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Spotlight on Asthma: March 2017

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woman jogger out of breathExercise and Asthma

Research has shown that if you have asthma, you are less likely to exercise than if you don’t have asthma. Research has also shown that exercise can improve your lung function and help you get better control of your asthma. Read More

syringesBiologics for Treating Asthma

Biological medications, often called biologics, are a relatively new type of medication for asthma. Compared to most medications that are made using chemical reactions, biologics are made using living systems. Read More

Close up of scaleObesity and Asthma

Does obesity cause asthma? Does asthma cause obesity? Researchers have been trying to find answers to these questions for years. Read More

Radon testDid you test for radon this winter?

Spring weather is right around the corner. Did you start a radon test this winter? If so, it may be time to send it to the lab to get your results. Read More


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Exercise and Asthma

Research has shown that if you have asthma, you are less likely to exercise than if you don’t have asthma. Research has also shown that exercise can improve your lung function and help you get better control of your asthma. One of the reasons why people with asthma do not exercise as often as others is due to the fear of triggering asthma symptoms. Keeping your asthma well-managed will reduce the chance that exercise will trigger symptoms and help you lead a full, active life.

woman jogger out of breath

When you exercise, you move much more air into and out of your airways than when you are at rest. This removes moisture from your airways and cools them down. This cooling and drying effect can cause your airways to tighten up (constrict). This can lead to typical asthma symptoms (e.g., shortness of breath, chest tightness, cough, and wheeze).

Follow these tips to help prevent asthma symptoms from exercise:

  • Keep your asthma well-managed so that exercise will be less likely to trigger asthma symptoms.
  • Warm up before exercise and cool down after. Start at a slower pace and slowly work up to a faster pace.
  • If outdoor air pollution or pollen are affecting your asthma, move your exercise indoors.
  • Get a written asthma action plan from your health-care provider. This will help guide you in adjusting your treatment based on how well your asthma is under control.

Many top athletes have asthma and successfully compete in their sports. Having asthma doesn’t mean that you can’t exercise at a high level. Experiencing exercise-induced symptoms is often a sign of poorly managed asthma. With the current understanding of how to manage asthma and the availability of today’s effective medications, people with asthma should generally be able to exercise like everyone else. If asthma stops you from exercising, see your health-care provider.

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Biologics for Treating Asthma

syringes

Biological medications, often called biologics, are a relatively new type of medication for asthma. Compared to most medications that are made using chemical reactions, biologics are made using living systems (e.g., bacterial/viral cells, plant or animal cells). An example of a common biologic is the flu vaccine, which is usually grown in chicken eggs.

Biologics are designed to inhibit certain components of the immune system that trigger inflammation—and it is inflammation in the airways that cause a lot of the asthma symptoms.

Biologics for treating asthma now include Xolair® (available since 2005), Cinqair™ and Nucala™.

Xolair®

Medication class: IgE-neutralizing antibody (Anti-IgE)

Immunoglobulin E (IgE) is a type of protein that our bodies naturally make in small amounts. In allergic asthma the IgE increases abnormally, causing swelling and tightening of the airways. Anti-IgE therapy reduces the ability of IgE to cause symptoms.

If you are following all the correct steps in managing your asthma but are still having a hard time getting your asthma under control, then your health-care provider may decide to send you for Xolair® injections. Xolair® may be prescribed to reduce the symptoms of asthma due to allergic triggers for individuals aged 12 and older.

If you are sent for Xolair® injections, you will receive them every two to four weeks. You need to continue using all of your asthma medication as prescribed by your health-care provider.

Possible side effects should be explained to you by your health-care provider.

Cinqair™, Nucala™

Medication class: Interleukin-5 (IL-5) inhibitor

Cinqair™ is given by intravenous infusion every four weeks.

Nucala™ is given by subcutaneous injection every four weeks.

IL-5 inhibitors are sometimes prescribed for the maintenance treatment of severe asthma in patients aged 18 years or older. It may be added when someone’s asthma is not under control despite using medium to high doses of inhaled corticosteroids plus another controller medication.

IL-5 inhibitors are only effective for people who have a certain level of eosinophil, a type of white blood cell in your blood. Your health-care provider will check your blood eosinophil level before prescribing the medication.

Possible side effects should be explained to you by your health-care provider.

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Obesity and Asthma

Does obesity cause asthma? Does asthma cause obesity? Researchers have been trying to find answers to these questions for years. Research shows that asthma is more common if you are obese than not obese. We also know that it is more difficult to get your asthma under control if you are obese.

Close up of scale

Your body mass index (BMI) can be used to assess health risks based on your weight. Your BMI is defined as your weight in kilograms divided by the square of your height in metres (weight/height2). Having a BMI of 30 or over is equated with being obese.

Although more research is needed, possible reasons why obesity may cause asthma symptoms include:

  • Extra weight around the chest area makes it harder to breathe
  • Fat tissue around the stomach area blocks the full expansion of your lungs
  • Increased risk of gastroesophageal reflux disease (heartburn), which can cause asthma symptoms
  • Fat cells cause inflammation throughout your body that can make your airways more hyper-reactive (more sensitive, or twitchy)
  • Reduced fitness level due to increased weight can lead to more asthma symptoms

Asthma is generally treated the same regardless of your weight. However, if you are over-weight, then losing weight can improve your asthma control and reduce the need for medications. Strategies for reducing weight should be a part of your overall treatment plan.

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Did you test for radon this winter?

Spring weather is right around the corner. Did you start a radon test this winter? If so, it may be time to send it to the lab to get your results. Health Canada recommends a testing period of at least three months. Once the test has reached the minimum testing period, send the device back to the lab listed in the original package. The lab will send you the radon level in your home. If your radon level is 200 becquerels per cubic metre (Bq/m3) or higher, it is recommended that you take steps to reduce it to a safer level.

Radon gas is created as uranium breaks down in rock and soil. It can enter homes and other buildings and build up to harmful levels inside.

Radon enters buildings through:

  • cracks in the wall or floor
  • pipe fittings
  • drains
  • sumps
  • basement windows
  • well water

Radon is the second leading cause of lung cancer after smoking. Each year an estimated 850 deaths in Ontario are due to radon-induced lung cancer. People who smoke and are exposed to high radon levels have an even greater risk of getting lung cancer.

High radon levels can be fixed. The higher the level, the sooner the action should be taken. A certified radon professional can help you find the best way to lower the level in your home.

Often the best way to reduce the radon level is with a method called “sub-slab depressurization” (see image below). This involves having a hole drilled through the basement floor. Then a vent pipe with a fan is installed, which draws the radon gas to the outside. This can reduce radon levels by over 90 per cent.

Diagram for sub-slab depressurization

To find a certified radon professional near you, contact the Canadian National Radon Proficiency Program. Visit https://c-nrpp.ca or www.takeactiononradon.ca.

For more information visit The Lung Association – Ontario radon website at www.on.lung.ca/radon.

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