May National Asthma and Allergy Awareness Month

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1 May National Asthma and Allergy Awareness Month Hello NCP Friends! Spring is in full bloom these days, so it is no surprise that all that pollen is covering your car the day after your fresh car wash. Although rates of asthma and allergy sufferers in Delaware have always been on the higher side, allergy season seems to be hitting EXTRA hard this year for many Delawareans. Therefore, since May is National Asthma and Allergy month, I decided to feature an article about asthma and allergies. Enjoy! What is National Asthma and Allergy Awareness Month? According to the CDC, asthma affects 18.7 million adults and 6.8 million children in the U.S. alone. As such, it s a condition that s always on the minds of public health officials and media outlets, and there is no better time than the month of May to get the word out to these folks about the disease and the key role respiratory therapists play in the care of patients who have it. As a result of the great impact asthma and allergies have on the population especially during the spring season, May has been designated as National Asthma and Allergy Awareness Month. What is the AAFA? The Asthma and Allergy Foundation of America (AAFA), a not-for-profit organization founded in 1953, is the leading patient organization for people with asthma and allergies, and the oldest asthma and allergy patient group in the world. The AAFA is dedicated to improving the quality of life for people with asthma and allergic diseases through education, advocacy and research.

2 Their Goal Asthma and allergies affect most people in the United States in some way. In 1953, three allergists started AAFA to raise money for education and research. Now, AAFA also offers resources and advocacy for all those affected, as well as healthcare providers and policymakers. Our goal is for those with asthma and allergies to live life without limits. The Impact of Asthma and Asthma Awareness Asthma, a lung disease, affects over 24 million people living in the United States, including more than 6 million children. It causes 3 in 5 people living with asthma to limit their physical activity or miss days at school and work. Asthma is also expensive, costing the nation $56 billion each year. On World Asthma Day (Tuesday, May 2) and throughout May, people with asthma and organizations dedicated to asthma control and education join together to increase awareness about asthma and improve the lives of all people with asthma. What is Asthma? Asthma is a disease that affects your lungs. It is one of the most common long-term diseases of children, but adults can have asthma, too. Asthma causes wheezing, breathlessness, chest tightness, and coughing at night or early in the morning. If you have asthma, you have it all the time, but you will have asthma attacks only when something bothers your lungs. In most cases, we don t know what causes asthma, and we don t know how to cure it. We know that if someone in your family has asthma you are more likely to have it. Asthma is one of the most common lifelong chronic diseases. There are more than 24 million Americans living with asthma, a disease affecting the lungs and causing repeated episodes of wheezing, breathlessness, chest tightness, and coughing. Although asthma cannot be cured, you can control your asthma successfully to reduce and to prevent asthma attacks, also called episodes. Successful asthma management includes knowing the warning signs of an attack, avoiding things that may trigger an attack, and following the advice of your healthcare provider.

3 How can you tell if you have Asthma? It can be hard to tell if someone has asthma, especially in children under age 5. Having a doctor check how well your lungs work and check for allergies can help you find out if you have asthma. During a checkup, the doctor will ask if you cough a lot, especially at night. He or she will then ask whether your breathing problems are worse after physical activity or at certain times of year. The doctor will then also ask about chest tightness, wheezing, and colds lasting more than 10 days. He or she will ask whether anyone in your family has or has had asthma, allergies, or other breathing problems. Finally, the doctor will ask questions about your home and if you have missed school or work or have trouble doing certain things. The doctor will also do a breathing test, called spirometry, to find out how well your lungs are working. The doctor will use a computer with a mouthpiece to test how much air you can breathe out after taking a very deep breath. The spirometer can measure airflow before and after you use asthma medicine.

