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Spotlight on Asthma: November 2016

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Boy in winter gearManaging Asthma in the Winter Season

Cold winter air can irritate anyone’s lungs. If you have a lung condition such as asthma, the winter air may affect you even more. Cold air can cause the airways in your lungs to tighten up, making it more difficult to breathe. Read More

Be a flu fighter. Protect yourself. Protect your family.Protecting Our Communities: Why everyone should get the flu shot

The influenza vaccine, or flu shot, is easily accessible across the country and free-of-charge in all but three provinces. Yet, up to 70 per cent of Canadians choose not to receive it. Read More

Diagnosing asthmaHow is Asthma Diagnosed?

The diagnosis of asthma is based on many factors, including a detailed medical history, a physical examination, and breathing test results. Most of the time diagnosing asthma is fairly easy. However, sometimes it takes more time and further testing to figure out if you have asthma. Read More

No smoking signRisk Factors for Developing Asthma

Predicting who will develop asthma is not easy. There are a number of risk factors that can make it more likely that you will develop asthma. The more risk factors you have, the more likely you will develop asthma. However, many people who have these risk factors never develop asthma. Read More


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Managing Asthma in the Winter Season

Cold winter air can irritate anyone’s lungs. If you have a lung condition such as asthma, the winter air may affect you even more. Cold air can cause the airways in your lungs to tighten up, making it more difficult to breathe.

Boy in winter gearKeeping your asthma under control can help to reduce your risks and help you stay active this winter. Exercise has many health benefits for your lungs and for your general health, plus it can improve your mood.

Keep your asthma under control
Take these steps to help keep your asthma under control:

  • Take your asthma medications as prescribed and have your inhaler technique checked whenever you visit your health-care provider
  • Avoid your triggers (e.g., smoke, strong scents, allergens)
  • Follow the written asthma action plan from your health-care provider that helps guide you in keeping your asthma under control. If you don’t have an asthma action plan, ask for one.

Reduce the effects of cold air
Steps to reduce the effects of cold air on your asthma include:

  • Wear a scarf or cold-weather mask around your mouth and nose – this can help to warm up the air you breathe in
  • Some people may need to take their “reliever” inhaler (usually blue) before being active in the cold air
  • Don’t start any physical activity if you have any symptoms
  • Warm up before your activity – start off slowly then work your way up to a more intense level
  • Cool down after your activity – slowly decrease the intensity of your exercise
  • If you have problems breathing during exercise, stop immediately, take your “reliever” inhaler right away and if possible, go inside to a warm place

If you find it hard to be active in cold air, find activities you like to do indoors. The goal is to be active most days of the week.

Winter weather means more time indoors
In the colder months we also spend more time indoors than at other times of the year. Think about the air you breathe indoors. Keep the air you breathe at home and in your car as clean as possible.

Common indoor asthma triggers include:

  • Cigarette smoke
  • Allergens (e.g., pets, dust mites, mould)
  • Strong cleaning products
  • Wood burning fireplaces/stoves
  • Dust
  • Scented products (e.g., air fresheners, perfumes)

Watch this short video from Cleveland Clinic for tips on keeping your lungs healthy in colder weather.

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Protecting Our Communities: Why Everyone Should Get the Flu Shot

Last year, less than one-third of Canadians got the flu shot. While vaccination rates started to creep up in the early part of the century (reaching 36 per cent in 2005), the rates have since dropped again with just 31 per cent in 2014.

The influenza vaccine, or flu shot, is easily accessible across the country and free-of-charge in all but three provinces. Yet, up to 70 per cent of Canadians choose not to receive it.

Protect yourself banner

The risk of declining vaccination rates
“The flu shot is something that everyone should be getting every year,” says Dr. Matthew B. Stanbrook, Staff Physician in Toronto’s University Health Network and Associate Professor at University of Toronto’s Department of Medicine. “Public health guidelines in Canada in every province recommend getting it and it’s for a good reason: influenza is really common, it happens every year, and everyone in theory is at risk.”

Declining rates of vaccination have been attributed to people feeling it is unnecessary. But, what many people may not consider is the role of vaccination in building community immunity. In every community there are groups of people who have a far greater risk both of getting the flu and of experiencing grave consequences such as infections and pneumonia as a result.

“The likelihood of older people, small children, or people with chronic health conditions getting the flu is so much greater if people around them are not vaccinated,” says Diane Feldman, Certified Respiratory Educator at The Lung Association. “For those people, complications from the flu can be dire.”

When a healthy individual chooses not to get immunized, they are not just putting themselves at risk, they are increasing the chances of transmitting a potentially fatal virus to some of the most vulnerable members of the community. Community immunity, or herd immunity, is a form of indirect protection from infectious diseases that occurs when a large percentage of the population is immune to an infection, thereby providing protection for individuals who are not immune.

