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Adult asthma has many causes

​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​If you have adult asthma you may experience one or more of the following symptoms: wheezing, shortness of breath, chest tightness and cough. 

These symptoms are usually recurrent and caused by exposure to allergens, respiratory tract infections, air pollution, exercise, cold air or from laughing or talking.

Triggers may include house dust mites, cat and dog dander, mold spores and tree, grass and weed pollens. The best treatment for adult asthma is avoiding the triggers.

Acute asthma, should it occur despite avoiding asthma triggers, is treated with bronchodilator medications such as inhaled albuterol. Similarly, exercise-induced asthma is often treated with the use of inhaled albuterol, 15 minutes prior to exercise.​​​​​

Persistent asthma is often treated with inhaled medications.

Asthma​ in farming and other agricultural occupations​​​​

Bronchial asthma is a hazard of farming. Exposure to heavy concentrations of dust during farming can trigger an asthmatic reaction including narrowed bronchial passages, increased mucous production and chest congestion. Exposure to dust can be caused by livestock, straw, hay, feed grains, and bedding within enclosed, poorly ventilated spaces. Seasonal pollens, fur-bearing animals, molds and house dusts also are common asthma triggers.

Treatment consists of recognizing the problem, avoiding specific asthma triggers and taking medicines. Although there is no cure for the condition, new understanding and treatments have helped many people with farm asthma. Proper barn ventilation and protective breathing masks are important to control asthma and other farm-related breathing problems.

It is important to exclude other causes of farm-related breathing problems such as farmer's lung disease, silo filler's disease, organic dust syndrome and other lung problems. Talk with your physician, allergist or lung specialist to confirm the cause.

Asthma in athletes and exercise-induced asthma​

Exercise-induced asthma (EIA), also known as exercise-induced bronchospasm (EIB), is one of the most common conditions among active children, adolescents and young adults. It should not keep you from enjoying sports or exercise.

Exercise-induced asthma is a temporary narrowing of the airways brought on by strenuous exercise. Fifty percent of people with hay fever and 10 percent of normal athletes have developed EIA.

Exercise-induced asthma begins when vigorous exercise increases breathing, which requires more oxygen. This causes cooling and drying of the airway. Eighty to ninety percent of asthmatics have difficulty breathing with vigorous exercise.

With asthma, airways are hypersensitive or twitchy. When exposed to certain triggers, such as low humidity, fatigue, emotional stress and inhaled allergens, or changes in airway temperature from cold dry air, the airways contract or tighten and become swollen.

The swelling may close some of the air passages causing air to be trapped. In order to protect the airway, more mucus is produced. The mucus becomes thicker, causing severe coughing and more irritation to the airways.

This reaction may cause shortness of breath with exercise, wheezing, chest tightness, dizziness and stomach problems. An inhaler is given to relax the muscles of the airway and restore normal breathing.

Stages of exercise-induced asthma

Exercise-induced asthma has three stages: an early phase, a refractory phase and a late phase.

The early stage is the most severe. EIA occurs during six to eight minutes of vigorous exercise and lasts 30 to 60 minutes before ending on its own.

The refractory phase, also known as the grace period, follows the early stage and occurs in about half of those with EIA. It may last a period of 30 to 90 minutes with little or no tightening of the airways occurring during exercise. Athletes should take advantage of this period so that they can compete without any problems.

The late phase is the least severe and may not occur in some people. Late phase symptoms will occur 12 to 16 hours after exercise and end within 24 hours.

To decrease the effects of exercise-induced asthma:

  • Avoid environmental factors such as inhaled allergens (dust, pollens, animal dander and air pollutants) and cold, dry air.

  • Continue to exercise on a regular basis.

  • Allow a warm-up and cool-down period of 10 to 15 minutes when exercising.

  • Avoid exercise if symptoms are present before exercise.

  • Slowly increase the intensity of workouts.

  • Participate in sports that are well tolerated by those with EIA such as football, downhill skiing, tennis, baseball, volleyball, wrestling, short distance track and field events, golf and gymnastics. Swimming is the most effective because breathing warm, moist air can completely or partially prevent EIA.

​Exercise-induced asthma will not affect an athlete’s performance if the right medication is taken. Inhalers can be short acting such as albuterol, or long acting such as salmeterol beta-2 agonists. Short acting inhalers are taken during an asthma attack because they work within five minutes and usually last one to two hours. They have been effective in 80 to 95 percent of patients.

Long acting inhalers work within 20 to 25 minutes, but must be taken four hours before exercise to work the best. When used 30 minutes before exercise, they can last up to 10 to 12 hours. If a long-term inhaler is used, a short-term inhaler should always be available and handy to stop an asthma attack.

Athletes suffering from exercise-induced asthma should continue to exercise on a regular basis. If the proper precautions are taken and the medications are used correctly, the athlete will be able to compete at the highest level with no difficulties.

Occupational asthma​

Occupational asthma is a lung disease in which the airways of certain people overreact to dusts, vapors, gases or fumes that exist in the workplace.

When these people inhale specific substances, extra fluid and mucus builds up in the breathing tubes or airways. This inflammation causes the muscles surrounding breathing tubes to be twitchy and tighten up. These events cause difficult breathing and usually a great deal of coughing.

Occupational asthma is usually reversible if the offending agent is avoided and the person with the condition is treated. Permanent lung damage can occur, if exposure to the substance that causes the reaction continues. In highly sensitive people, even quite low levels of exposure may provoke an episode.​​