Asthma explained

About asthma

Asthma causes the muscles in the airways to tighten and the lining of the airway becomes swollen and inflamed, producing sticky mucous. These changes cause the airways to become narrow, making it difficult to breathe.

Asthma can be triggered by a range of factors such as pollen, house dust mites, cigarette smoke, exercise or associated with a common cold.

Asthma cannot be cured, but with good management, people with asthma can lead normal, active lives. A range of programs and services are available to support people with asthma.

Symptoms of asthma

Asthma tends to run in families. Asthma affects everyone differently, and 2 children from the same family can have different asthma patterns and triggers.

Typical asthma symptoms include:

• wheezing – a whistling noise when breathing
• shortness of breath
• a tight feeling in the chest
• coughing.

These symptoms are often worse at night, in the early morning or during exercise.

Symptoms may be different for children. Find out more about asthma in children.

Asthma triggers

The triggers for asthma symptoms vary for different people. Some common triggers are:

• allergy triggers – such as house dust mites, pollens, pets and moulds
• cigarette smoke
• viral infections – for example, colds and flu
• cold air or changes in the weather
• work-related triggers – for example, wood dust, chemicals, metal salts
• exercise
• some medication.

In addition, asthma can also be triggered by a combination of high grass pollen levels and a certain type of thunderstorm, causing many people to develop asthma symptoms over a short period of time. This is known as thunderstorm asthma.

These events are uncommon and don’t occur every year, but when they do, they can happen in south-east Australia during the grass pollen season, from October through December.

Thunderstorm asthma

For people with current or past asthma, allergic rhinitis or hay fever, thunderstorm asthma can be sudden, serious and even life threatening.

Having good control of your asthma and hay fever can help reduce your risk of thunderstorm asthma.

If you’ve ever had asthma, talk to your GP about what you can do to help protect yourself from the risk of thunderstorm asthma this pollen season.

Watch our series of videos on thunderstorm asthma.

Diagnosis of asthma

There is no single test for asthma.

Doctors make the diagnosis of asthma when a person has breathing symptoms typical of asthma that come and go, and there is also evidence that sometimes air does not flow in and out of their lungs normally.

How well the lungs work (lung function) is tested using a spirometer machine.

Spirometry measures the amount of air you can breathe in and out of your lungs, and how hard and fast you can breathe out. You blow into a tube as forcefully as you can for a few seconds. The spirometer measures the amount of air pushed through the tube, as well as lung capacity and other measurements.

Most adults and children over 6 years of age can do the spirometry test correctly.

Treatment for asthma

Asthma can be well controlled with the appropriate medication in most people. The main types of medications used to control asthma are:

• Relievers – that act quickly to relax the muscles around the airways. This is the medication used during an asthma attack.
• Preventers – that slowly make the airways less sensitive to triggers and reduce inflammation inside the airways. They are taken daily to help keep you well.
• Combination therapies – that are preventers containing 2 or 3 different medicines.
• Add-on medications – that help manage severe asthma. This includes monoclonal antibodies.

Management of asthma

Your GP will prescribe the correct medication and explain how to use it. For good asthma management, it is important that you:

• See your GP for regular check-ups and work together to manage your asthma.
• Understand what triggers your asthma – this can be different for everyone.
• Try to avoid or reduce your exposure to these triggers.
• Use your medications as instructed by your GP, even when you feel well.
• Make sure you are using your inhaler correctly, including using a spacer and mask where required.
• Follow your written asthma action plan.

Ask your GP for a personal written asthma action plan. As well as being a reminder of your usual treatment, an action plan helps you to recognise worsening asthma and tells you what to do in response.

If your child has asthma, give copies of the asthma action plan to the school and to anyone else who regularly looks after your child.

Watch this video to learn more about good asthma management from the National Asthma Council Australia.

What to do during an asthma attack or flare-up

An asthma attack can come on gradually (for example, if a person gets a cold) or quite quickly (for example, if a person inhales something they are allergic to, such as pollen).

The symptoms to look out for include:

• increased wheezing, shortness of breath, chest tightness and coughing
• needing to use a reliever again within 3 hours of last taking it
• unable to talk in full sentences
• waking often at night with asthma symptoms.

An asthma attack can become life threatening if not treated properly, even in someone whose asthma is usually mild or well controlled.

If someone is getting an asthma attack, follow the instructions in their asthma action plan. If they don’t have an asthma action plan or you aren’t sure what to do, follow the 4 steps of asthma first aid.

Always call an ambulance in an asthma emergency

In an emergency, always call triple zero (000) and ask for an ambulance. Tell the operator that someone is having an asthma attack. The signs of an asthma emergency include when the person:

• finds it very difficult to breathe
• is unable to speak in sentences or only speaks one or 2 words per breath
• has lips that are turning blue
• has symptoms that get worse very quickly
• is getting little or no relief from their reliever inhaler.

While waiting for the ambulance, continue to follow the 4 steps of asthma first aid and give 4 puffs of reliever medication every 4 minutes.

Asthma in Australia

Some other facts about asthma in Australia include:

• Asthma is one of the most common reasons for admission to hospital for children.
• Asthma is more common among boys than girls in primary school age children.
• After the teenage years, more women have asthma than men.
• Asthma is more common among Indigenous Australians, particularly adults, than among other Australians.
• People with asthma commonly have other allergic conditions like eczema or hay fever.
• People with asthma report poorer general health and quality of life than people without asthma.
• Thunderstorm asthma events are uncommon and don’t occur every year. In south-east Australia they can happen during grass pollen season from October through December.

National asthma management strategies

Asthma is a national health priority in Australia. Strategies to monitor and manage asthma in Australia include:

• Asthma first aid – information about how to obtain prompt medical assistance in an emergency.
• Asthma Australia – provides a range of asthma-related programs and activities, and conducts asthma first aid training. It also delivers the Asthma Child and Adolescent Program and the Community Support Program.
• Australian Centre for Airways disease Monitoring (ACAM) – monitors and reports on airways disease (asthma and chronic obstructive pulmonary disease) in Australia.
• National Asthma Council Australia – works with health professionals to improve health outcomes for people with asthma and provides a range of information for the community.

Where to get help

• In an emergency, always call triple zero (000)
• Emergency department of your nearest hospital
• Your GP (doctor)
• Your nearest pharmacy (for medication)
• The Royal Children's Hospital Melbourne – videos to help you better understand and manage your child's asthma
• NURSE-ON-CALL Tel. 1300 60 60 24 – for expert health information and advice (24 hours, 7 days)
• National Home Doctor Service Tel. 13 SICK (13 7425) – for after-hours home GP visits (bulked billed)
• National Asthma Council Australia – for videos, resources, facts sheets, asthma action plans and asthma first aid
• Asthma Australia Tel. 1800 ASTHMA (1800 278 462)
• Asthma Australia Asthma App – asthma information, asthma medication and devices, device technique videos, asthma action plans and asthma first aid steps
• Severe Asthma Toolkit – an evidence-based website developed by clinicians for clinicians, led by the Centre of Excellence in Severe Asthma. It provides educational content on topics relevant to severe asthma and practical resources and tools to guide optimal asthma management by health care professionals