In my neck of the woods, the last few weeks have been filled incredible days of extreme heat. There was a time when I did not have to be concerned at all about the heat wreaking havoc my lungs. I used to hear the heat warnings on the news and not think much about them. That is something that has certainly changed for me. I am now hugely affected by weather conditions, especially heat and humidity. I was recently at an outdoor event and I felt like I was literally melting and needed to seek shelter and a cooler climate quickly. One minute I was fine, the next, my friend the wheeze was ever present.
I was doing some research recently, and came across some studies that noted that the mechanics of increased temperature effects on asthma are not fully known. It is suspected that increased temperatures and humidity are connected to an increase in airway triggers and bronconstrictiion.
Changes in temperature are thought to lead to airway obstruction, that are associated with asthma attacks, and changes in the onset and length of the pollen season, and increase pollen production.1-2 Even thunderstorms which are somewhat associated with heat events, are thought to trigger the release of fungal spores that are carried by wind, resulting in increased exposure to these triggers.3-5 At times heat events are also connected to heavy rainfalls which can also affect the humidity in the environment and and contribute to changes in airflow in the respiratory system, this can lead to asthma exacerbations.7-9 Increased heat can lead to higher concentrations of ground level ozone are also possibly related to asthma risks.6
What does this mean for me on hot days? If I had to categorize my most significant issue with heat recently. I believe it would be the theories surrounding the changes in airflow in the respiratory system and bronchostriction. My symptoms would lead me to believe that this is what I am having the most difficulty with. I have felt like I simply can not move air in or out. I am working on learning more about the science of these theories and will report back when I have further updates.
I need to be more proactive in preparing for hot days to keep exacerbations at bay. I have failed at doing this for the first couple of heat events this season, however, that is going to change. I will be keeping an eye out for weather warnings, heat advisories and other related health warnings. These are common issues on weather reports from government, environment and health agencies. This will help guide me in making the best decisions for outdoor activities and impending changes to my asthma status. I will be limiting my outdoor exposure on these hot days. Even quick trips out that had previously not bothered me, are now going to be rescheduled for later. I thankfully have air conditioning and will be spending more time in nice cozy cooler temps. I will also be discussing with my doctor if making some changes in my asthma action plan will help my discomfort during heat waves.
I am going to try an experiment for the remainder of the summer. I will track my symptoms and peak flows; to evaluate trends prior to heat event days to see if I can find a pattern and track the amount of rescue SABA that I am using. Confession, I don’t always track this information. I know that many of you may be reading this in horror. I am part of a specialized asthma centre that tracks asthma control by sputum cell counts.
I promise to report back at the end of these summer with the results of my experiment. Till then, stay hydrated, cool and away from increased heat related triggers.
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Cecchi L, D’Amato G, Ayres JG, Galan C, Forastiere F, Forsberg B, et al. Projections of the effects of climate change on allergic asthma: the contribution of aerobiology. Allergy. 2010;65(9):1073–1081
Ziska L, Knowlton K, Rogers C, Dalan D, Tierney N, Elder MA, et al. Recent warming by latitude associated with increased length of ragweed pollen season in central north America. Proc Natl Acad Sci. 2011;108:4248–4251. doi: 10.1073/pnas.1014107108.
Anderson W, Prescott GJ, Packham S, Mullins J, Brookes M, Seaton A. Asthma admissions and thunderstorms: a study of pollen, fungal spores, rainfall, and ozone. QJM. 2001;94:429–433. doi: 10.1093/qjmed/94.8.429.
Dabrera G, Murray V, Emberlin J, Ayres JG, Collier C, Clewlow Y, et al. Thunderstorm asthma: an overview of the evidence base and implications for public health advice. QJM. 2013;106:207–217. doi: 10.1093/qjmed/hcs234.
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Exposure to extreme heat and precpitation events associated with increased risk of hospitalization for asthma in Maryland, U.S.A. Sutyajeet Soneja, Chengsheng Jiang, Jared Fisher, Crystal Romeo Upperman, Clifford Mitchell, Amir Sapkota Environ Health. 2016; 15: 57. Published online 2016 April 27. doi: 10.1186/s12940-016-0142-z
Strauss RH, McFadden ER, Ingram RH, Deal EC, Jaeger JJ. Influence of heat and humidity on the airway obstruction induced by exercise in asthma. J Clin Invest. 1978;61:433–440. doi: 10.1172/JCI108954
Aitken ML, Marini JJ, Culver BH. Humid air increases airway resistance in asthmatic subjects. West J Med. 1988;149:289–293.
Mireku N, Wang Y, Ager J, Reddy RC, Baptist AP. Changes in weather and the effects on pediatric asthma exacerbations. Ann Allergy Asthma Immunol