Triggers

Knowing your triggers can be one of the most important things in managing your asthma, meaning you are more able to avoid and deal with your triggers means you are more likely to stay well with your asthma.

480px-asthma_triggers_2

What’s an asthma trigger?

An asthma trigger is anything that can set off your asthma by irritating your sensitive airways even more. You may find, for example, that being around cats or dust sets your symptoms off. Or it might be pollen, cold weather, or being near someone who’s smoking. (Asthma UK, Triggers – 2016)

asthma

How many asthma triggers can you have?

You can have one trigger, and it can be a mild one. Or you can have one trigger and it be a major one that gives you severe attacks. You may have multiple triggers all different sensitivities. Everyone is different and everyone reacts differently. You may even find that your triggers change over time and change in sensitivity. The key is to manage your asthma so you can see new patterns and pick up on any potential new triggers or changes in triggers.

Why do asthma triggers sometimes not cause symptoms?

The sensitivity of your airways can vary day to day, month to month, year to year. If your asthma’s well managed, your triggers are less likely to cause symptoms.

Also, your asthma symptoms can be caused by more than one asthma trigger at the same time. If this happens, it could cause a stronger reaction – for example, if you have a cold and you also come into contact with a cat. This can be why sometimes triggers do cause symptoms and why sometimes they don’t. (Asthma UK, Triggers – 2016)

images

How do you know which asthma triggers affect you?

If you understand which things trigger your asthma you might be able to avoid them. Sometimes it’s obvious what your triggers are. Sometimes it’s not. Asking yourself these two questions can help you work out which triggers affect you: (Asthma UK, Triggers – 2016)

1. HAVE I GOT ANY OBVIOUS TRIGGERS?

Often it’s obvious which things trigger your asthma – for example, when your symptoms start after you’ve come into contact with a cat or dog. Or you might find that your asthma symptoms are set off by a food allergy, alcohol, cigarette smoke or smoke from open fires. (Asthma UK, Triggers – 2016)

2. WHAT ARE YOUR OTHER TRIGGERS?

Sometimes it’s not easy to pinpoint exactly what triggers your asthma. This is because some triggers are invisible (such as grass pollen); you may have more than one trigger; and sometimes you may have a delayed reaction to a trigger. A bit of extra detective work may be needed – try keeping a diary of activities and symptoms to help you spot any patterns.(Asthma UK, Triggers – 2016)

Can you avoid asthma triggers?

“It’s impossible to avoid all triggers but you can cut your risk of developing asthma symptoms when you’re exposed to them,” says Dr Samantha Walker, Asthma UK.

Some asthma triggers are easily avoidable, such as cigarette smoke, pets and alcohol. But it’s impossible to avoid many common asthma triggers – things like pollen, pollution, colds, dust mites and cold weather. (Asthma UK, Triggers – 2016)

k-asthmatrigger-enhd-ar1

 

How can you deal with asthma triggers?

There are proven steps you can take to cut your risk of asthma triggers causing asthma symptoms or an asthma attack:

1. TAKE YOUR PREVENTER MEDICINE EVERY DAY

The best way to help your body cope well with any asthma triggers is to take your preventer inhaler every day as prescribed. Your preventer medicine is specially designed to work away in the background to help reduce sensitivity and irritation in your airways. Taking it every day means there’s less chance of a reaction if you come into contact with any triggers – so you’re more likely to able to go to work, have fun with your family and enjoy socialising with friends. (Asthma UK, Triggers – 2016)

ctxrmvwwyaaja9c

2. USE A WRITTEN ASTHMA ACTION PLAN

There’s space on your written asthma action plan to note down your triggers to help you spot when your asthma needs extra help. Using an action plan cuts your risk of ending up in hospital due to your asthma, as it contains all the information you need to look after your asthma well and reduce your likelihood of getting symptoms. If you haven’t got one, download an asthma action plan now and fill it in with your GP or asthma nurse as soon as possible. (Asthma UK, Triggers – 2016)

3. GO FOR AN ASTHMA REVIEW AT LEAST ONCE A YEAR

An asthma review gives you and your GP or asthma nurse a chance to make sure your written asthma action plan is up to date. It’s important to check regularly that you’re taking the right medicines in the right way and at the right doses so they’re always giving you the best protection against your triggers as possible.