4 What is an Asthma Attack? An asthma attack may include coughing, chest tightness, wheezing, and trouble breathing. The attack happens in your body s airways, which are the paths that carry air to your lungs. As the air moves through your lungs, the airways become smaller, like the branches of a tree are smaller than the tree trunk. During an asthma attack, the sides of the airways in your lungs swell and the airways shrink. Less air gets in and out of your lungs, and mucous that your body makes clogs up the airways even more. You can control your asthma by knowing the warning signs of an asthma attack, staying away from things that cause an attack, and following your doctor s advice. When you control your asthma: you won t have symptoms such as wheezing or coughing, you ll sleep better, you won t miss work or school, you can take part in all physical activities, and you won t have to go to the hospital.

5 What causes an Asthma Attack? An asthma attack can happen when you are exposed to asthma triggers. Your triggers can be very different from those of someone else with asthma. Know your triggers and learn how to avoid them. Watch out for an attack when you can t avoid the triggers. Some of the most common triggers are tobacco smoke, dust mites, outdoor air pollution, cockroach allergen, pets, mold, and smoke from burning wood or grass. How is Asthma Treated? Although asthma cannot be cured, you can control your asthma successfully to reduce and to prevent asthma attacks, also called episodes. Successful asthma management includes knowing the warning signs of an attack, avoiding things that may trigger an attack, and following the advice of your healthcare provider. Using what you know about managing your asthma can give you control over this chronic disease. When you control

6 your asthma, you will breathe easier, be as active as you would like, sleep well, stay out of the hospital, and be free from coughing and wheezing. Take your medicine exactly as your doctor tells you and stay away from things that can trigger an attack to control your asthma. Everyone with asthma does not take the same medicine. You can breathe in some medicines and take other medicines as a pill. Asthma medicines come in two types quick-relief and long-term control. Quick-relief medicines control the symptoms of an asthma attack. If you need to use your quick-relief medicines more and more, visit your doctor to see if you need a different medicine. Long-term control medicines help you have fewer and milder attacks, but they don t help you while you are having an asthma attack. Asthma medicines can have side effects, but most side effects are mild and soon go away. Ask your doctor about the side effects of your medicines. Remember you can control your asthma. With your healthcare provider s help, make your own asthma action plan. Decide who should have a copy of your plan and where he or she should keep it. Take your long-term control medicine even when you don t have symptoms. Click on this link to Learn How to Use Your Asthma Inhaler.

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8 Other things about Asthma to Consider Make sure you are up to date on vaccinations that help protect your health. Respiratory infections like influenza (flu) can be very serious for you, even if your asthma is mild or your symptoms are well-controlled by medication. Flu can trigger asthma attacks and make your asthma symptoms worse, and is more likely to lead to other infections like pneumonia. Getting the recommended vaccines will help you stay healthier. The important thing to remember is that you can control your asthma. What are Allergies? Allergies are one of the most common chronic diseases. A chronic disease lasts a long time or occurs often. An allergy occurs when the body s immune system sees a substance as harmful and overreacts to it. The substances that cause allergic reactions are allergens. When someone has allergies, their immune system makes an antibody called immunoglobulin E (IgE). These antibodies respond to allergens. The symptoms that result are an allergic reaction.

9 What are the Different Types of Allergens? Types of Allergens include: Drug (medicine) Food Insects that sting (bee, wasp, fire ant); bite (mosquito, tick); or are household pests (cockroach and dust mite) Latex Mold Pet (dog or cat urine, saliva and dander) Pollen What are the Symptoms of Allergies? The most common allergy symptoms can simply make you uncomfortable. For example, you may have watery eyes, runny nose, sneezing, a rash or hives. Other more serious symptoms, like trouble breathing and swelling in your mouth or throat, may be a lifethreatening reaction called anaphylaxis.

