VAREN BLACK: Hi, I'm Varen Black. Our topic today is asthma prevention, and my guest is Dr. Chris Winslow, a pulmonologist and asthma specialist at Northwestern Memorial Hospital. Dr. Winslow, in simple terms, what is asthma?
CHRIS WINSLOW, MD: Asthma is a disorder in which there is a swelling in the tubes that line the lungs. This swelling is the result of an inflammation, and it makes the airways of a person's lungs much more sensitive to things that they may be exposed to in their environment.
VAREN BLACK: What are some of the symptoms of asthma?
CHRIS WINSLOW, MD: The symptoms can be cough, wheezing, and shortness of breath. Chest tightness is also a symptom that can be found in asthma.
VAREN BLACK: What causes asthma? Is there a genetic factor?
CHRIS WINSLOW, MD: Well, it's not really clear exactly what causes asthma. It is known that it is a genetic disease. Asthma tends to be transmitted in families and among family members. There's a likelihood to inherit the propensity to develop asthma, but likely it's that plus exposure to things in your environment which may be what actually bring the disorder to develop.
VAREN BLACK: Is it true that asthma has become more common in recent years, and if so, why?
CHRIS WINSLOW, MD: That is true, and it is something that people are intensely studying right now. Asthma is a disease of urbanization, and I think as we spend more time in closed environments and as we tend to live more in cities, we're finding that asthma is more prevalent.
VAREN BLACK: What about having infections as children? I guess you develop problems as you get older?
CHRIS WINSLOW, MD: There is some evidence to suggest that infections at particularly sensitive times in a child's life or in a child who has a predisposition for asthma may increase the likelihood that they will develop asthma symptoms later on.
VAREN BLACK: Any special vaccines out there to prevent asthma?
CHRIS WINSLOW, MD: No, there really aren't. This is a disorder that the cause of which is really unknown, so there are no vaccines that can prevent you from developing asthma.
VAREN BLACK: How do doctors figure out what triggers asthma attacks in a particular patient?
CHRIS WINSLOW, MD: The simplest way is to sit down and talk to that individual. People that have been having asthma symptoms may or may not be clued into factors in their environment that may be triggering asthma. Some may be fairly obvious to people, for example, exposure to cigarette smoke may cause someone to develop wheezing or chest tightness or coughing. That's fairly clear. Some people will develop asthma symptoms in response to allergens in the environment, so at various times of the year, in spring or fall, they may find they're developing more symptoms. So the best way to try and determine a particular trigger for your asthma is just to sit down with your doctor and start to talk about some of the symptoms that you have and some of the relationships between those symptoms and your environmental exposures.
VAREN BLACK: What about allergy testing? What is it, and how does it work?
CHRIS WINSLOW, MD: Allergy testing is a way to determine if elements in the environment are irritating for you, and it's possible, then, if you are allergic to these substances in the environment that they may be contributing to the development of asthma symptoms. There are commonly known allergens that doctors would expose you to by scratching your skin and putting a small drop of the substance, if the extract of the substance, on that scratch and seeing if you develop any swelling or inflammation. That can be a clue to your identifying some of the things that you may be allergic to.
VAREN BLACK: Besides cigarette smoke, what are some other common triggers for asthma patients?
CHRIS WINSLOW, MD: Triggers are divided into two basic categories. There are irritants, and there are allergens. Irritants are something that you don't develop an allergic response to but nonetheless are, as the name implies, irritating to you.
VAREN BLACK: Such as?
CHRIS WINSLOW, MD: Such as cigarette smoke. No one is allergic to cigarette smoke, but inhaling that into your airways can aggravate or precipitate asthma symptoms in an individual. Strong odors, such as perfumes or household cleaning products or, maybe, strong cooking smells are other irritants that can provoke asthma symptoms in some individuals.
Other triggers that are allergens might be seasonal exposures to things that are in the environment when the grasses start blossoming and the trees start to bloom. Ragweed blooms in the fall. Dust mites are tiny, ubiquitous creatures in our environment that people can develop some sensitivities to. So those are allergens, substances that, when certain people are exposed to them, they can develop asthma symptoms.
VAREN BLACK: What about mold and cats and dogs?
CHRIS WINSLOW, MD: Mold and cats and dogs are also potential allergens. There are individuals that are very sensitive to animal dander, which is a combination of their fur and also the cells and the sweat that they secrete that is part of that fur, which becomes aerosolized in the environment.
VAREN BLACK: So the bottom line is keep your home or your environment clean?
CHRIS WINSLOW, MD: That's very important. The identification of both irritants and allergens that are important for your asthma is crucial, and then doing the best that you possibly can to avoid exposure to them. In your home that might mean pulling up your carpets because dust and dust mites and animal hair can become trapped in your carpets. Removing the carpets from your house, or at least your bedroom. If you have pets, minimizing your exposure to that as much as possible. Removal of the pet from the home, and if that's not an acceptable option, then keeping the pet out of the bedroom where an individual would sleep. Dust mite covers. Dust mites tend to live in mattresses, and since most people spend six to eight hours a day in bed, covering your mattresses with covers that prevent the dust mites from coming through and you being exposed to them would also be an important intervention that you can do to minimize your exposure to them.
VAREN BLACK: Thank you, Dr. Winslow. Good advice that will go a long way in helping asthma patients.
CHRIS WINSLOW, MD: My pleasure.
VAREN BLACK: Thank you for being with us. I'm Varen Black.