In this Issue January 2003

Smoking and Asthma - how to give up successfully

Conference Diary 2003/4

Bushfires and Asthma

With bushfires affecting a wide area around Australia it is timely for people to take special care of their health.

Inhalation of smoke may cause a range of respiratory problems, including asthma. Smoke may trigger asthma symptoms such as wheeze, difficulty breathing, chest tightness or cough and the extreme conditions prevailing in some areas of the country could trigger problems for people with asthma, including those who are not normally affected by smoke.

The National Asthma Council recommends that people with asthma should follow their personal Asthma Action Plan and continue taking their medication, especially preventer medication.

If anyone is concerned about the effects of bushfire smoke and their asthma they should see their doctor for a check up. Their doctor can review their Asthma Action Plan in case their asthma symptoms worsen or new symptoms develop.

People who do not normally suffer chest complaints should not hesitate to seek medical assistance if smoke affects their breathing.

Importantly this advice applies to fire fighters as well as to the many other people likely to be affected by smoke in areas where bushfires are continuing. Fire fighters should take extra special care of their asthma as they may have a longer and more intensive exposure to smoke.

Part of any bushfire season preparation should include having your Asthma Action Plan up to date and readily available.

Asthma Action Plans

Asthma and Diet

Food is not a common trigger for asthma. Foods, drinks and food chemicals affect less than 5% of people with asthma.

However, where people have an acute asthma attack triggered by food allergy or chemical intolerance, the reactions can be catastrophic. The triggers are largely avoidable and need to be identified by appropriate investigations organised by your doctor.

Potential Problem Foods

Foods that can produce severe airway constriction in sensitised people include nuts, fish, shellfish, milk, egg and various seeds. Reactions usually occur within minutes of eating, and asthma is usually just one of many reactions a person may experience. For people who have aspirin-sensitive asthma, dietary salicylates may contribute to poor asthma control. Check with your doctor, as salicylates are contained in some quite "ordinary" foods.

Just like everyone else, people with asthma should consume a wide variety of nutritious foods and talk with your doctor if you have any concerns about your diet..

Coexistence of unstable asthma and peanut allergy is particularly dangerous and has led to a number of deaths. Specialist advice about avoidance and a written Action Plan including adrenaline is strongly advisable.

There is no clinical evidence that reducing or eliminating dairy products will improve asthma symptoms or control, despite a strong community belief that cows' milk allergy is an important cause of asthma. Cows' milk allergy usually causes skin or gastro-intestinal symptoms. Respiratory symptoms are uncommon. There is no medical foundation for the widely held view that dairy products increase mucus secretions.

Parents may need advice from a paediatric specialist or an allergy specialist and dietician to see if withdrawal of cows' milk is necessary. Changing from dairy to soy may not be an answer as these products may possess similar allergic potential.

Food Additives

Food additives can trigger asthma and can be difficult to diagnose. Only metabisulfite/sulphur dioxide (220-228) has been shown as a frequent trigger of asthma. It is found in many foods and beverages (including most 'fast foods' and sausages) and usually triggers asthma in susceptible individuals within minutes of ingestion. Monosodium glutamate (additive No.621) is not a common precipitant of asthma attacks.

However, an attack of asthma induced by MSG can be severe and it is difficult to establish cause and effect as symptoms may not appear until 12 hours after ingestion. Because additives are found in a large and ever-changing range of foods, consultation with a clinician or dietitian who has specific expertise in this area may be helpful.

Diets for the treatment of asthma are only necessary where specific food or additive sensitivity has been demonstrated.

Any form of food or chemical challenges in people with asthma must be medically supervised in appropriate surroundings, which allow for monitoring and treatment of severe airway constriction or anaphylaxis resulting from a challenge test.

Aspirin Sensitivity

For people who have aspirin-sensitive asthma, dietary salicylates may contribute to poor asthma control. Check with your doctor, as salicylates are contained in some quite "ordinary" foods and the addition of a special class of asthma drug (leukotriene receptor antagonist) may significantly improve asthma control and permit a more liberal diet.

Just like everyone else, people with asthma should consume a nutritious diet from a wide variety of foods and talk with your doctor if you have any concerns about your diet.

