Have you recently experienced exacerbated asthmatic symptoms due to the backburning in Sydney? Or perhaps you've found yourself sneezing more often as we transition further into spring? Unsurprisingly, air quality plays a significant role in triggering asthma and allergy flare-ups. Common triggers can range from smoke and pollutants to seasonal culprits like pollen. Additionally, certain events like backburning, bushfires, and even thunderstorms can amplify these triggers. For those living in Australia who grapple with allergic rhinitis and asthma, it's not uncommon to notice a heightened response to some specific environment factors. Therefore, it's important to understand the underlying causes of these exacerbations, as well as the best treatment options and lifestyle measures to alleviate these symptoms. In this article, we'll delve deeper into these areas, ensuring you're equipped with knowledge and strategies for better respiratory health during challenging periods.
Defining Asthma and Allergic Rhinitis
Asthma is primarily defined by its chronic inflammation and constriction of the airways. Various factors can trigger asthma: allergies are a frequent culprit, but it can also be prompted by common colds, viral infections, exercise, cold air, stress, and even episodes of laughter.
Allergic rhinitis, commonly known as 'hay fever', is the body's heightened response to environmental allergens like pollen and mould spores. For those with allergic rhinitis, their immune system inaccurately perceives harmless substances as threats. This prompts the release of histamines and other chemicals, which then lead to the hallmark symptoms of allergies: sneezing, nasal congestion, and itchy eyes.
While asthma and allergic rhinitis are distinct conditions, their symptoms often overlap. Especially when triggered by environmental allergens, effectively managing allergic symptoms can also aid in reducing asthma exacerbations.
The relationship between allergic rhinitis (AR) and asthma is notably significant. For context, studies show that among individuals diagnosed with allergic rhinitis, nearly 38% also suffer from asthma. Furthermore, a staggering 85% of asthma patients display symptoms of AR (Acevedo-Prado et al., 2022). It's crucial to understand that subpar management of allergic rhinitis can intensify asthma symptoms, potentially leading to uncontrolled asthma and increasing the risk of severe attacks (Scadding et al., 2017).
The Effects of Backburning and Bushfires on Asthma
Bushfire smoke, emanating from burning forests, trees, and grass, comprises various substances including ash, gases, and small particulates. Notably, the presence of extremely fine particles, invisible to the naked eye, poses significant health risks as they can be deeply inhaled into the lungs.
Recently, numerous hazard reduction burns, commonly referred to as backburning, have been conducted in NSW, including the Greater Sydney Area. Backburning reduces available bushfire fuel to mitigate the severity of potential fires, which aids asthma sufferers by diminishing wildfire hazards. However, this can also have an immediate impact on asthma sufferers as smoke from these burns frequently drifts across residential zones, especially during late afternoons and evenings. Residents closer to these burns can sometimes find themselves enveloped in heavy smoke conditions.
The composition of bushfire smoke includes toxic gases such as carbon monoxide and nitrogen oxide, coupled with hazardous particles. The impact of these substances varies based on individual pre-existing health conditions and the duration and density of exposure to compromised air quality. Common symptoms comprise itchy eyes, sore throat, runny nose, and coughing. Yet, for the more vulnerable demographics – children, the elderly, smokers, and those with heart or lung ailments (including asthma) – the repercussions can be graver, including wheezing, chest tightness, and difficulty in breathing.
Tips to Safeguard Your Health from Bushfire Smoke
- Stay Indoors and Minimise Outdoor Activity: Especially for those with heart or lung issues, it's best to rest and avoid exposure to smoke.
- Seal Your Home: Keep windows and doors shut.
- Optimise Indoor Air Quality: If you own an air conditioner, set it to 'recycle' or 'recirculate'. Consider using an air purifier equipped with a HEPA filter to further decrease indoor smoke concentrations.
