Environmental Control

According to the Oct '02 study, 77% of all the households surveyed had persistent symptoms, which they went on to describe as moderate to severe. In addition, the publisher noted that in those surveyed Asthma negatively affected physical activity for 2/3 of those interviewed. And it gets worse as the Asthma gets worse because the chances of urgent care visits increased up to twice the normal amount in the cases studied.

The above study highlights how our standard of living is affected by Asthma symptoms. So management of those must be of utmost importance to us. In my humble opinion, probably the most important thing you can do to increase your enjoyment of life with Asthma is controlling your environment. Up to 60% of our time is spent in our homes, obviously it would have a significant impact on our lives. A fairly good working definition of Environmental Control is controlling or reducing or eliminating Asthma triggers to the extent one is able. Some measures we can take easily but will have a large impact on our lives and cost very little money.

First off, our lungs desire that we avoid contact with tobacco smoke. Studies show this is not just a concern for the future (cancer) but a very present irritant to the Asthmatic. The use of smokeless ashtrays and open windows and the like are shortcuts that can help somewhat, as is the use of a single room in the home for that purpose. However, these actions do not eliminate the pollution in the home, only decrease it somewhat. It is important then, that the Asthmatic have a smoke free home.

Why do we need to be so strict? Not all irritants from cigarettes disappear from the environment when the visible smoke disappears. Don't believe me? Here are two things you can do to prove that smoke does not go away when the cigarette does...

• Residue test: Put a clean white cloth into some warm soapy water and wring it out well until nothing drips off. Clean an area of your walls or furniture with this clean white cloth. Voila', now it is yellow or maybe even brown. This is residue from your cigarettes. It's not hurting anything on the walls, however it is in the drapes, the upholstery, the carpet, clothes and on the person that smokes. These chemicals are invisible and are released into the air each time these things are disturbed.

• Stinky Shirt Test: Procure a freshly washed and clean smelling Tupperware or like container with a lid and a t shirt that has been worn by the smoker while smoking and has not been washed yet. If you can get this after the first 2 or three cigarettes that day, the test is more effective because the shirt probably doesn't seem so bad. Take them both outside so that the air in your home does not skew the results of the test. Place the shirt into the container and seal it and keep it in a smoke free environment for a day or two. Now open it up (still in the smoke free environment) and take out the shirt. Be prepared for a very foul stench. This is what accumulates in your home when the smoker is doing his thing inside the home. Now cover the container back up and then keep it in a smoke free environment again. Come back after 2 days and open it up. Notice how the smell is still there? The problem source was gone and there was no smoke, but the chemicals definitely lingered there.

Everyone deserves clean air, even the person smoking, but the Asthmatic MUST have it. It is not rude or out of line to insist on a smoke free environment when you have Asthma, it's a matter of your health and possibly your life. If you are a smoking loved one, the best thing you can do for the Asthmatic in your life is to keep your ashes and smoke to yourself outside.

A very simple thing you can do as an Asthmatic to improve your household condition is to manage your windows better. When you are not cleaning, close them and use the air conditioner. Lock all that pollen and industrial pollution outside! Whatever comes into the home through windows and doors rarely makes it back outside and will concentrate in the home as it accumulates.

Which brings me to another important topic that should be addressed. Indoor air quality. It is a growing problem in our homes as things outside our homes get worse. After you've closed your windows and decide to keep the outside outside, your indoor air can still be 2-5 times more polluted than the air outside. This is primarily because unlike the outside environment, your house has no way of purifying itself or cycling the pollutants out of the air (when was the last time a river ran through or rain dampened your home?) So cleaning wisely and improving the pollution levels in the home may require some adjustments but in light of the facts, it is definitely worth making the changes.

The EPA has identified hundreds and hundreds of chemicals in the average home. Fumes, vapors, odors, chemicals and the like from cleaners, paints, spray air 'fresheners". cooking and perfume can be irritating to many Asthmatics and exposure to these things should be limited and controlled.

