For the more than 260 million people living with asthma worldwide, a good day and a bad day can depend on something as ordinary as making the bed, stepping outside, or walking past a colleague wearing perfume. Asthma is not simply a condition you are born with and carry quietly, on the other hand it is a dynamic, responsive disease, and the world around us is full of things that can trigger a crisis.
This World Asthma Day reminds us that treatment of asthma starts with understanding what provokes it. Triggers are not the same as causes, but they are powerful. Knowing yours could keep you away from the emergency department.
The Air Inside Your Home
It is a common misconception that staying indoors protects you. In reality, indoor air can be hostile to asthmatic airways just as anything outside.
Dust mites are among the most widespread triggers globally. These microscopic creatures thrive in mattresses, pillows, carpets, and soft furnishings, and it is their faecal particles — not the mites themselves — that inflame airways when inhaled. Regular hot washing of bedding, allergen-proof mattress covers, and reducing soft furnishings can make a difference.
Pet dander (especially of dogs and cats) is another indoor villain. Contrary to popular belief, it is not pet hair, but the proteins in animal skin flakes, saliva, and urine that sensitise airways. Even "hypoallergenic" breeds produce dander. If rehoming a pet is not an option, keeping animals out of the bedroom and using HEPA air filters can be of help.
Mould spores, often invisible to the naked eye, release allergens that are powerful asthma triggers. They thrive in bathrooms, kitchen, damp walls and any area with poor ventilation or water damage. Treating mould promptly and maintaining indoor humidity below 50% is advisable.
Tobacco smoke and cooking fumes — whether from gas hobs or wood-burning stoves ,are irritants that can trigger attacks even in those without allergy.
The World Outside
Step outdoors, and a different set of challenges awaits.
Pollen from trees, grass, and weeds is a seasonal but powerful trigger, with climate change, extending pollen seasons and increasing pollen concentrations year on year. Checking daily pollen forecasts and taking preventive medication before high-pollen days is a practical step.
Air pollution — People who live in cities, especially those living next to roads that experience heavy traffic congestion, face a high risk of exposure to air pollution, more specifically PM2.5 particles and ozone. Air pollution is known for causing inflammation of the airways as well as increasing sensitivity to allergens.
Weather changes can be surprisingly potent. Cold, dry air causes airways to constrict. Thunderstorms are particularly dangerous — a phenomenon called thunderstorm asthma occurs when storms rupture pollen grains into far smaller, deeply inhalable particles, occasionally causing mass casualty events. Sudden drops in temperature and high winds can all provoke symptoms.
Other Common Triggers
Exercise, viral respiratory infections, stress, non-steroidal anti-inflammatory drugs such as ibuprofen, and strong fragrances — from perfumes to cleaning products — round out the list of everyday hazards many people with asthma navigate without realising.
Region-Specific Triggers
India’s tropical climate amplifies asthma woes. High humidity in coastal areas fosters mould and house dust mites in homes, especially during monsoon, triggering attacks. Indoor dust exposure, presence of cockroaches, having pet dogs and cats also are triggers for asthma not getting controlled adequately. In high rise buildings and apartments, pigeons are a major source of allergy. Lush greenery releases pollen from coconut palms and rubber trees, while urban pollution in cities irritates airways. The cold winter and added air pollution in the northern parts of the country are major triggers for uncontrolled asthma.
Smoke from cooking with firewood and other biomass fuels, common in rural areas, and sudden weather shifts add to the burden.
Know Your Triggers. Own Your Asthma.
No two people with asthma have identical triggers.Consult your doctor to identify and document your personal trigger profile . Ensure that your preventer inhaler is taken consistently and not just during attacks, which remains the cornerstone of good asthma control.
This World Asthma Day, take a moment to audit your environment. The trigger that disrupts your next night's sleep may already be in your bedroom.
World Asthma Day is organised annually by the Global Initiative for Asthma (GINA) on the first Tuesday of May.
Disclaimer: The views expressed in this article are of the author and not of Health Dialogues. The Editorial/Content team of Health Dialogues has not contributed to the writing/editing/packaging of this article.