If you’re taking your medicines as prescribed but still having asthma symptoms, speak to your GP or asthma nurse so you can come up with a plan to improve things. It might be that something as simple as a change of inhaler technique could solve the problem. (Asthma UK, Triggers – 2016)

4.DO YOUR BEST TO AVOID THOSE TRIGGERS

Whether it’s a case of considering job change, changing your job rolls, ajusting what you do in your day, changing your washing powder etc.. if you CAN cut it out and avoid it then do so. You may find that it doesn’t affect you so much now, however constant exposure can build up irritation and inflammation over time and affect you further down the line. Is it really worth it? If you can’t avoid it, do your best to be around it as little as possible or manage being around them. You can’t control the weather, but if weather affects you be prepared. Look up the weather before hand, cover your chest and mouth when it’s cold outside or avoid going out in weather that affects you. Leave it for another day if you can. If you find pets affect you, ask that your pet owning friends visit you in clean clothes not you visiting them in their home. If you have to work around dust and this affects you, wear a mask and maybe try in short bursts and having breaks in between so  you aren’t exposing your airways for as long. Realistically it’s hard to avoid everything that may affect us, but being strict with your management of exposure to these triggers can be as important as taking your regular medication.

Triggers

Dandelion Clock

Allergies (Allergic Asthma)

Substances that cause allergies (allergens) can trigger asthma. If you inhale something you are allergic to, you may experience asthma symptoms. It is best to avoid or limit contact with known allergens to decrease or prevent asthma episodes.

2967689

Common allergens that cause allergic asthma include:

  • dust mites
  • cockroach
  • pollens
  • molds
  • pet dander
  • rodents(AAFA,2015)cat-dog_980x551

Avoiding triggers:

Pets Can Make Asthma Worse

Keep pets outside, if possible. If pets stay inside, keep them:

  • Out of bedrooms
  • Off upholstered furniture
  • Off of carpets

Wash your pet once a week.

If you have a central air conditioning system, use a HEPA filter to remove pet allergens from indoor air. Use a vacuum cleaner with HEPA filters.

Wash your hands and change your clothes after playing with your pet. (AAFA,2015)

k-asthmapet-enhd-ar1

I have a grade 2 (rated up to grade 5) allergy to dog dander. I have two dogs, both different fur types and one that i’ve had for years and one fairly new. I believe one affect me more than the other, however i’m aware repeated exposure can slowly build up your sensitivity overtime; meaning you can not have any reactions all your life then all of a sudden be allergic or have mild reactions to something. I only experience itchy eyes and the slightest sniffly nose. When I’m away from my dogs (even for weeks at a time) I’m not much different in my allergies, so for me I weighed up that keeping my dogs wouldn’t be detrimental to my health. However, even though they don’t affect me much and I get very little symptoms I manage it by not having the dogs in my bedroom anymore, washing my clothes regularly, hoovering regularly, not taking dog covered clothes into the bedroom, washing my hands regularly, having my dogs groomed and washed regularly, trying not to kiss and cuddle them as much as I did before (the hardest part!) As well as managing with medication such as antihistamines, nasal spray and eye drops. This is also for my other allergies, but it does help manage my symptoms with the dogs.

Many dogs have different types of hair, different types of skin/saliva and so you can react to one dog and not another. You just have to weigh up how allergic you are to dogs, have you been tested to see if thats what you are allergic to for definite? How much does the allergy affect you?

Just because you have asthma, that doesn’t mean you are automatically allergic to dogs or shouldn’t be around dogs. It’s down to if you have an allergy and how much this affects you.

Other Triggers to Watch out for

Do not use wood-burning fireplaces. If you need to burn wood, use an air-tight wood-burning stove.

Do not use perfumes or scented cleaning sprays. Use trigger sprays instead of aerosols.

Irritants in the Air

getty_rm_photo_of_smoke_stack

Irritants in the environment can also bring on an asthma episode. Although people are not allergic to these items, they can bother inflamed, sensitive airways:

  • smoke from cigarettes
  • air pollution such as smog, ozone, and others
  • wood fires
  • charcoal grills
  • strong fumes, vapors, or odors (such as paint, petrol, perfumes and scented soaps)
  • dusts and particles in the air
  • chemicals(AAFA,2015) 

    Avoiding triggers:

    Pollens

    When pollen levels are high:

    • Stay indoors and keep doors and windows closed. Use an air conditioner if you have one.
    • Save outside activities for late afternoon or after a heavy rain.
    • Wear a face mask while you are doing outdoor activities.
    • Do not dry clothes outdoors. Pollen will stick to them. Have someone who does not have asthma cut the grass, or wear a face mask if you must do it. (DXLINE, 2017)

    stay-away-from-asthma-triggers

Dust Mites

You can take several steps to limit exposure to dust mites.

