Asthma prevention: some tips.
The prevalence of asthma has increased all over the world. It is estimated that approximately 40% of the population has the genetic make-up to develop asthma. As many as 5% of the infants show the evidence of asthma soon after birth, 19% have symptoms by one year of age and 20% by the age of five years. One out of 20 children, as per hospital records, is asthmatic today whereas two years back it was one out of 40. The actual incidence in the community must be much more than that in the hospital records. Until a decade ago, there was low prevalence of asthma but in the past few years it is increasing alarmingly. In a study, asthma accounted for 30% of the total respiratory tract diseases in children. New effective methods for treatment are being discovered with the hope of cure but preventing asthma is more important. Asthma prevention falls into two categories.
Primary — Preventing the initial development of asthma in susceptible people.
Secondary — Preventing exacerbation in patients who have developed asthma.
Most of asthma originates in childhood and is associated with allergy. When an infant is exposed to an allergen, there is the production of THI cells and TH2 cells with the dominance of the first, leading to tolerance in the normal infant. However, in infants with a genetic predisposition to asthma, TH2 cells dominate, and tolerance to allergens cannot be established. Primary prevention aims at reducing the factors that may prevent the establishment of THI (tolerance-producing) cells in the perinatal period and infancy. These are:—
Avoidance of maternal smoking.
Delaying the introduction of salt, pulses eggs and allergen food in infants with the family history of allergies.
Reducing the environmental allergen load. (Don’t use talcum powder, fragrant soaps, perfumes and other unnecessary articles for the baby).
Avoid fixed carpets. If it is unavoidable, clean it by a vacuum cleaner.
Reduce soft furnishing. Don’t use soft toys.
Encourage ventilation and sun.
Frequently, place the bedding in sun.
Avoid smoking, room freshners agarbattis anti-mosquito coils and other fumes.
Use light-weight curtains. Wash them every fortnight.
Prefer window shades made of cotton to Venetian the blinds.
Avoid keeping pets in the bedroom at night. Bathe the pet every week with a shampoo.
Close the windows at night since night air carries much pollen.
Put mattresses and pillows in plastic casing; wash the bedding every week with hot water.
Repair plumbing leaks to check mould growth.
Check the refrigerator and throw the unused food away biweekly at least.
Seal dry grain, flour, rice and other stored food. Keep the storage area dry and clean.
Use damp cloth to dust.
Inside a car
Avoid parking under a tree.
Use the recirculating mode on airconditioners or heaters while travelling.
Avoid car perfume and smoking in the vehicle.
Wash your hands after gardening or handling animals to avoid rubbing allergens into the eyes or the nasal mucosa.
Perform exercises like walking at normal speed and deep breathing.
Wash sports equipment to prevent mould growth.
The early morning and late night air carries more pollens. Plan outdoor activities at other times.
It has been well established that food can affect asthma. Fatty acids particularly can have an adverse effect. Omega 3 fatty acids like fish oil, butter and monounsaturated oils are important in inflammation control.
Omega 6 fatty acids such as those in sunflower oil, margarine and polyunsaturated oils are proinflammatory and should be avoided. It is also prudent not to avoid food on presumptions alone as all nutrients are needed for growth.
In future, it will be possible to identify infants at risk based upon the genetic profile. The immune response may be modulated so that an infant develops a good THI response and becomes tolerant to the environment.