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.

We don’t know all the things that can cause asthma, but we do know that genetic, environmental, and occupational factors have been linked to developing asthma.

If someone in your immediate family has asthma, you are more likely to have it. “Atopy,” the genetic tendency to develop an allergic disease, can play a big part in developing allergic asthma. However, not all asthma is allergic asthma.

Being exposed to things in the environment, like mold or dampness, some allergens such as dust mites, and secondhand tobacco smoke have been linked to developing asthma. Air pollution and viral lung infection may also lead to asthma.

Occupational asthma occurs when someone who never had asthma develops it because he or she is exposed to something at work. This can happen if you develop an allergy to something at work such as mold or if you are exposed to irritants such as wood dust or chemicals at work over and over at lower levels or all at once at higher levels.

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, a doctor will ask if you cough a lot, especially at night. He or she will also ask whether your breathing problems are worse after physical activity or at certain times of year. The doctor will then 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 whether you have missed school or work or have trouble doing certain things.

The doctor may also do a breathing test, called spirometry, to find out how well your lungs are working by testing how much air you can breathe out after taking a very deep breath before and after you use asthma medicine.

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.

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.

What Causes an Asthma Attack?

An asthma attack can happen when you are exposed to “asthma triggers.” Your asthma triggers can be very different from someone else’s asthma triggers. Know your triggers and learn how to avoid them. Watch out for an attack when you can’t avoid your triggers. Some of the most common triggers are tobacco smoke, dust mites, outdoor air pollution, cockroach allergen, pets, mold, smoke from burning wood or grass, and infections like flu.

How Is Asthma Treated?

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 doctor’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.

You can control your asthma and avoid an attack by taking your medicine exactly as your doctor or other medical professional tells you to do and by avoiding things that can cause an attack.

Not everyone with asthma takes the same medicine. Some medicines can be inhaled, or breathed in, and some can be taken 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, you should visit your doctor or other medical professional 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 if you’re having an asthma attack.

Asthma medicines can have side effects, but most side effects are mild and soon go away. Ask your doctor or other medical professional about the side effects of your medicines.

The important thing to remember is that you can control your asthma. With your doctor’s or other medical professional’s help, make your own asthma action plan (management plan) so that you know what to do based on your own symptoms. Decide who should have a copy of your plan and where he or she should keep it.

If you have asthma, 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

Tobacco smoke is unhealthy for everyone, especially people with asthma. If you have asthma and you smoke, quit smoking.

“Secondhand smoke” is smoke created by a smoker and breathed in by a second person. Secondhand smoke can trigger an asthma attack. Make your home a smoke-free zone. Encourage household members who smoke to quit. If you have asthma, people should never smoke near you, in your home, in your car, or wherever you may spend a lot of time.

Dust Mites

Dust mites are microscopic bugs that are in many homes. If you have asthma and are allergic to dust mites, they can trigger an asthma attack. To prevent attacks:

• Use allergen-proof mattress and pillowcase covers to make a barrier between dust mites and yourself.
• Don’t use down-filled pillows, quilts, or comforters.
• Wash your bedding weekly and dry it completely.
• Vacuum carpets, area rugs, and floors regularly using a vacuum equipped with a HEPA filter.
• Keep relative humidity levels in the home low, around 30- 50%.

Outdoor Air Pollution

Outdoor air pollution can trigger an asthma attack. This pollution can come from many sources, including factories, cars, or wildfire smoke. Wildfire smoke from burning wood or other plants is made up of a mix of harmful gases and small particles. Breathing in too much of this smoke can cause an asthma attack.

Pay attention to air quality forecasts on radio, television, and the internet and check your newspaper to plan your activities for when air pollution levels will be low.

Pests (e.g., cockroaches, mice)

Cockroaches and other pests are often found where food is eaten and crumbs are left behind. To control pests in your home:

• Remove as many water and food sources as you can.
• Clean dishes, crumbs, and spills right away.
• Store food in airtight containers.
• Keep trash in a closed container.
• At least every 2 to 3 days, vacuum or sweep areas that might attract cockroaches or mice.
• Keep counters, sinks, tables, and floors clean and free of clutter.
• Seal cracks or openings in cabinets, walls, baseboards, and around plumbing.
• Use pesticide baits and traps in areas away from children and pets, following manufacturers’ instructions.
• Avoid using sprays and foggers as these can cause asthma attacks.