  • Wrap mattresses, box springs, and pillows with mite-proof covers.
  • Wash bedding and pillows once a week in hot water (130° F to 140° F).
  • If you can, get rid of upholstered furniture. Try to use wooden, leather, or vinyl.
  • Keep indoor air dry. Try to keep the humidity level lower than 50%.
  • Wipe dust with a damp cloth and vacuum once a week. Use a vacuum cleaner with a HEPA filter.
  • Replace wall-to-wall carpet with wood or other hard flooring.
  • Keep stuffed toys off the beds, and wash them weekly.
  • Replace slatted blinds and cloth draperies with pull-down shades. They will not collect as much dust.
  • Keep closets clean, and keep closet doors closed.  (DXLINE, 2017)

 

Mold Spores

Keeping indoor humidity at less than 50% will keep mold spores down. Keep sinks and tubs dry and clean, and fix leaky pipes. Empty and wash the refrigerator tray that collects water from the freezer defroster often.

Use an exhaust fan in the bathroom when you are showering. Do not let damp clothes sit in a basket or hamper.

Clean or replace shower curtains when you see mold on them. Check your basement for moisture and mold. Use a dehumidifier to keep the air dryer.  (DXLINE, 2017)

indoorpollutionwebsitefsv5

Respiratory Illness

  • colds
  • flu (influenza)
  • sore throats
  • sinus infections
  • pneumonia

Respiratory infections are the most common asthma trigger in children.

(AAFA,2015)

Exercise

Exercise and other activities that make you breathe harder can affect your asthma. Exercise—especially in cold air—is a frequent asthma trigger. Exercise-induced bronchoconstriction (EIB) is a form of asthma that is triggered by physical activity. It is also known as exercise-induced asthma (EIA). Symptoms may not appear until after several minutes of sustained exercise. (If symptoms appear sooner than this, it usually means you need to adjust your treatment.) With proper treatment, you do not need to limit your physical activity.

(AAFA,2015)

Weather

k-asthmaweather-enhd-ar1

Dry wind, cold air or sudden changes in weather can sometimes bring on an asthma episode.

(AAFA,2015)

Common weather triggers that can aggravate asthma symptoms include:

  • Cold air. Frigid temperatures can be an asthma trigger. “Cold air seems to predispose people with asthma to have more symptoms,” says Fineman. “Cold air can cause constriction of airways,” says Todd Rambasek, MD, an adult and pediatric allergist at ENT and Allergy Health Services in Cleveland, Ohio. For people with asthma, this can be a dangerous problem.
  • Wind and rain. Rainfall can increase and stir up mold spores, and wind can blow around pollen and mold.
  • Heat. In the summer months, increased ozone from smog, exhaust fumes, and pollutants tend to be higher and can trigger asthma symptoms.
  • Lightning. Thunderstorms, which can generate ozone, are now thought of as an asthma trigger.
  • Air pressure fluctuations. Barometric pressure triggers sinus episodes, and sinusitis is a common trigger for asthma symptoms. (Everyday Health, 2013)

Managing Weather-Related Triggers

Managing the symptoms of weather-related asthma is similar to managing asthma that is triggered by any cause, like pet dander. Whether the trigger is heat, pollen, or a fierce rainstorm, the best way to avoid climate-connected asthma is to first identify what your triggers are. Just as you would with other triggers of asthma, avoid these triggers and control your exposure.

Specific weather triggers will vary from individual to individual. If lightning storms tend to set off your asthma attacks, then stay inside. If cold air is your trigger, use albuterol before going out in the cold and wear a face mask or scarf over your face, and avoid going out as much as possible in the coldest parts of the day. If your asthma tends to worsen in hot summer months, use an air conditioner and try to stay in a controlled environment.

To stay on top of weather changes, monitor the weather forecasts — consider signing up for email and text updates from online services. Beyond temperature changes, watch the forecast for rain, humidity, air pressure changes, and ozone reports.

Another effective way to control weather-triggered asthma is by taking your prescribed asthma medications. Regular use of controller meds is an important part of managing asthma.

