It is a scary thing when you cannot breathe. Imagine the feeling of drowning, or literally "gasping for air". That is the picture of what many asthmatics have to deal with on a daily basis. In the US, some 15 million people are effected by this disease, 5 million of which are children. This number has doubled during the last 10 years and many researchers are both puzzled and concerned as to the reasons why.

Asthma can strike anyone at any time, though children appear to be the most vulnerable. There is strong evidence of an inherited tendency to being allergic to allergens in the air. Those that develop allergies are more likely to develop asthma. Many children will outgrow asthma; others will face a lifetime of asthma management.

The airways of an asthmatic are hyper-responsive to environmental triggers or allergens. There are a host of asthma "triggers," or substances in the environment that can set off asthma attacks. Some triggers cause an allergic reaction, a full-fledged immune response in someone whose immune systems is overly sensitive to normally harmless substances like pollen, or dust. Others directly irritate the lining of the airways and some do both. During an asthma attack the lining of the airways become swollen and filled with mucous. The muscles around the airway tighten, constricting airflow. Symptoms such as coughing wheezing and chest tightening can usually be relieved by a bronchodilator (such as Ventolin®). But the airway inflammation can remain, leaving the asthmatic vulnerable to many more attacks

Why the increase?
Although no one knows for sure, there are a number of theories as to why asthma is on the rise:

1. Spending more time indoors, exposing one to more allergens and triggers. During the last decade we have built tighter, more energy efficient buildings. This has led to less natural air exchange, less ventilation and more build up of potentially harmful substances.

2. Homes are carpeted and have cloth furnishings. These are ideal places for dust, dust mites and other known allergens to live and breed.

3. Air Pollution, both indoors and out. Especially exposure to smoke.

Every asthmatic needs a plan of action designed to help manage their asthma. This usually includes strong medications such as oral and inhaled steroids, airflow monitoring (so one knows if an asthma attack is pending.) And effective control of environmental triggers.

Avoiding environmental triggers and irritants - Controlling the home environment is a very important part of asthma and allergy care.

Dust and Dust Mites
· Encasing mattresses, pillows, and box springs with allergy resistant protective covers.
· Remove or regularly wash and clean dust catchers Stuffed animals, cloth blinds , knick knacks etc.
· A vacuum cleaner with an air filter or a central vacuum
· Wash all bedding on 130+ degrees each week.

Pollens and Molds
· Thoroughly clean bathrooms and other high moisture areas to reduce mold growth. Consider using mold protective sealers
· Immediate fixes all leaks, or water damaged areas.
· If Humidity is above 45%, consider a de-humidifier to reduce excessive moisture in the air. High levels of moisture lead to dust mite and mold proliferation.
· Keep windows closed during peak pollen times. Especially between 5am-10am.

Animal Dander
· Keep animals from bedrooms.
· Wash animals frequently.

Cockroach droppings
· Through cleaning of kitchen, putting away food promptly.
· Utilize bait/traps. Avoid use of strong chemicals if possible, as they can also be a trigger

Tobacco Smoke
· Never allow smoking in the home or anywhere near an asthmatic

Strong chemical fragrances, or sprays
· Utilize non-toxic, fragrance free products as much as possible, including household cleaners, deodorizers and the like.

Use HVAC air filters, air conditioners, and air cleaners to make your home cleaner and more comfortable.

Other Resources American Academy of Allergy, Asthma and Immunology http://www.aaaai.org/ American Lung Association http://www.lungusa.org/ National Allergy and Asthma Foundation/Mothers of Asthmatics http://www.aanma.org/