By: Kelli W. Williams, MD, MPH, FAAP, FAAAAI
Asthma is the most common chronic disease affecting children worldwide. About 1 in 12 U.S. children have asthma, according to the U.S. Centers for Disease Control and Prevention.
There is no cure for asthma, but there are ways to
control it. If your child has asthma, it is likely that one of the nine things listed here may cause it to flare up. These are called asthma triggers. Here is what you should know about asthma triggers and how to avoid them.
1. Viral infections
One of the most common triggers for an asthma flare is a viral respiratory infection. Any virus can cause an asthma flare. The most frequent is
rhinovirus—the virus that causes the common cold. Other viruses linked to asthma flares are respiratory syncytial virus (RSV), influenza (flu) and
parainfluenza infections.
Children who have an asthma flare caused by one of these viruses also have a harder time managing symptoms with their usual
treatment. This is called
treatment failure, and is often linked to hospitalization, emergency room visits, or relapse.
2. Tobacco & other pollutants
Pollutants can irritate the lungs and increase airway inflammation.
Tobacco smoke is especially damaging to the lungs and can trigger asthma flares. Children who are exposed to
environmental tobacco smoke have more wheezing, more severe asthma, and longer lasting symptoms. Other pollutants and lung irritants can cause asthma flares. These asthma triggers include ozone (smog), fragrances,
cleaning products, and chemicals.
What to do
Children with asthma should avoid being around tobacco smoke, including
secondhand and
thirdhand exposure. Consider using unscented products and try to ensure good ventilation when using cleaning chemicals.
3. Indoor allergens
Asthma flares from indoor allergens are common in children with
allergies. These allergens include
dust mites, cockroaches, mice, and pet dander. They can trigger asthma flares year-round, and mostly are found in the home and in schools.
What to do
To control asthma, parents should control their child's exposure to the allergens. Solutions include using allergy-proof covers on bedding and washing bedding weekly in hot water to get rid of dust mites. A dehumidifier can also minimize indoor mold and mildew growth.
4. Outdoor allergens
Seasonal exposure to outdoor allergens can also trigger asthma exacerbations.
Pollens and molds are the most common outdoor allergens. Pollens include trees, grasses, and weeds.
Pollen seasons vary based on where you live. Most tree pollens shed in the spring, grasses in the summer, and weeds in the fall. Mold exposure can vary depending on the humidity and rain. Alternaria, a common outdoor mold, can make asthma symptoms worse.
What to do
Like indoor allergens, the goal is to decrease your child's exposure to prevent asthma flares. If you know pollen is a trigger, it may help your child to wash off the pollen after being outside. For example, a grass-allergic child should bathe after playing soccer in the grass. Keeping windows closed during peak pollen seasons can also help reduce exposure.
5. Furry animals
Household pets are a common indoor allergen and trigger for asthma flares.
Cat and dog allergies are the most common, but hamsters, gerbils, and rabbits can also cause symptoms. The allergens can be found in the pet's dander (skin), saliva (drool), and urine.
What to do
If your child has a
pet allergy, strict avoidance of the animal is recommended. The home should be thoroughly cleaned if a pet previously lived there. A high-efficiency particulate air (HEPA) filter also can help.
6. Cold air & changing weather
Cold and dry air can be irritating to the lungs, cause airway inflammation and trigger asthma flares. This can happen on a cold weather day or even after exposure to a cold air conditioner. Sudden temperature changes can also trigger an airway spasm and worsen asthma.
What to do
Talk with your child's pediatrician or asthma doctor if your child is having weather-related flares to disuss adjusting medications.
7. Exercise
When they
exercise, many people with asthma develop cough, wheezing, chest tightness and shortness of breath. Symptoms can start 5-20 minutes after exercising and be very intense. They may get better with rest or require rescue albuterol to bring relief.
What to do
Some children with asthma need to take albuterol 20-30 minutes before activity to prevent an exercise-related flare. If your child frequently has asthma symptoms with exercise, talk with your pediatrician.
8. Insects
Children who have asthma and are allergic to insects are at increased risk for an asthma flare after a sting. The kinds of insects that cause symptoms typically are flying venomous insects (like honey bees, wasps, hornets, or yellow jackets) and fire ants. Asthma symptoms develop very quickly after a sting.
What to do
Sometimes, children need additional allergy medications to treat the reaction, including epinephrine and/or antihistamines. Children with asthma symptoms after an insect sting should see an allergist for evaluation.
9. Stress
Stress and anxiety can sometimes increase airway inflammation and trigger asthma symptoms. Children with asthma are increased risk for asthma attacks after a difficult life event (such as during the
COVID-19 pandemic or after the
death of a family member).
What to do
Don't hesitate to talk with your pediatrician if you are concerned about how
stress and anxiety is affecting your child's health and well-being, and ways to help build
resilience.
Remember
Keeping your child away from asthma triggers can help prevent flare-ups. It can protect your child's airway from being inflamed and keep it from overreacting. This can reduce how often, how long and how severe your child's asthma symptoms are and improve your child's quality of life. Talk with your child's pediatrician if you have any questions about controlling your child's asthma.
More information
About Dr. Williams
Kelli W. Williams, MD, MPH, FAAP, FAAAAI, is a member of the American Academy of Pediatrics (AAP) Section on Allergy and Immunology, AAP Section on Early Career Physicians, American Academy of Allergy Asthma and Immunology and Clinical Immunology Society. She is an Assistant Professor of Pediatrics and the Medical Director of Pediatric Ambulatory Infusion at the Medical University of South Carolina.