Pets

Furry pets can trigger an asthma attack if you are allergic to them. If you think a furry pet may be causing attacks, you may want to find the pet another home. If you can’t or don’t want to find a new home for the pet, decrease your exposure by:

• Keeping pets out of bedrooms,
• Washing furry pets,
• Using an air cleaner with HEPA filter, and
• Using allergen-proof mattress and pillow covers.

People with asthma are not allergic to their pet’s fur, so trimming a pet’s fur will not help your asthma.

Mold

Breathing in mold can trigger an asthma attack whether or not you are allergic to mold. Indoor mold growth is often found in damp areas such as kitchens, bathrooms, and basements, or in areas where water damage has occurred. There are many types of mold which can be found in any climate. Get rid of mold in your home to help control your attacks.

To reduce mold exposure in your home:

• Dry damp or wet items within 24 to 48 hours to prevent mold growth.
• Fix water leaks, such as leaky plumbing, which let mold grow behind walls and under floors as soon as you can.
• Replace absorbent materials, such as ceiling tiles and carpet, if mold is present.
• Use an air conditioner or dehumidifier to maintain low indoor humidity.
• Get a small tool called a hygrometer to check humidity levels and keep them as low as you can—no higher than 50%. Humidity levels change over the course of a day, so check the humidity levels more than once a day.
• Scrub mold off hard surfaces with detergent and water. Dry completely.
• Empty and clean refrigerator and air conditioner drip pans regularly.
• Run the bathroom exhaust fan or open the window when showering.

Cleaning and Disinfection

Disinfectants can trigger an asthma attack. People with asthma should try to stay away when cleaners or disinfectants are being used and right after their use. Follow these precautions when cleaning or disinfecting places where people with asthma may spend time, such as homes, schools, or workplaces:

• Avoid overuse of products. To help limit your exposure to asthma triggers, follow a schedule for cleaning and disinfecting to prevent overuse of products.
• Use safer products. Any disinfectant can trigger an asthma attack, but you can take steps to reduce the chances of that happening:
  • Use soap and water or cleaners certified by the EPA Safer Choice program to clean surfaces.
  • Clean visibly dirty surfaces before disinfecting.
  • Never mix disinfectant products.
  • Choose products for disinfecting that are less likely to cause an asthma attack, such as products with hydrogen peroxide (no stronger than 3%) or ethanol (ethyl alcohol). Ensure that products with hydrogen peroxide or ethanol do not contain other chemicals that can cause an asthma attack such as peroxyacetic acid or peracetic acid.
  • Avoid using bleach (sodium hypochlorite) or quaternary ammonium compounds in enclosed spaces and limit their use.
  • Avoid products with fragrances. The fragrances can trigger asthma attacks.
• Make sure there is enough air flow (ventilation).
  • Open doors and windows to bring in fresh air, if it’s safe to do so.
  • Improve ventilation by turning on exhaust fans. Exhausting the air (blowing it outside) is the most effective way to remove disinfectant vapors.
  • For buildings with heating or cooling systems that have fresh (outdoor) air intakes, turn on the fresh air intake to bring in fresh air.
  • • Using a high efficiency filter (MERV 13 or higher) with your heating and cooling system can help keep air clean by removing particles such as smoke, pollen, and traffic pollution from the air. Most air filters will not remove disinfectant vapors, though.
    • Make sure to follow the manufacturer’s instructions and to replace the filter as needed. Some systems cannot accept high efficiency filters. In this case, using the highest MERV rating possible will provide the most effective air cleaning.
• Use products safely and correctly.
  • Always follow the instructions on the product label. Do not mix chemical products together.
  • Wear protective gear such as gloves and goggles.
  • Spray or pour spray products onto a cleaning cloth or paper towel instead of spraying the product directly onto the cleaning surface (if the product label allows) to help limit exposure.
• Avoid disturbing dust because it can be an asthma trigger.
• Move away from the trigger (such as the area that was cleaned) if you experience an asthma attack, and follow your Asthma Action Plan. Call 911 for medical emergencies.

Other Triggers

Infections linked to influenza (flu), colds, and respiratory syncytial virus (RSV) can trigger an asthma attack. Sinus infections, allergies, pollen, breathing in some chemicals, and acid reflux can also trigger attacks.