Obviously some of these things you can't avoid. But some simple measures make our contact with them less of a problem. I cook with my exhaust fan or a small air filter running. I spray my perfume under my clothes to avoid breathing it directly. I paint with a mask on or drum up the money to have someone else do it. I refuse to use "air fresheners" since, in my opinion they are useless and in fact dangerous. First off they release noxious fumes such as formaldehyde into the air and second they only mask the problem they are trying to solve. When the smell of the air freshener is gone the original odor is back. I scent a room with natural potpourri or essential oils and I get rid of the foul odors with air circulation and filtration. When I am cleaning I avoid harsh chemicals and use only natural cleaning products. Very little in a well kept home need be cleaned with anything other than natural dish soap and hot water - even the toilet can be cleaned this way if kept clean. If I must resort to things like oven cleaner (I can not find asthma or earth friendly way to clean an oven, if you have ideas EMAIL me) I wear a mask and use a portable air filter. I used to open up the house and blow a fan to direct the fumes outside.

Mold is a common trigger for Asthmatics and must be kept at bay. I've found that usually oxygen based cleaners like Oxyclean work well for mold in the bathrooms, as long as you keep up with it. To avoid molds, you must refuse to give them an environment to grow in. Dehumidifiers help, as will a home filtration system with a HePA or greater filter. You can use your heating system, a portable heater, air conditioner, and oven or exhaust fans to keep the house from becoming moist. And you need to change out the filters in the air system to keep mold spores from spreading all over your home. And whatever you do, no matter who is sick with what, DO NOT use the vaporizer!!

Insects, in particular their waste products, are Asthma irritants as well. In fact, 20% of all homes without a visible infestation contain enough roach allergens to cause irritation. And our homes are literally crawling with dust mites. These lovely critters feed off our dead skin cells and nest in mattresses and upholstery.

The most important defense against these triggers is a change in housecleaning. First off, overall cleanliness is paramount. Homes with food particles spread about are more likely to have roaches and we slough off allot of dead skin cells each year which will turn to dust (another trigger) if the mites don't consume it. Secondly we need to pay more attention to cleaning the mattresses, pillows, and upholstery. Most of these things can also be covered with a mite proof covering. Past advice has been the removal of carpets; upholstery and draperies, but with good cleaning practices you don't need to resort to that, especially if you have good air filtration.

Dust is a common problem. The solution is to clean it out of the home effectively and then to keep it out. To keep it out you will need a good filter. You can't see 80% of the dust, but it affects you anyway. You need something that will get the majority of what you cannot see. To get rid of 98-99% of all dust, you need a filter of Hepa or greater. You need this for both air circulation and for surface cleaning (what you do when you dust, vacuum). If you are using a standard vacuum, go stand in a sunbeam, look at the exhaust and turn the machine on. See the dust? This is not helping your lungs or air filter at all and you should know that you are working against yourself if you are using a vacuum that does not have a Hepa or greater filter. You may as well use a broom or dustmop, which is much cheaper anyway. If you do not have a Hepa or greater filter on your surface cleaner, wear a mask or have someone else do the cleaning for you. Too much dust is stirred up for your lungs to endure.

Just as with the vacuum, the filter air system is also important. You need some sort of extra help here, HePa strenght if at all possible. You can get portable units which range from a couple hundred to a couple thousand dollars, or you can augment your existing air conditioning and circulation system. You must keep these filters clean and maintained once you have them. And on this note, this also includes the filters on portable window unit air conditioners. Honestly there is no excuse for letting that filter get dirty, it's right there accessible at all times!

And finally, one of the hardest topics to write about...animals. Man's best friend can turn out to be our lungs' worst enemy. Enzymes in the saliva and animal dander are triggers for Asthma in and of themselves, but additionally, pollen and air pollutants from outside will nest in the fur of our faithful friend. Then our beloved pets end up causing pulmonary distress whenever we hug or pet them. What a drag, huh?

If the Asthma is bad enough, it is imperative that the family considers putting Fido up for adoption. Sometimes the stress is too much on the body and the Asthma will remain out of control until this is done. But since each Asthmatic is different, not all must release their four legged family members into the custody of someone else. BUT, if you keep them you cannot let them become a health hazard. They need to be washed thoroughly every week, even cats, and groomed often to get rid of the extra hair. If the Asthma patient does this, I recommend the use of a mask. There are also an array of allergy products that claim to suppress our allergic/asthmatic responses to our pets. I do not know if they work, feel free to try them, but don't be surprised if they are not as effective as you'd like. Keep pets out of the asthmatics bed and out of their bedroom. If considering a pet for an asthmatic, consider something which has no dander and whose living environment can be easily cleaned without causing air pollution. Fish are great, as are reptiles and hermit crabs.

In closing, it is important to keep tabs on your triggers and keep your triggers as far from you as you can arrange. Do this and you may end up one of the ones who go on to live life to the fullest.

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