10 How Do Doctors Diagnose Allergies? Doctors diagnose allergies in three steps. They review your personal and medical history. They give you a physical exam. They do tests to identify your allergens. What Are the Treatments for Allergies? Good allergy treatment is based on your medical history and the severity of your symptoms. It can include three different treatment strategies: avoidance of allergens, medication options and/or immunotherapy (a treatment to train your immune system not to overreact). How Can I Prevent an Allergic Reaction? The best way to prevent an allergic reaction is to avoid your allergens. It sounds so easy, but you can t always avoid them. For example, it s not possible to avoid all

11 outdoor activities if you re allergic to bees and wasps. But there are steps you can take to reduce your chances of being stung and you can carry the medicine you will need if you are stung. It is important to prepare and have an allergy action plan. Don t let allergies interfere with your day-to-day activities at home, work or school. You can live a normal life despite having allergies. See your allergist for treatment and guidance. Take steps to avoid your allergens. Keep medicine with you at all times so you can treat an allergic reaction. Use our tips to help you manage your daily life with allergies. Allergy Facts and Figures Allergies are increasing. They affect as many as 30 percent of adults and 40 percent of children in the United States. Allergies in the News The article below is from CBS News regarding the early start on the 2017 Spring Allergy Season: Spring Allergy Season Started Early, Getting Worse By MARY BROPHY MARCUS CBS NEWS April 7, 2017, 5:00 AM Tree pollen counts are three times higher than this time last year in parts of California. Sneezing, sniffling, coughing, snorting ahh, the sounds of spring. This time of year, millions of children and adults across the U.S. are starting to feel their seasonal allergy symptoms kick up. In recent years, many may even have been noticing that the congestion and discomfort lasts longer, which some allergy experts chalk up to climate change. As temperatures rise, trees are starting to produce pollen more than usual in some areas and as spring turns to summer, flower and grass pollens will join the mix. By fall, as the other pollens subside, ragweed will be in full crescendo. What you should know about pollen, allergies, and relief Allergies happen when a person s immune system wrongly thinks a harmless substance is attacking it. The substance that prompts that reaction is called an allergen. In the

12 person who s allergic, the body perceives the allergen and has an over-exaggerated response to that allergen. The body creates an immune response that triggers a cascade of reactions that release the body s own mediators, such as histamine. The release of those mediators causes sneezing, a running nose, watery eyes, Dr. Sandra Lin, professor of otolaryngology and head and neck surgery at Johns Hopkins Medicine, told CBS News. Twenty million adults and 6.1 million children have been diagnosed with seasonal allergies also called allergic rhinitis and hay fever according to the U.S. Centers for Disease Control and Prevention. Regional trends CBS News spoke with Lin, from Baltimore, and allergy experts from Denver and California to get a picture of what s happening this year in different regions of the country. In the Baltimore area here, the normal high temperature for this time of year is 59 degrees Fahrenheit, and it s looking like we re going to exceed that. It s supposed to go up to 74 degrees this week. If it s warmer than normal, it can mean more pollen, Lin said. Dr. Sunil Perera, an allergist and immunologist practicing in the Sacramento, California, area said pollen conditions there are the worst they ve been in four years. Tree pollen counts are three times higher than they were this time last year. We had a four-year drought and pollen counts were low, but this year, with early rain and persistent rain, all the trees got ground saturation water, particularly the mulberry. Mulberry usually pollinate in April, but they started in March this year, Perera said. Heavy rains have also encouraged the growth of mold spores, so people who have allergies to both are feeling a lot of symptoms now, he said. Denver allergy expert Dr. Richard Weber, professor of medicine at National Jewish Health and the University of Colorado, told CBS News, his city has seen tree pollens continue to climb in recent years. We ve noticed here in Denver that the tree pollens for at least the last four to five years it s been very obvious the tree pollen counts are going up. Higher counts, higher peaks, lasting longer and possibly starting earlier. Certain trees, such as ash, traditionally started flowering in the area in April, but that s shifted noticeably.

