Marion Regional Healthcare System

Health Shorts

Asthma

23% of 1998 Olympians Had Asthma  

Testing under controlled conditions revealed that 23 percent of athletes competing in the 1998 Winter Olympics had exercise-induced asthma. In the 1996 Summer Olympics 30 percent of U.S. athletes with asthma won medals. Of athletes without asthma, 28.7 percent won medals.  [SOURCE: R.L. Wilbur et al, Med Sci Sports Exerc; 200, 32:732-7, "Just for Kids: Dispelling the Myths of Exercised-Induced Asthma by Joanna Zieger, American Academy of Allergy, Asthma Immunology; Jeffifer Gollhard and Michele Martinez, "Athletes and Asthma, AAAAI, August 6, 2001]

Acid Reflux May Trigger Asthma 

Gastroesophageal reflux disorder (GERD) and asthma often occur together in both adults and children, and it’s believed that the acid reflux may trigger the asthma. Some asthma medications such as theophylline, oral corticosteroids and nebulized albuterol have been found to cause acid reflux or make it worse.  When GERD is associated with asthma attacks, studies show that therapy with a proton pump inhibitor such as Prilosec or Prevacid improves asthma symptoms and reduces the need for medication. One study found that surgery was even more effective than medication in relieving GERD-related asthma.  [SOURCE: Kate Johnson, “Silent Gastroesophageal Reflux Linked to Asthma,” OB GYN News, May 15, 2005; Subin Jain, “Proton-Pump Inhibitor Therapy of Gastroesophageal Reflux Disease: Does It Treat the Asthma?” Chest, April, 2005]

Asthma Symptoms Not Always Typical

As most Americans know, the signs of an asthma attack are shortness of breath, tightness in the chest and wheezing. Sometimes, however, the disease presents with other symptoms that are not always recognized as asthma. These include:

· rapid breathing,

· sighing,

· fatigue or inability to exercise as usual,

· difficulty sleeping,

· anxiety or poor concentration,

· chronic cough.

Symptoms may vary with the individual or at different times with the same person. To complicate matters further, some disorders such as heart failure, bronchitis and vocal cord dysfunction can cause wheezing and other symptoms that are easily mistaken for asthma.

[SOURCE: Michael Smith, M.D., “Asthma Complexities,” MedicineNet, May, 2006]

Cleanliness Helps Manage Allergies

For children with asthma symptoms brought on by exposure to cat allergens, frequent washing of sheets proved to be an effective strategy, according to a recent study. Combined with removal of stuffed animals and use of dust-proof covers for the mattress and pillows, the frequent washing resulted in a 49-fold reduction in allergen levels in the bedroom. Among factors contributing to higher levels of cockroach allergens were food leftovers, exposed food, dirty pots and leaks in the kitchen. [SOURCE: T.T. Perry, et al, “Room-Specific Characteristics of Suburban Homes as Predictors of Indoor Allergen Concentrations,” Ann Allergy Asthma Immunol. 2006; 97:628-635]

Ease Traffic Congestion, Save Lives

A study focusing on the 1996 Atlanta Olympics demonstrated how public action to reduce traffic congestion can have a beneficial health effect on persons with asthma. Downtown Atlanta was closed to private automobiles during this period while park and ride buses provided fast, efficient public transportation. The city encouraged employers to implement alternative work hours and allow telecommuting whenever possible. The resulting decrease in ground level ozone levels brought about a 41.6 percent reduction in emergency visits and hospitalizations for Medicaid asthma patients during that period. [SOURCE: Michael G. Burke, “Drop in Air Pollution Reduces Asthma Exacerbations,” Contemporary Pediatrics, May, 2001; Michael S. Friedman, et al, “Impact of Changes in Transportation and Commuting Behaviors During the 1996 Summer Olympics Games in Atlanta on Air Quality and Childhood Asthma,” JAMA, February 21, 2001]

Endurance, Winter Athletes at Risk  

At highest risk of exercise-induced asthma are endurance athletes such as long-distance runners and winter athletes such as cross country skiers, ice skaters and hockey players. Sports requiring constant activity such as cycling, soccer and field hockey are also likely to trigger asthma symptoms in susceptible individuals. Swimming is often considered the ideal activity for a person with asthma because of the warm, humid environment and the horizontal position of the body in the water. Some swimmers are vulnerable, however, because of sensitivity to chlorine. Other activities less likely to trigger an asthma attack include walking, hiking, racquet sports, baseball and downhill skiing.  [SOURCE: American Academy of Allergy, Asthma & Immunology, "Tips to Remember: Exercise-Induced Asthma; Christopher C. Randolph, "Exercise-Induced Asthma, Part 1: How To Make the Diagnosis," Journal of Respiratory Diseases, July, 2002]

Fall, Winter Are the Cruelest Seasons

When you have asthma, fall and winter tend to be the cruelest seasons. Emergency department visits for asthma are generally lowest during the summer, highest during the fall and winter. Although allergens may be in the air during the spring, other irritants likely to bring on an asthma attack include cold, moist air, air pollution and viral infections–all of which are more common during the winter months. Exercise challenge tests given to a group of 17-year-old subjects in Israel found that positive results during the summer were less than half those in other seasons. [SOURCE: Shmuel Goldberg, et al, “Sensitivity of Exercise Testing for Asthma in Adolescents is Halved in the Summer,” Chest, October, 2005]

Some Pools Increase Asthma Risk  

For a child or adult with asthma, a warm, humid indoor swimming pool is considered an ideal environment for a workout. A recent study from Belgium, however, found that some pools develop a buildup of a gas called trichloramine that may trigger an asthma attack. Trichloramine is a byproduct of chlorine mixed with swimmers' sweat, urine and other organic matter. Levels are usually highest in the air just above the water's surface. The problem can be averted by proper ventilation of the pool and requiring that swimmers shower before entering. Most doctors advise asthma patients to be aware of the risk but to continue their workouts.  [SOURCE: Douglas Zipes, "Asthma and Indoor Swimming Pools," Medical Update, November, 2003]

Steroids for Asthma Won’t Pump You Up

If you’re taking inhaled steroids for asthma, you don’t have to worry about getting huge muscles like those of top-level athletes accused of using performance-enhancing drugs. The antiinflammatory drugs prescribed for asthma and other medical conditions are corticosteroids. The performance-enhancing drugs that build muscle mass are anabolic steroids. [SOURCE: Norman Edelman and Jerome Bettis, “Asthma Control: Know Your Score,” WebMD Live Events Transcript, March 29, 2005]

Undertreated Asthma Can Be Fatal  

A study of 263 competitive and recreational athletes who died of a sudden asthma attack found that more than 77 percent were not using anti-inflammatory medication at the time of death. "They probably were not treated well enough," wrote the authors.  [SOURCE: Miriam E. Tucker, "Undertreated, Mild Asthma Can Be Fatal in Athletes; Monitor Closely," Family Practice News, July 1, 2002]

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