Asthma and Food Fact File

Australasian Society of Clinical Immunology and Allergy

Will Moving to Another Area Help Asthma?

Unfortunately the whole of Australia is an asthma zone with many triggers - asthma prevalence in this country is pretty much the same over all states and is perhaps slightly higher in rural areas than the cities. It is very much dependent on the local allergens - pollens, grasses, moulds, house dust mite, and so on.

Coastal cities tend to have higher dust mite levels, particularly if they have humid climates. Inland regions, while drier and with lower dust mite levels, have many types of pollens and moulds that can trigger asthma. You would be best to consider what, in particular triggers, your asthma when deciding where to live.

Local flare-ups in asthma symptoms can occur, usually seasonally, when pollens are released and high humidity or thunderstorms cause pollen granules to burst and provoke asthma attacks.

Precautions can be taken to make your house 'asthma-friendly' wherever you live:

Encase mattress and pillows in mite-proof covers. Your pharmacist can advise on this.
Wash bedclothes weekly in hot water (over 55°).
Shake and air pillows and quilts in the sun weekly.
Use synthetic or wool doonas or quilts rather than feathers or down.
Remove soft furry toys and soft furnishings, if possible.
Soft toys can be placed in the freezer overnight to kill dust mites.
Helpful suggestions for cleaning:
- wear a mask
- dust with a damp cloth or electrostatic duster
- wet-mop rather than vacuum or use an electrostatic mop
- consider ducted or well-filtered vacuum-cleaning systems.

Asthma & Allergy

For more information or support, contact your local Asthma Foundation on 1800 645 130 or visit your local Asthma Foundation web site.

Asthma New South Wales

Asthma Northern Territory

Asthma Queensland

Asthma South Australia

Asthma Tasmania

Asthma Victoria

Asthma Western Australia

Smoking and Asthma - how to give up successfully

People with asthma should not smoke, but for those who unfortunately do there is good news - getting back to work is a good time quit. Social occasions over the holiday period are probably not the most favourable situations to quit.

Battling nicotine addiction requires both motivation and planning. Everyone knows many good reasons not to smoke and certainly people with asthma know that the less exposure to smoke the better.

Being a Non-Smoker

The benefits of quitting can be felt surprisingly quickly. After twelve hours almost all of the nicotine is out of your system. After twenty-four hours the level of carbon monoxide in your blood has dropped dramatically. You now have more oxygen in your bloodstream. After five days most nicotine by-products have gone. Within days your sense of taste and smell improves. Within a month your blood pressure returns to its normal level and your immune system begins to show signs of recovery.

Support

Quitting has a far better chance of success when you have good support systems in place. Doctors and pharmacists can aid smoking cessation with information, goal setting and proven pharmacological smoking cessation aids i.e. nicotine replacement therapy and bupropion hydrochloride, the non-nicotine based tablet Zyban.

The Quit web site has excellent resources for helping to give up smoking and remaining a non-smoker. Of particular interest is the advice the Quit site provides about helping other people to give up smoking.

Finally, the whole process of giving up smoking will involve some taxing times and may involve a relapse or two. It is difficult to break habits, but it is in your own interest to keep trying until you succeed. Good luck and good health.

Quit

ASH - Action on Smoking and Health

Conference Diary 2003/4

The Thoracic Society of Australia and New Zealand 2003 Annual Scientific Meeting Adelaide Convention Centre 4 - 9 April 2003 TSANZ Annual Scientific Meeting Adelaide
Australian & New Zealand Society of Respiratory Science 2003 Annual Scientific Meeting Adelaide Convention Centre 4 - 6 April 2003 ANZSRS Annual Scientific Meeting Adelaide
2nd World IPCRG Conference Respiratory Disease in Primary Care 'The Way Forward' 19 - 22 February 2004 Hotel Sofitel, Melbourne, Australia IPCRG Melbourne 2004
The 2004 Australian Asthma Conference ‘A fresh breath – looking to the future’ 22 - 25 February 2004 Hotel Sofitel, Melbourne, Australia. Asthma Conference 2004

Submit brief conference/meeting details to the National Asthma Council for possible posting in our Conference Diary by email to nac@NationalAsthma.org.au.