13 8 Health risks that could get worse with climate change We ve now seen ash pollen all March, and cottonwoods, cedars, juniper trees all of which normally come out in April, we ve now seen for the last month, in March. We re seeing things starting earlier and stretching out a little longer, said Weber. Climate change is affecting pollen counts, said Weber. A number of years ago, there was some real question about whether climate change really existed and whether temperatures were going up. I think now only the greatest of deniers will still not admit we re definitely seeing some changes, Weber said. The ultimate impact of warming things up is that increased heat has a distinct impact on flowering plants. Lin said pollution is a factor exacerbating allergies and asthma (which often goes hand-in-hand with allergies). Some people theorize high pollen counts are because there is a change in our climate. It s probably more than one thing going on. It s multifactorial, Lin said. Allergy remedies To quell symptoms such as watery eyes, a scratchy throat, stuffy nose, even an irritated roof of the mouth, Lin said people can first try over-the-counter medicines such as second generation antihistamines (Allegra and Claritin, for example); steroid nasal sprays (Flonase, Nasacort, Rhinocort); and eye drops specifically made to treat allergy symptoms. Unlike older over-the-counter medicines, the new drugs don t make you sleepy and you don t need to dose up as often. Use them consistently, though, Lin said. Nasal steroid sprays work better if you use them regularly. My patients find nasal rinses really helpful, too, Lin said. The saline rinses are available over-the-counter and can be used a couple of times a day, and do not contain medications. Why your allergies get worse each year An allergist can run blood and skin tests so you can learn your allergic triggers. The tests even show how allergic you are, said Perera.

14 In some patients who get symptoms it goes into the airways and they get chest tightness and wheezing. That means they re getting early asthma symptoms, Perera warned, so it s important to see a physician if you have those symptoms to develop a more comprehensive picture of your health. Immunotherapy may be an option for some. Perera explained what that involves: We can make a mix of things a patient is allergic to and then start immunizing them starting with a little dose and building up to maximum tolerance. Patients find that the next season, they don t get as many symptoms and their asthma doesn t progress. Some patients find relief for years, he said. Avoidance measures help, too. Stay inside during high pollen count days, advised Lin. If you do go out, rainy days may be better because they tamp down the pollen for the short term. It s hard to resist getting outdoors on a beautiful, breezy spring day the worst kind of day for seasonal allergy sufferers because the wind carries pollens on the air and people breathe them in and get them in the eyes, too. Lin advises showering after being outdoors and wash clothes you ve worn outside. Pets can bring allergens into the house on their fur, so try not to sleep with pets that spend a lot of time romping in the yard or woods, Lin said. A vacuum with a HEPA filter and home air filters can reduce pollens that come into the house, too. There are also high-tech home allergen monitoring systems, small devices that check home air quality and give a report back, said Perera. You can monitor all the pollen that the cat or dog brings in, and test every hour to see the level. To monitor pollen counts in your community, visit the American Academy of Allergy, Asthma and Immunology s web site, the National Allergy Bureau. Knowing if pollen counts are going to increase can help you plan your day. Allergies can exacerbate asthma and lead to sinus infections, so if they are affecting your quality of life, see your primary care physician or an allergy specialist, the experts recommended. Studies show productivity goes down when you re suffering from allergies, in your personal and work life, said Weber. There are some who don t want drug treatments, said Perera. He has patients who ve tried home remedies like eating local honey regularly, or bee pollen. I see people who take bee pollen. As long as it helps, fine. But patients who are allergic to ragweed may get a cross reaction to chrysthemum pollen, he warned, noting that there isn t a body of scientific research backing up these methods. All About Pollen- Just in Time for Spring! Variety of Pollens throughout Allergy Seasons For many allergy sufferers, pollen can be a vicious word reminiscent of many sneezy, unhealthy days and nights. How can fine powder released from flowering plants affect our senses so greatly?

15 To explain pollen is a plant s only form of reproduction and it s produced in mass quantities. It s carried in the air and can land in a person s eyes, nose, lungs and on skin. For people with allergies, pollen is an allergen that causes an allergic reaction. Their immune system treats the pollen as an invader and responds by mobilizing to attack by producing large amounts of antibody. This allergic reaction can cause the following symptoms: itchy watery eyes, runny nose, itchy throat, hives, fatigue, and irritability. When is Pollen Season? Pollens spread by the wind. Pollen from trees, grasses, and weeds are the main cause of allergies. Spring is not the only allergy season, many plants pollinate year round. Your location will determine the time and duration of your pollen season. Pollen counts will vary from day to day as well as hour to hour. Different Pollens for Each Pollen Season In springtime, pollen from the trees begins its release between January and April, depending on the climate and location. These trees include elm, pine, birch, ash, hickory, poplar, and cypress to name a few. Summertime is when grass pollen reigns supreme: pollen from northern grass in colder climates, such as timothy, rye, and blue; and southern grass pollens in the warmer climates, such as Bermuda Grass. In the fall, typically weed pollen takes control. These weeds include ragweed, nettle, mugwort, fat hen and sorrel.