Physical exercise; some medicines; bad weather, such as thunderstorms or high humidity; breathing in cold, dry air; and some foods, food additives, and fragrances can also trigger an asthma attack.

Strong emotions can lead to very fast breathing, called hyperventilation, that can also cause an asthma attack.

Everyone with asthma needs their own Asthma Action Plan. Work with your health care provider to create a plan that works for you. Your goal is to prevent and control your asthma attacks.

Doing Well

• I don’t have cough, wheezing, chest tightness, or trouble breathing at any time.
• I can do all the things I usually do.
• When I use a peak flow meter my peak flow* is more than 80 percent or more of my best peak flow.
• Continue taking your long-term control medicine.

Asthma Is Getting Worse

• I have some cough, wheezing, chest tightness, or trouble breathing. Or
• I wake up at night because of my asthma. Or
• I can’t do some of the things I usually do. Or
• When I use a peak flow meter my peak flow* is half to three quarters of my best peak flow.
• Add your quick-relief medicine and continue your long-term control medicine.
• If your symptoms get better after an hour keep checking them and continue your long-term control medicine.

Medical Alert!

• I have a lot of trouble breathing. Or
• My quick-relief medicines don’t help. Or
• I can’t do any of the things I usually do. Or
• I was in the yellow zone for 24 hours and I’m not getting better. Or
• When I use a peak flow meter my peak flow* is less than half of my best peak flow.
• Add the other medicines your doctor has prescribed and call your doctor.
• If your symptoms don’t get better and you can’t reach your doctor, go to the hospital.

*Peak flow measurement is a quick test to measure air flowing out of the lungs.

During and after an emergency, you may have questions about how to manage your or your child’s asthma. Here are some important steps:

Follow your Asthma Action Plan:

• Take all your asthma medication exactly as prescribed. Don’t stop any medications or change your asthma treatment plan without talking to your healthcare provider.
• Talk to your healthcare provider, insurer, and pharmacist about creating an emergency supply of at least 30 days of prescription medications, such as asthma inhalers. Make sure that you have at least 30 days of non-prescription medications and supplies in case you need to stay home for a long time.
• Know how to use your inhaler.
• Avoid your asthma triggers.

Take everyday precautions.

Wash your hands. Washing hands with soap and water is the best way to reduce the number of germs on them. If soap and water are not available, use an alcohol-based hand sanitizer that contains at least 60% alcohol. Hand sanitizers are not effective when hands are visibly dirty. Wash your hands:

• Before, during, and after preparing food
• Before eating food
• After using the toilet
• After changing diapers or cleaning up a child who has used the toilet
• Before and after caring for someone who is sick
• After blowing your nose, coughing, or sneezing
• After touching garbage
• During a disease outbreak in your community, stay home as much as possible.
• When you do go out in public, keep away from others who are sick. Avoid crowds and people who are sick and wash your hands when you get home.
• If someone in your home is sick, have them stay away from the rest of the household.
• Avoid sharing personal household items such as cups and towels.

Clean and disinfect.

Clean things you or your family touch frequently like tables, doorknobs, light switches, countertops, handles, desks, phones, remotes, keyboards, toilets, faucets, and sinks. Avoid disinfectants that can cause an asthma attack. Have someone who doesn’t have asthma clean and disinfect. When they use cleaning and disinfecting products have them

• Minimize use of disinfectants that can cause an asthma attack.
• Make sure that people with asthma are not in the room.
• Open windows or doors and use a fan that blows air outdoors.
• Apply disinfectant to a cloth or paper towel instead of spraying it.
• Always follow the instructions on the product label.

Take steps to help yourself cope.

Strong emotions can trigger an asthma attack. Help yourself cope with stress and anxiety.

Get prescription assistance.

The Emergency Prescription Assistance Program (EPAP) can help some people in a disaster area who don’t have health insurance get their prescription drugs, medical supplies, or medical equipment. EPAP is only available when activated in a federally-identified disaster area. Learn more about EPAP: https://go.usa.gov/xQnr3 [1-855-793-7470].

Before a Hurricane or Other Tropical Storm

During and after a hurricane, you may need supplies to keep your family safe and healthy. Remember that a hurricane could cut off your power and water supply. You also may not be able to drive because of damage to your car. Roads may be flooded or blocked.