While it’s not possible to control the weather, you can take steps to limit asthma attacks. Identify your weather triggers and then do what you can to protect yourself from the elements. (Everyday Health, 2013)

Feeling and Expressing Strong Emotions

  • anger
  • fear
  • excitement
  • laughter
  • yelling
  • crying

When you feel strong emotions, your breathing changes – even if you don’t have asthma. It may cause wheezing or other asthma symptoms in someone with asthma.

(AAFA,2015)

Why do emotions trigger asthma?

Everyone feels emotions such as love, hate, anger, and excitement. Sometimes we react by expressing ourselves: for example, crying when we feel sad or laughing when we feel happy or excited.(Asthma UK – Triggers – emotions, 2016)

Asthma symptoms can be triggered by our emotions, and by the way we express them.(Asthma UK – Triggers – emotions, 2016)

How common is this trigger?

Studies have shown that there’s a link between strong emotions, including stress, and asthma symptoms getting worse – 69% of people with asthma tell us that stress is a trigger for their asthma.

GINA (Global initiative for asthma) lists laughter as a main asthma trigger, and the American Thoracic Society did a study which showed that half of its study group had laughter as a trigger for their asthma.(Asthma UK – Triggers – emotions, 2016)

Who is most at risk?

Emotions are not going to be an asthma trigger for everyone all of the time. But you’re more at risk of symptoms coming on or getting worse during those times when your emotions are strongest. This could be a time of stress, such as exams, or of excitement, such as a big family wedding or birthday.

Anyone with asthma can find emotions trigger their asthma symptoms, but there are certain groups more at risk:

People whose asthma is not well managed – If you’re looking after your asthma well, strong emotions are less likely to trigger asthma symptoms. Your written asthma action plan will help you do this. People whose asthma is not well managed are more at risk from all their triggers, including emotions.

Children – Children react quickly to things going on around them, and are more likely to cry or laugh than adults, often all on the same day. A child can often run around happily one minute and fall over and have a tantrum the next. Strong emotional reactions could trigger asthma symptoms.

Excitement could trigger asthma symptoms, and parents and carers often tell us they’re worried about their child around birthday parties or Christmas because in the past they’ve had asthma symptoms, and even asthma attacks, around exciting events like this.

Teenagers – Teenagers are known for their strong emotional reactions and mood swings. At this age, the part of the brain linked to managing and controlling emotions isn’t fully developed, so young people experiencing strong emotions have less ability to control how they react and express them.

Teenagers are also going through big hormonal changes and this can influence how they feel and react. Sometimes this can mean they’re more likely to do things such as smoking and drinking – these things also put them at risk of asthma symptoms and asthma attacks. (Asthma UK – Triggers – emotions, 2016)

How do emotions trigger asthma?

Strong emotions such as fear, excitement or anger can affect the way we breathe. Our breathing might be quicker and less regular and we might take short quick breaths through our mouths. Because this air hasn’t passed through our noses, it hasn’t been warmed, so it hits our airways while it’s dry and cold. This kind of breathing can trigger asthma symptoms for some people.

The same happens when we laugh or cry a lot – the cold, dry air reaches our airways which react with asthma symptoms, such as uncontrollable coughing and a tight chest.

There’s a higher risk with uncontrollable laughter or sobbing because our breathing will be even more quick and irregular and we’ll be breathing through our mouths. Asthma symptoms can come on very quickly sometimes and could move on to an asthma attack. (Asthma UK – Triggers – emotions, 2016)

How do you know if this is a trigger for you?

Keeping a symptom diary is a useful way to find out if your asthma, or your child’s asthma, is being triggered by emotions and emotional reactions. If you notice your asthma is worse when you’re upset, angry or excited then make a note of it. You might start to notice a pattern.

Using a written asthma action plan can help you keep an eye on any change in asthma symptoms and tell you what to do when you notice these.

Cut your risk

As with all asthma triggers, your best line of defence is to make sure you’re managing your asthma well.

