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Column originally published Dec 7, 2004

There Are Many Things That You Can Do To Reduce Severity Of Asthma

Question: Our five-year-old son was admitted to the hospital recently. He was coughing a lot and had trouble catching his breath. At the beginning, we didn’t know his condition was that serious. He coughs whenever he runs, and he gets wheezy when he goes to bed. We have to give him the puffers almost every day. We thought that it was just normal for him to do that. We have since learned that he has severe asthma, and he got worse after a virus infection. I am sharing custody with his father, and we don’t completely agree upon the changes that are needed in his environment. I would appreciate some advice from you.


One of the most important aspects in helping children with asthma is to improve their home environment. Many parents have found that by making changes in their children’s environment, their asthma becomes less severe over time, and they require less medicine to keep asthma under control.

There are several important things that can trigger asthma in children and adults. These include dust, mildew, cigarette smoke, animal dander, and chemicals. Some parents are not able to recognize any of these triggers because they are present in their home environment all the time. I will go over them in some detail here.

Dust is present in almost all homes across Canada, unless one lives in places where it is very dry. The problem stems from the droppings of tiny insects in the dust that are called dust mites. These insects grow very well in pillows, mattresses, carpets, stuffed toys, and drapes. They also accumulate in large quantities inside the ducts in houses that use forced-air heating system.

Since you mentioned that you son wheezes when he goes to bed, it is very possible that dust mites in the pillow and mattress are affecting him. You can buy pillow and mattress covers lined with plastic, with a zipper at one end that can seal the pillow or mattress inside. This will keep the droppings of dust mites away from your son when he sleeps in his bed. Washing everything in bed once a week, including his blankets, can also reduce the amount of dust around him. If he has a lot of stuffed toys, it is advisable to remove most of them, and a few that he loves should be placed in washer and dryer once a week to get rid of these dust mites.

If you have carpet in his bedroom, you should make arrangement to remove it as soon as possible, and replace it with a hard surface flooring. If your house is mostly carpeted, change the flooring in his bedroom first, because he likely spends at least eight or ten hours a day in his room. Don’t wait until you can afford to make changes to the whole house.

If you have forced-air heating system, it will blow around lots of dust when the furnace is on. You cannot effectively clean the ducts using your home vacuum cleaner. Hire professionals who can clean your whole duct system can remove most, although not all, the dust that is collected there. Putting high efficiency filters at the furnace can also reduce the circulation of dust in the house. A hot-water heating system can prevent much of this problem, although it is too expensive to change the heating system for most families.

Mildew is found in places where the humidity is high, like around the windows, on the walls and ceiling of bathrooms, as well as in basements. If there is a leak in the wall or from the pipes, mildew will grow in large numbers. Basement is the best breeding ground for mildew because of cooler temperature and high humidity.

Humidity is an important factor in the growth of dust mites and mildew. By keeping the indoor humidity between 40-50%, you can reduce the growth of dust mites and mildew. This can be achieved by the use of a dehumidifier in the basement. If there is an air-exchange system, adjust the control to keep the humidity below 50%.

If you burn wood in the furnace or woodstove, you have an additional challenge.   Mildew grows on the surface of wood. You are going to bring mildew into your house when you take the wood indoors. If wood is an important source of heat for your home, try to stack the wood outside and keep it covered. Only bring in enough for a day or two at a time.

Cigarette smoke is a universal irritant for all children with asthma. Research has consistently shown that these children develop more episodes of asthma, and more severe attacks, if they are exposed to cigarette smoke at home. Parents and caregivers should avoid smoking indoors, even in their basement. It is important to know that even if they smoke outside, they still carry some smoke on their body when they return indoors, although it is still far better than smoking inside. Furthermore, they set a bad example for these children.

Chemicals can also irritate the sensitive bronchial tubes of children with asthma. These chemicals include household cleaning agents, as well as perfumes, colognes, hair sprays, and even scented candles. Sometimes painting a child’s room can send the child to hospital because of the chemicals from the paint.

Animal dander has long been suspected of contributing to asthma problem in children. However, the picture is more unclear these days. Recent research suggested that some children exposed to more than one cat from birth have a lower chance of developing asthma than those without contact with cats. The answer is still unclear. However, if a child clearly develops allergy and asthma symptoms when exposed to an animal, it is better to keep it outside.

Many parents have found that by improving their children’s home environment, they are more healthy more of the time. When they get sick, they don’t get nearly as sick as before, and require less asthma medicine than before to recover.

Another important thing that you can do to help your son is to get influenza vaccine for the whole family. Every winter, influenza affects almost all communities across North America. Children with asthma are especially prone to severe infection and asthma attack. The flu shot can reduce the chance and severity of infection.

I will not discuss about asthma medicine in this column. You should work with your doctor to decide what are the best medications that he needs to keep his asthma under good control. You can contact your local lung association for additional information.