That’s why it’s best to be prepared — stock up on everything you might need, including:

• At least a 3-day supply of asthma medications
• Copies of important documents such as insurance cards and immunization records (and asthma action plans, if available)
• Equipment you may need to use when cleaning up after the storm, including N95 respirators, goggles, protective gloves, and waterproof boots.

Remember that certain items, like medications and paper documents, need to be kept in waterproof containers.

Avoiding Common Asthma Triggers During and After a Hurricane or Other Tropical Storm

Influenza, commonly called “the flu”, can trigger an asthma attack. Everyone 6 months of age and older should get a flu vaccine every year. It is particularly important for people with asthma to be vaccinated against the flu every year because they are more likely to have serious health problems from getting the flu. 

Illnesses such as colds or the flu can trigger an asthma attack. Keeping hands clean helps prevent the spread of these germs. 

During and after a disaster it is natural to experience different and strong emotions. Strong emotions can trigger an asthma attack.

If your home was flooded and you were not able to dry your home (including furniture and other items) within 24-48 hours, you should assume you have mold growth. Breathing in mold can trigger an asthma attack. If possible, people with asthma should stay away from moldy sites.

Children should not take part in disaster cleanup work.

Using Asthma Medications or Devices During and After a Hurricane or Other Tropical Storm

Asthma can be controlled by taking asthma medication exactly as directed by a doctor or other medical professional. 

When a power outage occurs after a storm, some people may use generators as a backup power source. These generators provide power to appliances, lights, and other vital items in the home, including “breathing treatments” for asthma (also known as nebulizer machines). Using generators improperly can cause poisonous gas (carbon monoxide) to build up in a home, garage, or camper. Never use a generator indoors or less than 20 feet from any window, door, or vent. When using a generator, use a battery-powered or battery backup carbon monoxide detector. 

This information is based on what we currently know about the spread and severity of COVID-19.

Risk of severe illness from COVID-19

People with moderate-to-severe or uncontrolled asthma are more likely to be hospitalized from COVID-19. Take steps to protect yourself.

Follow your Asthma Action Plan

• Keep your asthma under control by following your asthma action plan.
• Avoid your asthma triggers.
• Continue current medications, including any inhalers with steroids in them (“steroids” is another word for corticosteroids). Know how to use your inhaler.
• Do not stop any medications or change your asthma treatment plan without talking to your healthcare provider.
• Talk to your healthcare provider, insurer, and pharmacist about creating an emergency supply of prescription medications, such as asthma inhalers. Make sure that you have 30 days of non-prescription medications and supplies on hand in case you need to stay home for a long time.
• Be careful around cleaning agents and disinfectants

Follow the recommendations below to reduce your chance of an asthma attack while cleaning. Follow recommendations for cleaning your home and in your facility.

• If you have asthma:
  • Ask an adult without asthma to clean and disinfect surfaces and objects for you.
  • Stay in another room when cleaners or disinfectants are being used and right after their use.
  • Use cleaning agents and disinfectant only when necessary. In routine situations, high-touch surfaces and objects might be cleaned effectively with soap and water.
  • Make a list of the urgent care or health facilities near you that provides nebulizer/asthma treatments and keep it close to your phone.
  • If you have an asthma attack, move away from the trigger, such as the cleaning agent or disinfectant or the area that was disinfected. Follow your Asthma Action Plan. Call 911 for medical emergencies.
• The person cleaning and disinfecting should:
  • Choose disinfectants that are less likely to cause an asthma attack, using the U.S. Environmental Protection Agency (EPA)’s list of approved products, such as:
    • Products with hydrogen peroxide (no stronger than 3%) or ethanol (ethyl alcohol). Ensure that products with hydrogen peroxide do not contain other chemicals that can trigger asthma attacks such as peroxyacetic acid or peracetic acid.
  • Limit use of chemicals that can trigger asthma attacks, such as bleach (sodium hypochlorite) or quaternary ammonium compounds (for example, benzalkonium chloride), and do not use them in enclosed spaces.
  • Follow additional precautions for cleaning and disinfecting places where people with asthma might be, to reduce exposure to asthma triggers.
• Use products safely and correctly:
  • Always read and follow the directions on the product label to ensure you are using it safely and effectively.
  • Wear skin protection such as gloves and consider eye protection to protect yourself against splashes.
  • Make sure there is enough air flow (ventilation).
  • Use only the amount recommended on the label.
  • Use water at room temperature for dilution (unless stated otherwise on the label).
  • Do NOT mix chemical products. Label diluted cleaning solutions.
  • Spray or pour spray products onto a cleaning cloth or paper towel instead of spraying the product directly onto the cleaning surface (if the product label allows).
• Store products safely and correctly
  • Store and use chemicals out of the reach of children and pets.
  • Label diluted cleaning solutions.
  • Follow EPA’s 6 steps for Safe and Effective Disinfectant Use.