- Use Masks When Necessary: If outdoor activity is unavoidable during peak smoke periods, N95 facemasks fit snugly over the nose and mouth and reduce exposure
- Avoid Additional Indoor Pollutants: Refrain from activities like smoking cigarettes or using wood stoves, which contribute to indoor air pollution.
- Ventilate When Possible: If there's a respite from the smoke, seize the opportunity to air out your home and enhance indoor air quality.
Understanding the Pollen Impact
Pollen consists of fine grains released by grasses, weeds, and trees, which play a pivotal role in the fertilisation of other plants. These microscopic particles are dispersed far and wide by agents such as insects, birds, and notably, the wind.
For individuals with allergic rhinitis, the presence of pollen can induce a host of symptoms. Common reactions include sneezing, nasal congestion, and itchy eyes. However, the pollen can also enter the lungs and trigger asthma symptoms.
The concentration of pollen in the atmosphere is influenced by both seasonal variations and geographical location. For instance, cities like Brisbane and Darwin often experience high pollen throughout the year. In contrast, cities such as Sydney and Canberra tend to hit peak levels primarily during Spring and Summer. For a comprehensive understanding of the pollen seasons across Australia's diverse regions, the Australasian Society of Clinical Immunology and Allergy (ASCIA) offers an informative calendar. This tool provides insights into the flowering times of plants known to produce allergenic pollen throughout the various states.
Thunderstorm Asthma
At Zenith Pharmacy, we prepare ourselves to offer timely medication and guidance for asthma and allergy sufferers, especially during periods identified as high-risk events. Among these critical times is the Thunderstorm Asthma season, typically spanning from October to December, when patients face an elevated risk of thunderstorm-induced asthma.
Recall the major epidemic in Victoria back in 2016, which tragically resulted in 10 deaths and hundreds of hospital admissions. Such asthma episodes were provoked in allergic individuals who inhaled air containing an elevated concentration of pollen allergens during thunderstorms. Current understanding points to a lethal mix of surging pollen counts, notably from ryegrass, and the powerful winds characteristic of storms. The situation is further exacerbated by lightning, which breaks down pollen into even finer particles, enabling them to penetrate deeper into one's lungs. A noteworthy risk factor during these events includes individuals with poorly managed asthma, and those unaware of the potential severity of their condition—some might not even realise they have asthma at all.
Those particularly susceptible to acute asthma exacerbations during a thunderstorm include individuals with allergic rhinitis (especially those allergic to grass pollen), those with a documented history of asthma and those with non-diagnosed asthma. When faced with such high-risk conditions, thorough treatment and management become paramount. In the sections to follow, we will delve into key treatments and preventive measures to adopt during such high-risk events, whether they be bushfires, thunderstorms, or the standard allergy season.
Treatment Options & Advice
For those who suffer from allergic rhinitis during allergy seasons or specific events like bushfires and storms, common remedies include antihistamines, decongestants for short-term use, and corticosteroids. These treatments can alleviate inflammation and nasal congestion, addressing many standard allergy symptoms.
However, it's crucial to remain vigilant about your symptoms, and identify whether there might be an underlying need for asthma-targeted treatments. Recognising the link between your hay fever and potential asthma, or even the risk of developing asthma, is paramount. In our pharmacy, we frequently encounter patients who, while having never been diagnosed with asthma or only acknowledging it as a mild condition, find themselves sufferingfrom severe symptoms during high-risk seasons. The concerning reality is that many individuals exhibit poor asthma control. When you factor in the heightened risks from triggers such as thunderstorms on top of poor management or lack of diagnosis, the situation can lead tosevere asthma episodes.
Being armed with the right knowledge, preventive measures, medication, and technique is imperative, especially during intense allergy periods. We place significant emphasis on understanding the risks associated with thunderstorm asthma, mastering proper avoidance strategies, being proficient in asthma first aid, and ensuring good asthma control, which includes knowing how to use your inhaler correctly.
