A ëBreath-Takingí Illness ï Living With Asthma ï Rise of Asthma Rates Living With Asthma Asthma specialists recommend a few key steps toward getting triggers out of the house and away from lungs: ï If you have a dog or cat, talk to your doctor about how it might affect your asthma. If you canít possibly give up the pets, keep them away from bedrooms, especially rooms of the family members with asthma. ï Buy allergen-proof covers for mattresses, pillows, and box springs. Be sure to wash soft bedding every week in hot water. Purge the bedroom of feather pillows, down comforters and pillows more than five years old. ï Do not smoke or permit smoking in your home. ï Damp mop and vacuum carpets at least once a week. Try to limit the number of "dust catchers" in your bedroom, like blinds, bookshelves, canopies, difficult-to-launder drapes and chenille bedspreads. ï As much as possible, reduce exposure to household sprays, such as hair spray, deodorants and room deodorizers, spray cleansers and polish es and solvents. ï Certain foods and beverages can induce asthma attacks, with wine identified as the most common trigger. If you notice asthma symptoms more frequently after drinking alcohol or eating certain foods, stay away from them and see if the symptoms subside. A ëBreath-Takingí Illness Experts Try to Understand Rise of Asthma Rates Around World by Gina Shaw Asthma rates continue to skyrocket all over the world. The World Health Organization estimates that between 100 million and 150 million people around the globeómany of them childrenósuffer from asthma, a disease characterized by coughing, wheezing, tightness in the chest and difficulty breathing. The prevalence of the disease in Western Europe has doubled over the past 10 years. And although the number of Americans with asthma is up a startling 75 percent since 1980, over the past two decades the rate of asthma in children younger than 5 years old has jumped by 160 percent. India has approximately 15 million to 20 million asthmatics, and the rate of asthma in African countries ranges from 11 percent in Kenya to 18 percent in Nigeria. Asthma and chronic bronchitis are the most common and most significant airway diseases in Africa. This "breathtaking" disease can be a killer: Deaths from asthma have reached more than 180,000 worldwide. Whatís causing this alarming increase, and what can be done about it? The answer to the first question still puzzles scientists and researchers. Itís been called one of the greatest mysteries in modern medicine. Doctors once thought that air pollution might be a major factor in the exploding asthma epidemic, but it seems that the answer is more complex. Some places with extremely clean air, such as New Zealand, have very high rates of asthma. When researchers at the University Childrenís Hospital in Munich, Germany, compared asthma rates among children in a less-polluted West German city with children in two highly polluted cities in the east, they found exactly the opposite of what they expected: The West German children, who breathed cleaner air, had more asthma. "The poor quality of air we breathe in the inner city, due to industrial and automotive emissions, is wreaking havoc on our airways," said Dr. Jorge H. Sturam, a Harvard Pilgrim health care allergist. "Yet, in rural areas where there is less industrial and automotive pollution, asthma is still a problem for many." Scientists theorize that the "westernization" of societies worldwide may play a role in higher rates of asthma. Houses with tightly fitting window treatments, air conditioning, and various money-saving devices designed to keep heated or air-conditioned air inside do something else: reduce air flow through the home. That keeps more allergensósuch as dust mites and molds, among the most common asthma triggersóinside where they can irritate the lungs. The popularity of wall-to-wall carpeting and big, soft, puffy furniture may also be a contributing factor to aggravated asthma because millions of dust mites live in soft furnishings. Genetics also plays a role in the development of asthma. One in three people with asthma shares the problem with another member of their immediate family, and scientists have found genetic markers associated with a predisposition to asthma. Although scientists still donít know everything about what causes asthma, theyíre learning more and more about how to control and treat it. But since many studies have reached conflicting conclusions about the best treatments, more research is crucial. Last year for example, pharmaceutical giant GlaxoSmithKline announced that it would fund an international study involving more than 3,600 adults and adolescents with asthma, designed to create a new international consensus on how to control and manage the disease. The yearlong study, called Gaining Optimal Asthma Control (GOAL), which was announced at the 10th European Respiratory Society Annual Congress, will publish its findings in 2002. When itís properly controlled, asthma doesnít have to limit your activities. Famous asthmatics such as track star Florence Griffith Joyner and swimmer Amy Van Dyken prove that you can live an active life with asthma. The answer to living a full, successful life with asthma is twofold: finding the appropriate medication and taking control of your environment. At this point, the standard treatment for most patients with mild to moderate asthma continues to be the "gold standard": drugs known as inhaled corticosteroids, according to Dr. Stephen Lazarus, a professor of medicine and pulmonary specialist at the University of California San Francisco. These drugs should be taken on a regular basis to prevent asthma attacks, not as emergency treatment when an attack seems imminent. But not everyone loves inhaling steroids. Using an inhaler on a regular basis can be a hassle, and some fear the long-term side effects. Itís true that some studies have shown long-term use of inhaled steroids to have some side effects, including the loss of bone density and slowed growth in children, but many allergy specialists say that there are far more problems with the underuse of steroids to treat asthma than with side effects from overuse. Still, people who have mild cases of asthma do have another option: a class of drugs called leukotriene modifiers. Several of these are on the market now, the most popular of which is Singulair because it requires only one dose daily. One potential new treatment for asthma, Xolair, an experimental injection that showed promise in several studies in controlling asthma symptoms and reducing the need for steroids, hit a roadblock this summer. In July, the Food and Drug Administration asked the drugís manufacturers for more information on side effects, a development that means possible approval will be delayed at least a year. No matter what medication an asthmatic takes, controlling the asthma triggers in daily life is just as important. Thatís not always easy, as there can be a lot of these triggers in the form of house dust mites, tobacco and wood smoke, fungi and animal dander, cockroach droppings, paint, perfumes, molds, pollen and concentrated auto and industrial fumes. Still, even if you canít eliminate all possible triggers from daily life, a home "asthma audit" can reduce the things that aggravate asthma and help ward off attacks. Gina Shaw is the medical writer for The Washington Diplomat.