Will It Ever Go Away
Asthma has a variable course. Many children with asthma see it improve or appear to go away as they get older. This can happen any time in childhood or adolescence. If asthma was only intermittent in nature and triggered by viral respiratory infections , there is an excellent likelihood that asthma will be much less of a problem as the child gets older. Sometimes the nature of the asthma changes with age. A young child may have asthma initially only from viral infections. As the child ages, asthma may occur less from viral infections , but inhalant allergy may become an important contributor to the asthma. If asthma persists into adult life, or returns later in adult life after a period of remission, persisting asthmatic symptoms may not be readily explainable by any environmental factors.
Whatever the course, however, asthma is virtually always controllable with acceptably safe measures. While ongoing medical evaluation of asthma should assess whether the disease is still active and continues to need treatment, it is not wise to withhold treatment in the hope that asthma will go away by itself. That may indeed occur, but it may not, and there can be considerable avoidable suffering and disability in the interim.
What Occupations Are At Risk For Asthma
Some of the occupations where asthma has been seen are listed in the following tables. It should be noted that the lists of occupational substances and microbes which can cause asthma are not complete. New causes continue to be added. New materials and new processes introduce new exposures and create new risks.
Not specifically listed are common household and workplace triggers which include dust, mould, pollen, scents, and smoke.
What Asthma Treatment Options Are There
You have options to help manage your asthma. Your healthcare provider may prescribe medications to control symptoms. These include:
- Anti-inflammatory medicines: These medicines reduce swelling and mucus production in your airways. They make it easier for air to enter and exit your lungs. Your healthcare provider may prescribe them to take every day to control or prevent your symptoms.
- Bronchodilators: These medicines relax the muscles around your airways. The relaxed muscles let the airways move air. They also let mucus move more easily through the airways. These medicines relieve your symptoms when they happen.
- Biologic therapies for asthma when symptoms persist despite being on proper inhaler therapy.
You can take asthma medicines in several different ways. You may breathe in the medicines using a metered-dose inhaler, nebulizer or other inhaler. Your healthcare provider may prescribe oral medications that you swallow.
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Key Health Inequalities In Canada: A National Portrait Executive Summary
Health inequalities in Canada exist, are persistent, and in some cases, are growingFootnote 1Footnote 2Footnote 3. Many of these inequalities are the result of individuals’ and groups’ relative social, political, and economic disadvantages. Such inequalities affect peoples’ chances of achieving and maintaining good health over their lifetimes Footnote 4. Where inequalities in health outcomes or in access to the resources that support health are systematic and can plausibly be avoided or ameliorated by collective action, they may be deemed unjust and inequitable Footnote 5Footnote 6Footnote 7.
This report describes the magnitude and distribution of key health inequalities in Canada, a critical step in facilitating action to advance health equity. It is a product of the Pan-Canadian Health Inequalities Reporting Initiative, a collaborative undertaking by the Public Health Agency of Canada, the Pan-Canadian Public Health Network, Statistics Canada, and the Canadian Institute for Health Information.
The Health Inequalities Reporting Initiative aims to strengthen health inequalities measurement, monitoring, and reporting capacity in Canada. It is intended to support surveillance and research activities, inform policy and program decision making to more effectively reduce health inequalities, and enable the monitoring of progress in this area over time.
Figure 1. Summary of the analytical approach for the Health Inequalities Reporting Initiative
Does Asthma Cause Permanent Damage
The airway obstruction of asthma is generally completely reversible and usually does not cause permanent damage to the lungs, heart, or other organs. However, severe acute episodes of asthma can be associated with life threatening events and even fatalities. Survival of severe life threatening events can be associated with damage from lack of oxygen during the severe exacerbation, and lack of oxygen to the brain can cause loss of consciousness and brain damage.
Chronic asthma with ongoing airway inflammation may also be associated with what is called “remodeling” of the airways. This describes permanent changes occurring in the tissues surrounding the airways that results in permanent narrowing of airways. The potential for this emphasizes the importance of monitoring pulmonary function in patients with asthma at regular intervals, particularly those with a chronic pattern of asthma.
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Environmental Risk Factors For The Exacerbation Of Asthma
Many substances that can cause new onset asthma can also trigger asthma attacks in people with the disease. Environmental risk factors that exacerbate asthma symptoms include these:
- Chemical sensitizers and irritants used in manufacturing and other workplaces
- Tobacco smoke, and outdoor air pollutants that infiltrate the indoor environment
- Family and community stressors/psychosocial stress
Interactions among different exposures may be important in the exacerbation of asthma. For example, a 2003 study found that asthma symptoms in children ill with a respiratory virus are likely to be more severe if the children are exposed to nitrogen dioxide, even at levels below current air quality standards. In a study from 2011, combining exposure to low levels of pollen with exposure to levels of pollutants commonly found in urban air dramatically worsened asthma symptoms.
