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Winter, 2010

GIP in Focus

Home Is Where the Asthma Triggers Are

Home may well be where the heart is, but it's also where an array of potential asthma triggers live, including: various by-products from (and pesticides used to eliminate) dust mites, cockroaches, and rodents; dandruff from pets; moisture that can lead to mold; tobacco smoke; and other things that can cause asthma to flare up.

The good news is that there is heightened awareness of how allergens and irritants in the home environment can trigger asthma symptoms.

“A growing body of evidence shows that reducing exposure to potential asthma triggers in the home is essential to helping manage the disease,” said James Krieger, M.D., M.P.H., Chief, Chronic Disease and Injury Prevention Section, Public Health - Seattle and King County, Washington.

Mold in petri dish
Household mold, as seen growing in this petri dish, is a potential asthma trigger.

As you may know, controlling environmental exposures that can make asthma worse is one of six key actions (known as Guidelines Implementation Panel—GIP—messages) that—when taken together—can help people control their asthma in partnership with their health care provider.

Dr. Krieger was a member of the team that helped create those six priority GIP messages: his research on the success of home visits by trained community health care workers, in helping identify and reduce asthma triggers, was one of several studies upon which the GIP message dedicated to reducing exposure to asthma triggers in the environment (home and otherwise) was based.

Krieger cites the following example of how the home environment can affect asthma: one-year-old Jose was waking up at night with asthma symptoms. As it turned out, Jose was allowed to sleep on the floor every so often. What his family didn’t know is that a combination of dust-mite allergens, fumes from the undiluted bleach used to clean the home, and fumes from a spray used to kill cockroaches, was triggering these nighttime asthma attacks.

This was coupled with the fact that his mother was not administering Jose’s medication properly.

After a community health worker helped teach the family about environmental triggers in the home, and how to administer the medications the right way, Jose’s condition improved so much that he went two months without a single asthma symptom.

Dr. Krieger states that two critical steps in helping children (and adults) like Jose are for providers and home health workers to work jointly to do the following:

  • Spend more time with asthma patients, to institute and follow the GIP actions and the science-based asthma guidelines from which they stem.
  • Conduct home visits, in order to build the kinds of trusting relationships that are needed to help families reduce exposure to triggers, use medications and devices correctly, learn how to take action when asthma gets worse, and secure good care from the health care system.

Dr. Krieger notes that these actions are especially important in communities where the greatest disparities and highest asthma burden exist.

Last Updated December 2010