How do you get asthma?

Asthma is a long-term condition that usually starts in childhood but can also have its first onset in adulthood. It occurs when the airway linings become sensitive to an irritant or allergen and then cause the airways to tighten. This then can cause the symptoms of cough, wheeze, and tightness in the chest.

Occupational asthma is caused by materials in the workplace that irritate the lining of the airways. If you develop asthma as an adult, this should be considered.

Is there a cure for asthma?

Children who develop asthma often grow out of their symptoms as they get older but for some it does continue into adulthood. If you develop asthma as an adult then it is usually lifelong unless caused by occupational irritants. There's currently no cure for asthma. However if you follow your treatment plan then symptoms should be controlled enough that you can lead a normal active life. Treatment could include inhalers, tablets, or breathing exercises.

Is asthma passed on in families?

Sometimes. Research has identified a small number of genes that can be passed on from parents that make a person more susceptible to developing asthma. More research needs to be done to look at the impact of these genes on asthma.

What causes asthma to get worse?

Asthma can be triggered by allergens or pollutants such as animal hair, pollen, or car fumes. Some people find exercise or cold air triggers their asthma. Viral illnesses such as the common cold, COVID-19, or flu can also exacerbate asthma symptoms, so it is good to ensure you have a reliever inhaler with you in these circumstances.

Smoking and being overweight can also have a detrimental effect on asthma.

What treatment is available for asthma?

Asthma is usually treated with medication that is delivered from an inhaler. These can be to treat the symptoms when they occur (a 'reliever'), or to prevent the symptoms (a 'preventer'). Some people need inhalers that combine the two, a combined inhaler. Tablets or other treatments may be needed if these alone are not sufficient at controlling symptoms.

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What is the difference between a 'reliever' inhaler and a 'preventer' inhaler?

A reliever inhaler is usually blue, and the most common preventer inhaler (beclomethasone) is in a brown inhaler. However there are many inhalers on the market that come in a variety of colours.

Asthma symptoms are caused by the muscles around the airways tightening which leads to a cough and further tightening causing a wheeze. The reliever inhaler forces the muscles to relax, alleviating symptoms, whilst the preventer inhaler helps make the airways less sensitive to triggers so helping prevent symptoms from occurring.

The key message is that the blue inhaler is used for immediate relief, while the brown inhaler is used to reduce symptoms and prevent further attacks. Remember when symptoms present themselves, or in the event of an asthma attack, to use the blue inhaler.

Further information on the difference between blue and brown inhalers.

Do inhalers contain CFCs?

CFCs are gases that are used in aerosols, such as inhalers, to help propel a substance or medication out. They are harmful to the ozone due to the release of chlorine atoms on their exposure to ultraviolet light and are currently being phased out. The aerosol inhalers that we supply use a different type of non-CFC propellant, hydrofluorocarbon (HFC 134a). This gas spends less time in the atmosphere so the danger to the ozone is insignificant but it still contributes to climate change as it is a powerful greenhouse gas.

Dry powdered inhalers do not contain CFCs.

How do inhalers contribute to the carbon footprint?

An inhaler that contains a gas to propel the ingredients inside it out, such as the Ventolin Evohaler, uses hydrofluorocarbons (HFCs). This has a global warming potential thousands of times more than carbon dioxide. The HFC gases released into the atmosphere absorb some of the infrared radiation released by the earth which is then released in all directions warming the surface of the earth and the lower atmosphere further. For further information see The Problem with Inhalers – Green Inhaler. You can reduce your impact by using only what you need of your pressurised inhaler or by changing to a dry powdered device, such as the Ventolin Accuhaler, which does not contain these gases.

Changing your inhaler should always be discussed with your GP or asthma nurse who will explain the differences and different inhaler technique.

Can inhalers be recycled?

There is currently no recycling project set up specifically for inhaler canisters. However by returning them to your pharmacist they can be incinerated in medical waste. If there are any damaging propellants in the inhalers, these are broken down by the high temperatures into far less damaging greenhouse gases.

Can you use asthma inhalers when pregnant?

It is important to keep your asthma under control when pregnant to optimise the health of your baby. Most inhalers can still be used but speak to your GP about your treatment if unsure. Some women find their asthma gets better whilst pregnant, however some find that it gets worse.

Can you use asthma inhalers when breastfeeding?

Most inhalers can be used when breastfeeding but please check the patient information leaflet in the medicine pack or speak to your GP if you are not certain.

Do you need to use asthma inhalers for life?

Asthma symptoms are usually intermittent. However if you have asthma symptoms often then you will need to take a daily 'preventer' inhaler to help reduce them. If your symptoms are infrequent then you will only need to use an inhaler when your symptoms flare up. During your asthma review at your GP practice, an asthma management plan should be agreed that explains when and how to use your inhalers and when treatment should be stepped up to use a different dose or medication to control symptoms better, or stepped down if you are not experiencing any symptoms. Once symptoms settle or disappear, you may need no treatment at all.

What is an asthma attack?

An asthma attack is when your symptoms get much worse and are not relieved by your usual blue 'reliever' inhaler. It can happen quickly or build-up over a few days. You may experience symptoms of wheeze, chest tightness, cough, or difficulty in breathing. If you're needing to use your blue inhaler more than every 4 hours then this is a sign your asthma is not well controlled and you need to seek medical help.

What to do in an asthma attack?

  • Sit up straight - try to keep calm.
  • Take 1 puff of your reliever inhaler (usually blue) every 30-60 seconds up to 10 puffs.
  • If you feel worse at any point OR you don't feel better after 10 puffs telephone 999 for an ambulance.
  • If the ambulance has not arrived after 10 minutes and your symptoms are not improving, repeat step 2.
  • If your symptoms are no better after repeating step 2, and the ambulance has still not arrived, telephone 999 again immediately.

How can you prevent having an asthma attack?

Taking your prescribed medication routinely will help keep your asthma under control. You should discuss having an asthma management plan with your doctor or asthma nurse who will advise what you can do if you feel your symptoms have flared up. It is important to step down to your usual treatment once your asthma is under control. Stopping smoking if you do smoke can also help improve your asthma symptoms and maintaining a healthy weight.

Is hay fever linked to asthma?

An allergy to pollen can trigger asthma symptoms as it can cause airways to narrow further. It can be useful to know which pollens trigger your asthma so you can take additional hay fever treatment during their peak seasons to reduce your risk of developing an asthma attack. There is a good calendar to help guide you with this on asthma.org.uk.

Should you use a nebuliser for asthma?

No - nebulisers are not recommended for most people with asthma. People with severe asthma who are using a nebuliser at home under the care of a specialist should seek urgent medical help if using it for symptoms of an asthma attack.

Would a dehumidifier or air purifier help with asthma?

Dehumidifiers take the moisture out of the air which can actually sometimes trigger some people's asthma due to the dryness. Currently there is no evidence of the benefits.

Air filters or purifiers can aid in removing allergens and some people find these help with their asthma symptoms. More research is needed to conclude if and how useful they are.

Dr Amanda Wood

Authored 17 January 2022 by Dr A. Wood
MB ChB Manchester University 1984. NHS GP in Bristol.

Reviewed by Dr C. Pugh, Dr B. Babor, Dr P. Hunt
Last reviewed 15 February 2022
Last updated 12 May 2022

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