How To Tell If You Have Asthma
When something triggers your asthma symptoms, the membrane lining your airways swells, the muscles around the tubes constrict, and the airways fill with mucus. As these tubes narrow it becomes more difficult to breathe, causing symptoms such as wheezing and coughing, congestion, shortness of breath, and chest tightness or pain. If you have asthma, performing normal daily activities can be strenuous, and it may take longer to recover from a respiratory infection, such as a cold or flu.
An asthma attack or flare-up is a sudden worsening of these symptoms, including severe wheezing, uncontrollable coughing, rapid breathing, sweating, and anxiety. These symptoms require immediate medical attention.
But not everyone experiences asthma in the same way. Symptoms vary from person to person, can change with age, differ between attacks and may intensify during exercise, with a cold, or under periods of elevated stress.
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Family And Community Stressors/psychosocial Stress
Family and community stressors such as financial problems, divorce, exposure to violence at home or in the community, and systemic and structural racism can make children more susceptible to many health problems, including asthma. There is solid evidence that psychosocial stress contributes to the initial onset of asthma, especially when combined with other risk factors. Stress can also trigger asthma in people with the disease.
Stress can add to and even magnify the impacts of exposure to other environmental conditions that foster the onset or increase the severity of asthma. For example, children in relatively low-income families who are also exposed to traffic-related air pollution are at greater risk of frequent asthma symptoms than children in the same neighborhoods whose families are financially better-off.
Asthma Causes And Triggers
When you have asthma, your airways react to things in the world around you. Doctors call these asthma triggers. They might cause symptoms or make them worse. Common asthma triggers include:
- Infections like sinusitis, colds, and the flu
- Allergens such as pollens, mold, pet dander, and dust mites
- Irritants like strong odors from perfumes or cleaning solutions
- Air pollution
- Strong emotions such as anxiety, laughter, sadness, or stress
- Medications such as aspirin
- Food preservatives called sulfites, found in things like shrimp, pickles, beer and wine, dried fruits, and bottled lemon and lime juices
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What Are Common Asthma Attack Triggers
An asthma attack happens when someone comes in contact with substances that irritate them. Healthcare providers call these substances triggers. Knowing what triggers your asthma makes it easier to avoid asthma attacks.
For some people, a trigger can bring on an attack right away. Sometimes, an attack may start hours or days later.
Triggers can be different for each person. But some common triggers include:
- Air pollution: Many things outside can cause an asthma attack. Air pollution includes factory emissions, car exhaust, wildfire smoke and more.
- Dust mites: You cant see these bugs, but they are in many homes. If you have a dust mite allergy, they can cause an asthma attack.
- Exercise: For some people, exercising can cause an attack.
- Mold: Damp places can spawn mold. It can cause problems for people with asthma. You dont even have to be allergic to mold to have an attack.
- Pests: Cockroaches, mice and other household pests can cause asthma attacks.
- Pets: Your pets can cause asthma attacks. If youre allergic to pet dander , breathing in the dander can irritate your airways.
- Tobacco smoke: If you or someone in your home smokes, you have a higher risk of developing asthma. The best solution is to quit smoking.
- Strong chemicals or smells.
With asthma, you may not have all of these symptoms. You may have different signs at different times. And symptoms can change between asthma attacks.
Treatment And Medication Options For Asthma
There is no cure for asthma, but you can alleviate and prevent your symptoms through quick-relief and long-term control medication. Long-term control medication works to reduce inflammation to make your airways less sensitive to asthma triggers. Its usually taken daily through an inhaler or as an oral pill. Quick-relief medicines help to relieve symptoms when they happen, relaxing the tight muscles around your airways and easing the flow of air.
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The Quality Of Health Care
The quality of health care is one of the agenda in the health care system due to the dramatic transformation of health care system accompanied by new organizational structure and reimbursement strategies . Quality is the degree to which services for individuals and populations increase the likely hood of desired health outcome and are consistent with current professional knowledge . Clinical indicators help to monitor the health care quality and it is related to structure
What Else Should I Know
The best way to manage asthma is to prevent flare-ups. Do that by following your asthma action plan and avoiding triggers, taking any medicines your doctor prescribes as directed, and getting a flu shot each year.
Your doctor also may ask you to keep track of your asthma symptoms in an asthma diary. This can help the doctor track how you feel after taking medicines. Your doctor might also ask you to use a peak flow meter as a way to monitor your asthma.
Caring for asthma takes a bit of work. But if you follow your asthma action plan, take your medicines properly, recognize your symptoms and triggers, and check in with your doctor regularly, you can do anything that people without asthma do.
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Measuring A Public Health Issue
Public Heath Assignment 2Measuring a public health issuea16679271.Describe why this health problem is a public health issue for young Australians.Asthma is a chronic condition affecting the respiratory system and has a considerable impact on both individuals and a population. Everybody is susceptible to asthma, some more than others, depending of a variety of factors including, age, sex, geographical location and income. Asthma is particularly prevalent in younger children and the elderly and
How Many People Die From Asthma
- On average, ten Americans die from asthma each day. In 2019, 3,524 people died from asthma. Many of these deaths are avoidable with proper treatment and care.7
- Adults are five times more likely to die from asthma than children.7
- Women are more likely to die from asthma than men, and boys are more likely than girls.7
- Black Americans are nearly three times more likely to die from asthma than white Americans.7
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Increased Risk Of Infection
With all types of asthma, exposure to irritants inflames your airway tissues, causing an asthma attack. It’s your body’s way of protecting the tissue, but it restricts air passage in and out of the lungs and makes breathing difficult. Chest tightness and wheezing are signs of inflammation.