If you feel ill

Call your healthcare provider to ask about your symptoms. If you don’t have a healthcare provider, contact your nearest community health center or health department. Remember to call 911 for medical emergencies.

Take steps to help yourself cope with stress and anxiety

• It is natural for some people to feel concerned or stressed as more cases of COVID-19 are discovered and our communities act to combat the spread of disease. Strong emotions can trigger an asthma attack.

Influenza, commonly called “the flu,” is caused by the influenza virus, which infects the respiratory tract (nose, throat, lungs). People with asthma are more likely to have serious health problems from getting the flu, yet most people with asthma don’t receive a flu shot every year.

If you have asthma, you need to take steps to prevent getting the flu. Respiratory infections such as the flu can affect your lungs, causing an asthma attack. Flu vaccine is the first and most important step you can take to protect yourself and your loved ones from the flu.

People who have asthma should also get the pneumococcal vaccine to protect against pneumonia and talk to their health care provider about any additional vaccines they might need. Pneumococcal infections are a serious complication of influenza infections and can cause death. Pneumococcal vaccine may be given at the same time as influenza vaccine.

Each year thousands of adults in the United States get sick from diseases that could be prevented by vaccines — some people are hospitalized, and some even die. People with asthma or COPD are at higher risk for serious problems from certain vaccine-preventable diseases. Getting vaccinated is an important step in staying healthy. If you have lung disease, talk with your doctor about getting your vaccinations up-to-date.

Why Vaccines are Important for You

• Adults with COPD or asthma are more likely to get complications from the flu.
• COPD and asthma cause your airways to swell and become blocked with mucus, which can make it hard to breathe. Certain vaccinepreventable diseases can also increase swelling of your airways and lungs. The combination of the two can lead to pneumonia and other serious respiratory illnesses.
• Vaccines are one of the safest ways for you to protect your health, even if you are taking prescription medications. Vaccine side effects are usually mild and go away on their own. Severe side effects are very rare.
• Immunization provides the best protection against vaccine-preventable diseases.

Vaccines You Need

• Influenza vaccine to protect against seasonal flu every year
• Pneumococcal vaccine to protect against serious pneumococcal diseases
• Tdap vaccine to protect against tetanus, diphtheria, and whooping cough
• Zoster vaccine to protect against shingles

There may be other vaccines recommended for you based on your lifestyle, travel habits, and other factors. Talk to your healthcare professional about which vaccines are right for you.

Getting Vaccinated

You may regularly see your COPD or asthma specialist, or maybe your primary care provider. Either is a great place to start! If your healthcare professional does not offer the vaccines you need, ask for a referral so you can get the vaccines elsewhere. Adults can get vaccines at doctors’ offices, pharmacies, workplaces, community health clinics, health departments and other locations. To find a place near you to get a vaccine, go to http://vaccine.healthmap.org. Most health insurance plans cover recommended vaccines. Check with your insurance provider for details and for a list of vaccine providers covered by your plan. If you do not have health insurance, visit www.healthcare.gov to learn more about health insurance options.

Even if you have asthma, you shouldn’t avoid exercise all together. Regular physical activity is essential for managing health, improving energy, and reducing the risk of chronic disease. If you already have a chronic condition like asthma, regular exercise can help you manage it.​

With a doctor’s guidance, regular exercise could help asthma by:

• Increasing your lung capacity.
• Promoting blood flow to your lungs and heart.
• Improving endurance and stamina.
• Decreasing airway inflammation.
• Improving overall lung health.

In general, the best exercises for asthma involve brief bursts of exertion. Gentle, low-intensity activities are also ideal. These exercises don’t overwork your lungs, so they’re less likely to cause asthma symptoms. Be sure to consult your doctor and pay attention to your body when starting an exercise routine.

Here is a list of activities to try:

• Swimming;
• Walking;
• Hiking; and
• Biking.

You should also ask your doctor what you should do if you have an asthma attack while exercising. By having a plan in place, you can workout with confidence.