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17 Track Pollen Levels in Your Area If you want to know the allergy levels for your location, Pollen.com provides you with the tools to track pollen in your hometown and across the nation. Whether you re traveling or staying home, we can give you the allergy forecast you need. Pollen season can last all year round, so tracking your local pollen count can help you manage your allergies. Protect yourself from pollen season. Pollen in the News A wonderful article from AccuWeather about this year s pollen season: Eastern US allergy sufferers face early, prolonged spring pollen season By Kevin Byrne, AccuWeather staff writer March 04, 2017, 3:39:15 PM EST An early taste of spring for much of the eastern United States is unwelcome news for those who struggle with seasonal allergies, as pollen counts are increasing earlier and impacts may be felt for a longer period of time this season. The springlike warmth could alter the timing of the peak of allergy season, triggering symptoms for allergy sufferers sooner than normal.

18 According to AccuWeather Senior Meteorologist Alan Reppert, the warm air that arrived in late February provided early growing opportunities for plants, which is causing the pollen season to be about days ahead of normal in some areas. In parts of the mid-atlantic and Ohio Valley that typically have snow on the ground in late February and early March, allergies are already beginning to increase. Thanks to only short bursts of cold air, Reppert expects this trend to continue into the northern Plains and Northeast even with a much earlier start to the pollen season. Much of the Southeast through the East Coast is looking to have increased levels of pollen this year due to the mild end of winter and also the early start to the growing season in many areas, Reppert said. Trees have begun to pollinate in several cities across the South and Northeast. According to the American Academy of Allergy, Asthma and Immunology's National Allergy Bureau, a high concentration of tree pollen has already been reported in Greenville and Charleston, South Carolina; Savannah, Georgia; and Miami and Tampa, Florida. Elsewhere, York, Pennsylvania, is reporting a high concentration, while a moderate concentration of tree pollen has been observed in Washington, D.C. Tree pollen peaks in the spring and, along with grass pollen in the summer and weed pollen in the fall, is one of the main types of allergens, according to Dr. Martha Hartz, chair of pediatric allergy and immunology at the Mayo Clinic Children s Center in Rochester, Minnesota: Tree pollen does trigger eye symptoms and sometimes that s what s most bothersome to people is their eye symptoms, Hartz said.

19 Experts state that allergens tend to flourish on hot and breezy days, while damp and rainy weather tends to clear the pollen from the air. Reppert said early warmth could make for a very long pollen year for those with allergies, especially due to an early tree and grass pollen season. This April 22, 2013, photo shows Maple trees which release a lot of wind-borne pollen while mold is produced by leaves littering the ground, in Langley, Wash. (AP Photo/Dean Fosdick) The return of colder air might help mitigate conditions, but it likely won't be enough to slow the spread of pollen fully. If the cold air comes in after trees start to pollinate, it can help to slow things for a time, but unless it gets cold enough to freeze the plants and trees, the trees should start right back up from where they started and increase pollen production again, Reppert said. Through the second week of March, there could be opportunities for a freeze to develop down into northern South Carolina with normal low temperatures in the upper 30s and lower 40s at night, according to AccuWeather Lead Long-Range Forecaster Paul Pastelok. "The risk of a freeze will continue through late April and early May from the mid-atlantic into the Northeast," Pastelok said.

20 For those who suffer from allergies, it s best to limit time outdoors on high pollen days, especially during the early mornings and early evenings. Keeping windows closed at night when possible is also recommended. The best way to avoid the pollen is to stay indoors and in air conditioning as much as possible," Reppert said. Resources