Experiencing emotions is part of life, so we can’t avoid them, but we can be aware of them. If you know you’re going through an emotional time be aware that it might have an effect on your asthma. Use a written asthma action plan to help you stay on top of your asthma – whatever’s going on in your life. (Asthma UK – Triggers – emotions, 2016)

Medicines

Some medicines can also trigger asthma:

  • If you are sensitive to aspirin and NSAIDs (nonsteroidal anti-inflammatory drugs)
  • If you take medicines known as beta blockers – they can also make asthma harder to control

(AAFA,2015)

Other Asthma Triggers

Other triggers to consider and discuss with your healthcare provider are:

  • sulfites in food
  • hormonal changes during the menstrual cycle
  • other medical problems like reflux

(AAFA,2015)

 

How I deal with My triggers:

I have many triggers as you may or may not be aware from my about me page. I’ve gone through many phases, from ignoring them till i couldn’t anymore. Kind of avoiding them and dealing with them and then wrapping myself in a bubble and avoiding life. Life needs to be lived and enjoyed so it’s important that yes you need to manage your asthma well, but if you spend your whole life focusing on your asthma and what you can and can’t do, soon asthma will take over your life. It’s about finding the balance.

Allergic triggers:

Pollen :

I have an app that updates me on the pollen count in the area, as well as telling me how strong the wind is. Mostly it’s just a case of half the year pollen affecrs me and I just deal with it. However, on the days that are extremely high pollen counts and/or windy. I do my best to make sure windows are shut and if I can avoid going outside that day and leave something to do another time then I do. So instead of just staying shut in from March to September, I just follow the pollen counts and on the very worst days I try my best to avoid going outside.

Dog Dander:

I have two dogs, they are my life and are like my children. When I found out I was allergic to them I was devistated. I’m very VERY lucky that my allergy i only mild and doesn’t affect me much. However, I still do my best to manage. As stated higher up, I make sure that I don’t have them where I sleep, hoover regularly, groom and wash them regularly, wash my hands lots, and cut down on kisses and cuddles! I have a special brush for them to help really strip the dog hair, this is done once a month to remove as much hair as possible without leaving them bald. Helps with how much hair is around the house massively. Well worth the investment buying a good comb/brush! I do tend to get someone else to brush them, but if i have to I wear overalls or clothes that i immediately strip out of after and gloves and a mask just so i’m not getting the worst of the hair and dander on me. I also make sure they have baths and a good scrub, get rid of any loose and dead skin and loose hair. I have been told about special shampoo’s that supposidly help with dander and allergies. Yet to buy or use this. However supposidly it does exist.

If I’ve been with my dogs, I strip my clothes off before going into my bedroom and wash my hands well. So, I will sit and play with them. Then, when i’m finished i’ll just de-dog as much as possible. I don’t get many symptoms, the most I get is if i’ve been around them and then i itch my eyes I get itchy eyes and the longer i’m around them up close I get sniffly nose. Other than that, it doesn’t drastically affect me. Hence why I haven’t got rid of them. I mean look at these cuties how can you get rid of them!

wp_20160817_12_44_58_pro

For my allergies I take medication to help reduce symptoms and make day to day life more symptom free, however it’s important to remember this is just managing symptoms. The best thing to manage allergies is to reduce exposure in the first place.

 

Other Triggers:

Perfumes/sprays/bleaches:

Some will affect me more than others, but unfortunately until i’ve been exposed I never know how badly they affect me till i’m often in full swing of an asthma attack. I’d probably say 80% of perfumes and deodorants send me into a severe asthma attack or i can instantly feel symptoms and they tend to be quite bad. Obviously, I don’t use any myself but if i notice someone with some on, i will instantly cover my mouth with my sleeve or clothing so that i’m not breathing so much in. If i feel my airways reacting I will without hesitation try and remove myself from the situation or I will ask them to move away from me because of my asthma. I find liquid perfumes less reactive than aerosole and I use roll on deodorants instead of the sprays. So, I am able to wear deodorant! Plus there is a few perfumes I can wear without reaction (this did take some trialing to get to)

When it comes to any cleaning sprays or bleaches I just avoid them as best as possible. I don’t risk it. I just find other chores round the house I can do instead and ask someone else to do those tasks for me. Cleaning chemicals tend to be the worst for me and often are used in smaller spaces making it even worse. One too many times have I had severe attacks from cleaning chemicals that I just don’t bother. I use wipes that are milder to clean with, and that is about it. Great excuse to get someone to clean the toilet right!?

Where I can’t avoid having to use certain things I just put a scarf on, spray quickly, walk away and come back after it’s settled a bit. This will be a last resort though.

