This week marks not only the start of spring, but also Asthma Awareness Week, and asthmatics around the country are preparing for the increased levels of pollen in the air that the change of season brings.
The National Asthma Council Australia CEO Siobhan Brophy said in a statement earlier this week that general practitioners and health services needed to properly inform asthmatics about the connection between allergic rhinitis and asthma, particularly as thunderstorm season approaches.
“People who have allergic rhinitis (either with or without known asthma), are sensitive to ryegrass pollen, or have poorly controlled asthma, are at heightened risk of a flare-up during storms in spring and need to proactively manage their symptoms,’ Ms Brophy said in the statement.
“Health professionals can help patients keep their symptoms under control by reviewing their asthma and allergy management, and making sure written asthma action plans are up to date,” she said.
Senior Lecturer at Griffith University senior lecturer Dr Helen Petsky, who specialises in asthma and cough research, is also concerned about the potential dangers that the upcoming storm and pollen season pose for asthmatics.
Dr Petsky said there were a lot of different triggers that would cause an asthma attack, animal hair, dust, stress, perfumes, chemical exposure, and pollen.
“When the air changes and we see a different flow of air because a thunderstorm is coming and the pollens have been picked up in that, it can be a trigger to some patients,” she said.
“And, unfortunately, we’ve seen deaths in Australia related to this.”
In Melbourne in November 2017 a phenomenon dubbed “thunderstorm asthma” occurred when a high pollen count brought on by strong winds and moisture in the air resulting in the deaths of 10 people and the hospitalisation of thousands.
Dr Petsky said it was important that both health professionals and patients were educated about the best ways to manage asthma, and having an up-to-date asthma action plans was a good way to achieve that.
Asthma affects one in nine Australians, but fewer than one in every five people with asthma who are aged over 15 years have a written Asthma Action Plan, according to a 2018 report by the Australian Government Productivity Commission.
“So, there is a large amount of education to the health professionals, but then it’s also passing that information on to our patients and making sure they know what their current treatment is, and also that they’re able to self-manage,” Dr Petsky said.
“There’s a thing called an asthma action plan, which basically every person with asthma should have, and patients should be able to follow these asthma action plans and be able to manage their asthma,” she said.
“Unfortunately, the uptake of written asthma action plans is very poor.”
Dr Petsky emphasised the importance of self-management and self-awareness for practitioners and asthmatics ahead of pollen season.
“There’s lots of different triggers and a lot of work’s been done now and money spent in putting in pollen counters outside big cities so that we can get warning systems of pollen increasing,” she said.
Dr Petsky said another problem was caused when patients failed to understand the difference between the different asthma medications.
The two main types of asthma medication are preventers and relievers, which are usually used in inhalers or puffers.
Preventer medicine is usually a low-dose inhaled corticosteroid, which is taken daily to try to prevent asthma flare ups and which assists in long-term asthma control.
Reliever medication is more of a short-term fix and asthma sufferers carry reliever puffers with them as a form of quick relief when asthma symptoms arise.
A 2019 Asthma Australia survey of 2700 people with asthma found that 40 per cent of those asthmatics used the quick fix reliever medication to treat their short-term symptoms and one in four of those people needed urgent treatment for their condition in the previous year.
“In the last few years, reliever medication has been available to buy over the counter of a pharmacy, which only used to be a prescription-only medication, and so the change was made to make it available,” she said.
“So, people were able to treat their symptoms when they needed to, but perhaps this has led to more use of the blue [reliever] puffer because it’s more readily available.”
“We’re seeing more people GP shopping and health services can only do what the client is presenting at the time, and so often that might lead to just treating the symptoms for that day, and then not being able to follow up because the patient’s not re-presenting for follow up services.”
“There’s another type of medication available called a preventer and the preventer works on the inflammation that’s going on in your lungs,” Dr Petsky said.
“If a patient is needing reliever medication more regularly, it’s showing that there’s high amount of inflammation, so it should be treating the inflammation,” she said.
Dean Witchell is in his early twenties and is an asthmatic who doesn’t have a current action plan.
Mr Witchell said he used both the preventer and the reliever medication and said asthma awareness was important all year around.
“When I was younger, I would make sure to take my preventer in the morning and [at] night to help me sleep, and I made sure to carry my reliver during the winter and spring months just in case of a flare up,” he said.
“The coldest part of winter is harsh to asthmatics, especially if they try and exercise, and entering the spring these effects become more all-round as even during the day you can be struck by mild asthma.”
“I find using the preventer is good if you are prone to having some sort of asthma for a large chunk of the day.”
“I mostly use the reliver now as my asthma has somewhat subsided and [I] only usually need instant relief, but when I am sick and have been regularly getting mild asthma, I use the preventer, which does go a long way in helping.”
Asthma Awareness Week runs from September 1 to 7, coinciding with the start of the spring season.
For more information about asthma in Australia, visit the National Asthma Council Australia’s website.