For those at risk, the importance of using inhalers effectively can't be stressed enough. Inhalers can only deliver medication to the lungs effectively when used with the correct technique. Improper use of an inhaler results in minimal to no medication reaching the lungs. If there's any uncertainty surrounding inhaler usage, or for queries about spacers and other asthma medications, we ardently recommend a consultation with a pharmacist or reaching out to knowledgeable resources online.
Moreover, patients, whether they've had past episodes, currently suffer, or are undiagnosed with asthma, or those with allergic rhinitis, must be particularly cautious.
Recommended precautions include:
- Avoiding direct exposure to storms, especially the initial wind gusts that precede them.
- Always having a reliever on hand and consistently taking preventive medicines as prescribed.
- Regularly reviewing their asthma action plan.
- Being familiar and proficient with the four essential steps of asthma first aid.
Home & Everyday Advice + Trigger Prevention
Another crucial aspect of asthma and allergy control is reducing exposure to triggers. Here are some simple precautions that can help minimise susceptibility during high-risk seasons:
- Stay Updated on Pollen Levels: Regularly check the pollen forecast and exercise increased caution on high pollen days.
- Medication: Ensure you use preventer medicines as directed and always have your asthma reliever at hand.
- Limit Grass Exposure:
- Avoid mowing the grass yourself and remain indoors when someone else is mowing.
- If mowing is unavoidable, wear a mask and consider taking a non-drowsy antihistamine beforehand.
- Garden Wisely: Opt for low-allergen plants that attract birds or insects for pollination, reducing airborne pollen.
- Limit Outdoor Activities: Ideally, stay indoors, particularly on windy days or following thunderstorms which can elevate pollen counts.
- Vehicle Precautions: When driving, keep car windows shut and use the recirculating setting for your air conditioning.
- Maintain closed windows to prevent pollen from entering.Think about investing in an air purifier to further reduce indoor pollen levels.
- Laundry Considerations: Refrain from using an outdoor clothesline for drying as airborne pollen can settle on garments.
- Personal Hygiene: Rinse off or wash your hair before bed, preventing transferred pollen from causing night-time allergy flare-ups.
Adhering to these tips can significantly reduce your exposure to spring allergens, making the season more enjoyable and symptom-free.
Conclusion
Environmental factors, including backburning, bushfires, and seasonal changes, profoundly impact those with asthma and allergic rhinitis. The intertwined nature of these conditions requires heightened awareness and management, especially given the potential dangers of bushfire smoke and seasonal allergens like pollen. Events such as thunderstorms further escalate risks. Effective treatment, proper inhaler usage, and preventive measures are essential for safeguarding respiratory health. We encourage those who are vulnerable to asthma and allergies to stay informed and proactive, especially during high-risk periods.
References
Acevedo-Prado, A., Seoane-Pillado, T., López-Silvarrey-Varela, A., Salgado, F.-J., Cruz, M.-J., Faraldo-Garcia, A., Nieto-Fontarigo, J.-J., Pértega-Díaz, S., Sanchez-Lastres, J., San-José-González, M.-A., Bamonde-Rodríguez, L., Garnelo-Suárez, L., Pérez-Castro, T., Sampedro-Campos, M., & Gonzalez-Barcala, F.-J. (2022). Association of rhinitis with asthma prevalence and severity. Scientific Reports, 12(1). https://doi.org/10.1038/s41598-022-10448-w
Scadding, G. K., Kariyawasam, H. H., Scadding, G., Mirakian, R., Buckley, R. J., Dixon, T., Durham, S. R., Farooque, S., Jones, N., Leech, S., Nasser, S. M., Powell, R., Roberts, G., Rotiroti, G., Simpson, A., Smith, H., & Clark, A. T. (2017). BSACI guideline for the diagnosis and management of allergic and non-allergic rhinitis (Revised Edition 2017; First edition 2007). Clinical & Experimental Allergy, 47(7), 856–889. https://doi.org/10.1111/cea.12953