Inhaled corticosteroids are often used to control inflammation in asthma. However, continual inflammation can increase the risk of lung infections because it allows infectious material to become trapped in the lungs.
What Is An Asthma Attack
An asthma attack may include coughing, chest tightness, wheezing, and trouble breathing. The attack happens in your bodys 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.
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 doctors advice. When you control your asthma:
- you wont have symptoms such as wheezing or coughing,
- youll sleep better,
- you wont miss work or school,
- you can take part in all physical activities, and
- you wont have to go to the hospital.
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What Is The Prognosis For Asthma
The prognosis for asthma is generally favorable. Children experience complete remission more often than adults. Although adults with asthma experience a greater rate of loss in their lung function as compared to age-controlled counterparts, this decline is usually not as severe as seen in other conditions, such as chronic obstructive pulmonary disease or emphysema. Asthma in the absence of other comorbidities does not appear to shorten life expectancy. Risk factors for poor prognosis from asthma include
- a history of hospitalizations, especially ICU admissions or intubation,
- frequent reliance on systemic steroids,
- significant medical comorbidities.
The airway narrowing in asthma may become fixed over time and can resemble COPD or emphysema. The other main complication of asthma is due to side effects from oral steroid use, which can include bone loss , weight gain, and glucose intolerance.
Who Can Get Asthma
Anyone can develop asthma at any age. People with allergies or people exposed to tobacco smoke and secondhand smoke are more likely to develop asthma.
Statistics show women tend to have asthma more than men, and asthma affects Black Americans more frequently than other races.
When a child develops asthma, healthcare providers call it childhood asthma. If it develops later in life, its adult-onset asthma.
Children do not outgrow asthma. They may have fewer symptoms as they get older, but they could still have an asthma attack. Your childs healthcare provider can help you understand the risks.
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Climate Change Pahs Outdoor Air Pollutants And Asthma
As carbon dioxide levels rise and temperatures increase due to climate change, both ground-level ozone and airborne pollen levels are increasing. The combination of higher levels of asthma-related air pollutants associated with changes in atmospheric conditions is expected to continue to increase the frequency of asthma attacks in people with asthma. These conditions may also increase rates of new onset asthma.
Effects of climate change on asthma:
- Increases in levels of ozone and fine particulate matter can trigger inflammation of the lungs and reduce lung function, causing chest pain and coughing.
- Increasing carbon dioxide concentrations affect the timing of allergen distribution, amplifying the allergenicity of pollen and mold spores.
- Longer growing seasons for allergens will produce more airborne allergens and could lead to more asthma attacks worldwide, including for 10 million Americans with allergic asthma.
- Increasing precipitation due to climate change can increase mold spores, an asthma trigger and a likely risk factor for the initial onset of asthma.
- Increasing frequency of droughts can increase dust and particulate matter, which are both causes and triggers of asthma.
- Increasing wildfire activity due to global temperature changes could exacerbate asthma and increase asthma emergency department and hospital visits.
Signs Symptoms And Complications
How often signs and symptoms of asthma occur may depend on how severe, or intense, the asthma is and whether you are exposed to allergens. Some people have symptoms every day, while others have symptoms only a few days of the year. For some people, asthma may cause discomfort but does not interfere with daily activities. If you have more severe asthma, however, your asthma may limit what you are able to do.
When asthma is well controlled, a person shows few symptoms. When symptoms worsen, a person can have what is called an asthma attack, or an exacerbation. Over time, uncontrolled asthma can damage the airways in the lungs.
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Environmental Risk Factors For The Development Of Asthma
Gene-Environment Interactions in the Development of Asthma
Interactions among genes and environmental risk factors are important in the development of asthma, as demonstrated by research that considers genetic make-up as well as exposure to traffic. Several studies comparing rates of new asthma cases of asthma among children living near a busy roadway to children living farther away suggest that near-roadway exposures early in life increase the risk of asthma by as much as 2.5 times.
When genetic make-up is considered, the relative risk of developing asthma among children with different characteristics living near or farther from a busy roadway can be magnified. For example, glutathione S-transferase and epoxide hydrolase are enzymes involved in detoxification and elimination of chemicals like polycyclic aromatic hydrocarbons in tobacco smoke and traffic exhaust that can play a role in the development of asthma. Certain genetic variants in GST and EPHX1 are individually associated with increased risk of developing asthma. A 2007 study found that a variant in the gene EPHX1 increased the risk of asthma by 50 percent. That variant plus a variant of GST increased the risk of asthma four-fold. And those two variants plus living near a major roadway increased the risk by nine-fold, compared to people with neither variant who did not live near a major roadway.
image from Joshua Miller at Creative Commons