irritants. If you live in cities where air pollution levels are consistently high, wear a good mask when walking outdoors. If you are exposed to chemicals at work, you should follow established safety instructions.

 

Medical conditions

Several medical conditions and illnesses are associated with asthma, including:

 

  • Bronchiolitis
  • Allergic bronchopulmonary aspergillosis
  • Chronic obstructive pulmonary disease
  • Obesity
  • Nasal polyps
  • Rhinitis
  • Pregnancy
  • Respiratory infections and inflammatory conditions including the flu, colds, pneumonia, and sinusitis

 

Exercise

Physical activity usually means that people are breathing harder to pump more oxygen to the muscles. This can cause breathlessness and lead to asthma in some patients. Exercise-induced asthma is more common in professional athletes (22.8%) and particularly high in winter sports participants (54.8%). Exercise-induced asthma symptoms are more often triggered by cold, dry air. 

 

That doesn’t mean asthmatics can’t exercise, but they must take special precautions. Studies suggest that asthma patients should work out in smaller sections. Any high-intensity exercise should not last longer than 5 to 8 minutes to avoid an asthma attack.

 

Hormones

Fluctuations in hormone levels during puberty and menopause in women are associated with late-onset asthma and changes in asthma patterns. Hormones play an important role in mediating the body’s inflammatory response, but whether they could be useful in treating asthma is not fully understood.

 

Weather

Sudden changes in weather and dry wind or cold air can trigger asthma. Thunderstorms can also bring on an asthma attack (“thunderstorm asthma”).

 

Emotion-triggered asthma

Although research in the area of psychologically-triggered asthma is currently sparse, emotional outbreaks and panic disorders have previously been associated with asthma attacks. Whilst emotions may not always be the cause of asthma, 28% of asthma patients report that stress, depression, low mood, fighting with others, anger and feelings of excitement are frequent triggers of an attack.

 

Causes of asthma in children

Although many of the causes described above can lead to asthma in children, having a family history of the condition is linked to higher risk of developing asthma in childhood. Children with allergies are particularly prone to developing asthma.

 

Additionally, babies that are born prematurely and require a ventilator during their first few weeks or months, may develop respiratory issues.

 

Watch out for these signs of asthma in children:

 

  • Whistling or wheezing sounds made during breathing
  • Frequent coughing
  • Shortness of breath and complaints of a tight feeling in the chest

 

What helps asthma?

Asthma treatment will depend somewhat on the underlying causes.

 

In the first instance, try to avoid known causes to minimize your risk of getting asthma. Protect yourself from environmental or occupational triggers and take precautions when exercising outdoors.

 

To reduce the severity or prevent an asthma attack, doctors will usually prescribe either reliever or preventer inhalers. Reliever inhalers are usually given to patients who are rarely exposed to asthma triggers. As the name suggests, the inhaler works by relieving the symptoms of an attack.

 

Preventer inhalers are used every day and are prescribed for more severe cases of asthma.

 

For more information, speak to your doctor or healthcare provider.

 

References

  1. Horak, F., Doberer, D., Eber, E., Horak, E., Pohl, W., Riedler, J., … Studnicka, M. (2016). Diagnosis and management of asthma - Statement on the 2015 GINA Guidelines. Wiener klinische Wochenschrift, 128(15-16), 541–554. https://doi.org/10.1007/s00508-016-1019-4
  2. Lombardi, C., Savi, E., Ridolo, E., Passalacqua, G., & Canonica, G. (2017). Is allergic sensitization relevant in severe asthma? Which allergens may be culprits?. World Allergy Organization Journal, 10: 2. https://doi.org/10.1186/s40413-016-0138-8
  3. Thomson, N. (2004). Asthma and cigarette smoking. European Respiratory Journal, 24/5: 822-833. https://doi.org/10.1183/09031936.04.00039004
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  5. Millard M. W. (2003). Dispelling the myths of exercise and asthma. Proceedings (Baylor University. Medical Center), 16(4), 388–391. doi:10.1080/08998280.2003.11927933Yung, J. A., Fuseini, H., & Newcomb, D. C. (2018). Hormones, sex, and asthma. Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology, 120(5), 488–494. https://doi.org/10.1016/j.anai.2018.01.016
  6. Vazquez, K., Sandler, J., Interian, A., & Feldman, J. M. (2017). Emotionally triggered asthma and its relationship to panic disorder, ataques de nervios, and asthma-related death of a loved one in Latino adults. Journal of psychosomatic research, 93, 76–82. https://doi.org/10.1016/j.jpsychores.2016.11.010
  7. Lampkin, S. J., Maslouski, C. A., Maish, W. A., & John, B. M. (2016). Asthma Review for Pharmacists Providing Asthma Education. The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG, 21(5), 444–471. https://doi.org/10.5863/1551-6776-21.5.444

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