Dust:

Dust is everywhere, can’t be avoided. Some situations are going to guarantee more dust. Again like with the cleaning chemicals, unless It’s necessary I just avoid situations that are going to be exposing me to larger amounts of dust and when I do have to be exposed I wear a mask/scarf. When I was working around dust before I always made sure I had masks and changed them regularly. I did other job tasks where possible, so I would do someone elses task whilst they helped me do mine. This just reduced the amount i exposed myself sometimes.

Smoke:

Smoke is a huge trigger for me, I think being around second hand smoke my whole life hasn’t helped and doesn’t help my recovery. My family now don’t smoke around me, and I avoid being near anyone that smokes. If the wind is blowing in a certain direction I try to make sure i’m ahead of the wind. If i’m attending a BBQ I wait until it’s settled before going outside. If people are burning in the area and I can smell smoke.. Even if it’s miles away.. If i can smell it. I avoid the outside. I’m quite upront to people that smoke around me, I wont hesitating in asking them to smoke elsewhere as I have asthma and it affects me. Or i excuse myself and explain why. Even if it’s a complete stranger in town, if they come next to me smoking I just cover my mouth and explain as nicely as i can. I don’t hesitate though, every second i’m breathing it in is another second that i’m breathing it in. Just remember to smile and say please and thank you, don’t want people hating asthmatics! Just most don’t realise it’s an issue. But don’t put up with it, letting people know often makes them more aware so they smoke in less crowded areas next time.

Pollution:

This is one of those mild triggers that you don’t realise how much it’s affecting you till you leave high pollution areas for awhile and then come back to an area with higher pollution. I live in quite a high pollution area, I can’t do anything about this right now although I do want to move to South France into a drastically lower pollution area. The things I do avoid is walking or being near busy roads, If I can walk down another road with less traffic then I do that instead. If I can avoid town centers as much as possible, then I do. Or I go at times when it’s less busy. This may only make the tiniest of differences but every little counts!

Being Ill:

Being ill pretty much is guaranteed to set my asthma off. I try to make sure I eat a healthy diet with lots of fruit and veg, especially oranges and kiwis to help boost my immune system. If i know somoene who is ill. I avoid them like the plague! I use antibacterial hand gel lots and if they come near me I just pull some clothing across my face. I make sure I’m not touching stuff they have eaten or drunk from. Because being ill makes me so ill and then sets my asthma off, this one I can’t ignore too much. If I have to avoid someone for a week till they are better, then I do it! If I feel something coming on that can be treated then I see the doctor/nurse asap or get some over the counter medication to help speed the healing process. Sometimes speaking to the pharmacist can be a huge help at the quickest way to get over something. If I can feel a cough or chest infection coming i really monitor and manage it. I start antibiotics asap when needed and i keep checking my peak flows when ill just to see when it’s starting to affect my airways. It’s all about monitoring and quick management. Unfortunately my long term steroid use has made me quite resistant to antibiotics and given me a weakened immune system… This means I really can’t take as much risk as anyone else with being ill.  I also make sure I wash my hands well and make sure I keep things such as neb masks clean, inhalers clean and try to reduce my risk of picking up things.

Emotions:

Laughing – Yes, that’s right laughing can give me an asthma attack. I have to be in a flare up or it to really affect me. Learned that one the hard way.. watching ‘Dad’s army’ Reruns in hospital after an asthma attack was NOT a good idea. I try to have a no laughing rule when in hospital, although when you are the kind to laugh at your own jokes days later it’s pretty hard.

Stress/Anxiety – They just make me more tense, my breathing quicker and don’t really give me asthma attacks but they don’t help if i’m already having an asthma attack. Now I try to chanel Rafiki from lion king and just learn to not get stressed out by things.

rafiki

 

Hakuna Matata – It means no worries for the rest of your days!

 

 

References:

AAFA – Asthma triggers and causes (2015) Avilable at: http://www.aafa.org/page/asthma-triggers-causes.aspx [Accessed 01/02/2017]

DXLINE – Avoiding Triggers. Available at: http://dxline.info/diseases/stay-away-from-asthma-triggers [Accessed 01/02/2017]

Everyday Health 2013. Avilable at http://www.everydayhealth.com/asthma/how-weather-affects-asthma.aspx [Accessed 01/02/2017]

Asthma UK – Triggers, Emotions (2016)  Available at: https://www.asthma.org.uk/advice/triggers/emotions [Accessed 01/02/2017]

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s