Environmental Issues in Managing Asthma

This paper summarizes available evidence on the current practices for managing environmental issues with patients who have asthma and highlights many of the recommendations of the National Asthma Education and Prevention Program’s Expert Panel Report 3 (NAEPP), Guidelines for the Diagnosis and Management of Asthma.

Full reference of the article: Diette GB, McCormack MC, Hansel NN, Breysse PN, Matsui EC. Environmental issues in managing asthma. Respir Care. 2008 May;53(5):602-15; discussion 616-7. PMID: 18426614; PMCID: PMC2396450.

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Full Article Summary

Environmental control practices are a sensible, evidence-based component of the overall management of asthma. Control of the environment requires attention to exposures that originate from both the outdoor and indoor environments. The indoor environment notably contains particulate matter, NO2, secondhand smoke, and O3, and allergens from furred pets, dust mites, cockroach, rodents, and molds.

The 2007 NAEPP guidelines recommend eliminating indoor smoking and improving ventilation. The guidelines are more specific about allergen avoidance; they recommend identifying allergens to which an individual is immunoglobin E sensitized. Further, the guidelines emphasize multifaceted, comprehensive strategies to reduce exposure.

Outdoor air pollutants can impact asthma, and guidelines recommend that individuals with asthma avoid exertion outdoors when concentrations of certain pollutants are elevated. Outdoor allergens include tree, grass, and weed pollens, which vary in concentration by season. Recommendations to reduce exposure also include keeping windows and doors closed, using air conditioning, and perhaps HEPA room-air filters, as well as thorough daily washing to remove allergens from one’s person.

Though there are still considerable research opportunities to identify additional means to improve the environment for the sake of asthma health, research to date has shown that careful attention to these specific environmental controls can improve the health of people with asthma.

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