Building community immunity
“Herd immunity is terribly important, it’s what keeps our populations safe,” says Dr. Tom Kovesi, Paediatric Respirologist at the Children’s Hospital of Eastern Ontario and Professor at University of Ottawa’s Faculty of Medicine. “With influenza it’s tough because you need about 80 per cent or more of the population getting the vaccine for herd immunity to really work and we’re just not there yet.”

“If you’re not convinced about getting the flu shot for your own protection,” says Feldman, “you should get it for the protection of other, more vulnerable, people around you.”

For more information on how the flu shot protects you and your family, watch this video from the Canadian Paediatric Society: Protect your family from the flu

Find a flu shot clinic in Ontario.

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How is Asthma Diagnosed?

Female doctor

The diagnosis of asthma is based on many factors, including a detailed medical history, a physical examination, and breathing test results. Most of the time diagnosing asthma is fairly easy. However, sometimes it takes more time and further testing to figure out if you have asthma.

Here are the common ways that asthma is diagnosed.

Medical history
Your health-care provider will ask you about:

  • Your medical history and your family medical history (e.g., allergies, eczema, hay fever)
  • The symptoms you have been experiencing:
    • Common asthma symptoms include cough, wheeze, shortness of breath, and chest tightness
    • Asthma symptoms often happen at night or in the early morning hours
    • Exercise, cold air or having a cold often bring on asthma symptoms

Physical examination
Your health-care provider will:

  • Examine your chest and breathing rate
  • Listen to your lungs with a stethoscope for unusual sounds while you breathe
  • Examine your nasal passages for signs of allergies
  • Examine your skin for signs of eczema

Lung function testing
Breathing tests such as “spirometry” are the most important tests for diagnosing asthma.

  • Spirometry testingSpirometry testing involves taking in a deep breath and breathing out as hard and long as you can into a tube. After you breathe out all of your air, you then inhale as fast and deep as you can until your lungs are totally full. This measures the speed and amount of air you are able to breathe in and out.
  • Spirometry testing is often done before and after using a reliever inhaler (usually blue) to see if there is an improvement in your lung function
  • Children under six years of age are not usually able to do a spirometry test
  • If your spirometry test results are normal but your health-care provider still thinks you might have asthma, you may be sent for further testing. A “challenge test”, usually using methacholine, can help to diagnose asthma.

Allergy testing
Your health-care provider may refer you to an allergist for an allergy assessment. This may include an allergy skin test that tests you for reactions to specific allergens. This can help you to find out what allergens may be causing your asthma symptoms.

An allergy skin test involves placing drops of allergens on your forearm or back and making small scratches in the skin where the drops are located. The amount of redness and swelling caused by the allergens will help determine if you have any allergies.

Trial of asthma medications
Your health-care provider may prescribe asthma medications for you to take, to see if they improve your asthma symptoms. If asthma medications improve your symptoms, this increases the likelihood that you have asthma.

Other tests
Chest x-rays are not very useful in the diagnosis of asthma, but they may help to rule out other reasons for your symptoms.

A blood test or sputum (phlegm, mucus) test may sometimes be ordered.

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Risk Factors for Developing Asthma

Predicting who will develop asthma is not easy. There are a number of risk factors that can make it more likely that you will develop asthma. The more risk factors you have, the more likely you will develop asthma. However, many people who have these risk factors never develop asthma.

Here are some of the more common risk factors.

Genetic (hereditary) factors

  • If someone in your family has asthma or allergies (e.g., eczema, hay fever), then you have a higher chance of developing asthma

Allergies

  • If you have allergies or eczema, you have a higher chance of developing asthma
  • The earlier in life you develop allergies, the greater your risk of developing asthma
  • Some research shows that an allergy to mould or cockroach allergens can increase your risk of asthma
  • Exposure to dust mites and pets may increase your risk of asthma. More research is needed to confirm this.

Tobacco smoke

  • No smoking signChildren exposed to tobacco smoke during or after pregnancy have an increased risk of developing asthma
  • Smoking increases the frequency and severity of asthma flare-ups
  • Smoking increases your risk of developing other health problems such as emphysema, lung cancer, heart disease and more
  • Reduce the risks to your children by keeping your air smoke-free at all times

Work exposures

Outdoor air pollution

  • Some research shows that people who live near major highways and other polluted places are more likely to develop asthma

Infections

  • Certain viral infections during infancy have been linked with developing asthma or asthma-like symptoms. More research is needed to confirm this.

Gender

  • Before the teen years, boys are more likely to develop asthma than girls
  • After the teen years, women are more likely to develop asthma than men

Obesity

  • Research has suggested that obesity may be a risk factor for developing asthma. More research is needed to confirm this.

 

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