Do you have an allergy or asthma? Identifying triggers is a key step in avoiding attacks. Here is a rundown on causes, symptoms and remedies

VFW Magazine, August, 2003 by Norman Brown

The sneezing and sniffling that millions suffer may come to a close when ragweed season ends in September. But for many others who suffer from allergies or asthma, the symptoms can last year round. And attacks can vary from mild to severe and last a few hours, several days or longer.

Nearly 36 million of us suffer from seasonal allergic rhinitis, or hay fever, which causes more than 8 million physician visits yearly for various troublesome symptoms.

But allergies can develop at any time of the year, and pollens are not the only offenders. Molds, dust mites and animal dander also can trigger an allergic reaction indoors. And so can other irritants in the environment (smoke, chemicals, ozone).

"The numbers afflicted by rhinitis, sinusitis, asthma and other allergic diseases are mounting," says Dr. Eugene Bleecker, director of the Center for Genetics of Asthma and Complex Diseases at the University of Maryland. "And the key may be hidden in our bodies or lurking in the air we breathe. But for now, the best medicine is still awareness and action."

Symptoms & Causes

As annoying as watery eyes and a runny nose can be, both seasonal and year-round allergies can potentially have a far more serious effect. They can trigger asthmatic symptoms if you already have asthma, including coughing, wheezing and shortness of breath due to narrowing airways and inflammation.

An allergy is simply an overreaction to something the body views as an invader. When an allergen enters the body, the immune system initiates a chain reaction to protect itself. White blood cells produce antibodies, which cause the release of chemicals such as histamine that produce the classic allergy symptoms.

"Both indoor and outdoor air play a role," says Dr. Bleecker, who notes that the symptoms of allergy, and its sister disease asthma, increase along with the number of triggers. The number of people who have asthma also is soaring; those over 50 are most at risk. According to the American Lung Association, 17 million Americans have asthma today--an increase of 40% since 1982.

Experts aren't sure why asthma is on the rise. But they speculate that air pollution, airtight homes and sealed offices may be prime culprits because these buildings may carry a heavy load of dust mites, carpet fumes, mold and other irritants. Also blamed: secondhand smoke, viral infections and some medications.

Controlling Irritants

In a susceptible person, any of these irritants can trigger an attack. But allergies are often mistaken for colds because the symptoms are similar: nasal discharge, watery eyes and a sore throat. Allergies also cause itching of the nose, eyes or skin with repeated sneezing. There is usually no fever, and symptoms can last for weeks or months.

If your doctor orders skin tests, ask if you need to stop taking any medications. Antihistamines, in particular, can interfere with test results. And if you're allergic to a drug such as penicillin, aspirin or sulfa, wear a metal bracelet that identifies your allergy. Then you can go after the most common triggers:

Pollen. Avoid walks through woods and fields, keep windows shut when pollen counts are high, and exercise outdoors late in the day when there is less pollen in the air.

Dust mites. Wash bedding once a week and use allergy-free pillow and mattress covers. Vacuum and shampoo carpets regularly, dust with a damp cloth and wet-mop floors.

Pet dander. Keep pets out of your bedroom and off furniture. Bathe your pet frequently, ventilate the house as often as possible and use an efficient air filter for shedding.

Molds. Empty garbage bags daily and clean bathtubs and refrigerators with a fungicide. Keep levels of molds and other allergens low with a dehumidifier--below 50% to discourage growth.

Chemicals. Avoid scented tissues, and use special soaps, cosmetics and detergents whenever possible. Wear a nasal mask when using cleaning products.

The worst thing you can do is adopt a wait-and-see attitude. The more aggressive the treatment, the better the outcome. Use green plants to purify household air, humidifiers to lubricate airways and vaporizers if an attack has begun.

Asthma and Exercise

If you cough or wheeze during workouts, you may have exercise-induced asthma. You should get a doctor's advice on the problem, but the situation in general is very manageable. "Warm-ups and cool-downs are crucial," says Dr. Norman Edelman, consultant to the American Lung Association.

They decrease the possibility of suffering an attack during or after exercise. Just 10 minutes of light aerobics or stretching will decrease the bodily changes that can cause narrowing of the airways and bronchial muscles.

Walking, golf and weight training are less likely to result in exercise-induced asthma because they are less disruptive to the airways. By contrast, running, skiing and swimming require deep, rapid breathing for extended periods and are more likely to cause asthma attacks.

Dr. Edelman advises patients to avoid exercising in cold, dry air (indoors or outdoors), when air pollution (ozone) or pollen levels are high, in very dusty gyms and around people wearing perfumes or cosmetics. "Regular exercise increases overall fitness," he says, "and if undertaken appropriately, can be done without ever having an attack."