How to cope with asthma in the summer

Asthma in the summer

For many of the 5.4 million people in the UK affected by asthma, summer can be a particularly trying time.

Two thirds of those with the long-term breathing condition find air pollution triggers their symptoms, and allergies to pollen, such as grass pollen, can also cause an asthma attack. As many as 60% of people with asthma also suffer with hay fever.

Over the summer months, people with asthma are exposed to increased levels of pollen, air pollution and smoke from barbecues and cigarettes

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Asthma

Asthma is a common condition that affects the airways. The typical symptoms are wheeze, cough, chest tightness, and shortness of breath. Symptoms can range from mild to severe. Treatment usually works well to ease and prevent symptoms. Treatment is usually with inhalers. A typical person with asthma may take a preventer inhaler every day (to prevent symptoms developing) and use a reliever inhaler as and when needed (if symptoms flare up). This leaflet gives a general overview of asthma. There are other separate leaflets in this series.

by Dr Colin Tidy, MRCGP

What causes asthma in the summer?

Hay fever

People with asthma have airways that are more sensitive to allergens such as pollen. This is a top trigger for asthma attacks in summer, affecting an estimated 3.3 million people in the UK.

When someone with allergic asthma breathes in something they are allergic to - such as pollen from birch, oak and pine trees, as well as grasses and weeds - their airways become narrow and inflamed, leading to asthma symptoms.

High humidity and thunderstorms in summer trap these particles in the air for longer and break them into much smaller pieces, meaning they are inhaled much more deeply into people's lungs.

People with asthma who also have a pollen allergy not only experience classic hay fever symptoms, such as itchy eyes and a running nose, but are also at an increased risk of a life-threatening asthma attack.

Asthma + Lung UK found that people with asthma find hay fever disruptive to their work and that asthma has even caused teenagers to drop an exam grade.

"Both asthma and hay fever are caused by atopy - a tendency to allergies," explains GP Dr Clare Morrison. "Hay fever is when the lining of the nasal passageways is ultra-sensitive, and asthma is when the lining of the lung airways is affected.

"Those who suffer from both may get relief from taking antihistamines. It's important to keep the nose clear, as breathing through the nose, rather than the mouth, helps to filter out pollen and pollution that would otherwise get into the lungs.

"A steroid nasal spray, mentholated sweets, and steam inhalations with the addition of eucalyptus oil can help keep the nose clear. It's also important to blow the nose regularly and avoid sniffing."

Summer air pollution

It's not just hay fever-prone asthmatics who experience summer asthma flare ups. Non-allergic asthma in the summer can be made worse by the health effects of air pollution during warmer months.

Some types of air pollution are worse in summer, while others are worse in winter. Summertime heat-waves mean extreme heat and stagnant air, which helps tiny particles - such as dust, dirt, and smoke - enter your lungs more easily.

So, in hot weather inhaling irritants such as pollution from vehicles and factories can cause more irritation and inflammation in the airways. Common summer pastimes, like being around barbecue smoke and outdoor cigarette smoking, can make this worse if you have asthma.

The risk of wildfires in the UK grows as we experience more extreme heat and droughts during summer. Among the other safety risks, this creates another summer asthma trigger, as fires pollute the air with carbon monoxide.

Why are inhalers so important?

An asthma attack occurs when something triggers the muscles in their airways - the tubes that carry air in and out of your lungs - to tighten, causing sticky mucus to build up. This narrows the airways and makes it hard for people to breathe, leading to chest tightness, wheezing, coughing or waking at night with a cough.

Most people with asthma are prescribed two types of inhalers - a preventer inhaler which is usually brown, and a reliever inhaler which is usually blue. The preventer helps to reduce the sensitivity and inflammation in the airways, meaning sufferers are less likely to experience symptoms and have an asthma attack.

Preventer inhalers are a long-term treatment and taking them regularly as prescribed - usually every day - is the an important part of managing asthma.

Some people with asthma actually feel better during the summer months as there aren't as many cold and flu viruses going around. However, this may mean sufferers are less likely to take their preventer inhaler, which could make them more likely to react to their asthma triggers.

"I recommend that patients ensure they have sufficient reliever inhalers, usually salbutamol, but don't simply rely on increasing the usage of these," says Morrison. "If symptoms start to deteriorate, it's important to step up the use of preventer inhalers, containing steroids, to avoid problems escalating further.

"If in doubt see your GP or asthma nurse for a check-up and advice.

How can I control asthma in the summer?

A common-sense asthma action plan can help asthma in the summer by limiting sufferers' exposure to triggers like pollen and pollution.

1. Keep an eye on the weather forecast, particularly heat and humidity, as well as the pollen count - when it's high, try to stay indoors, particularly at the start and end of the day, when levels are higher, and keep windows closed.

2. Avoid parks and gardens - and take a shower and change your clothes when you get back indoors to wash away any pollen particles in your hair.

3. Dust regularly with a damp cloth to minimise pollen inside the house - use a vacuum cleaner that's efficient at blocking very fine particles.

4. Avoid drying clothes outside on high count days - as pollen particles can stick to clothes and sheets, which can make symptoms worse at night time.

5. Head out in the morning when the air quality is higher and pollution levels lower - if this isn't possible, try to stick to back streets where there are fewer cars, and try to avoid outdoor activities close to main roads.

For more information on managing your asthma triggers, visit Lung + Asthma UK.