IF YOU suffer from asthma, you probably know that triggers which set your symptoms off aren’t always easy to predict.
They can change over time, or even according to the time of year it is – while cold air might leave you wheezing during winter, pollen can have a similar effect as the weather warms.
Aside from pollen, you’ve probably heard of other common triggers like dust mites, pet hair, pollution and cigarette smoke.
But you might not know that foods like sausages, hormonal changes, emotions like stress or anger and even the environment you work in can prompt a potentially life-threatening asthma attack.
To mark World Asthma Day, GP Dr Andrew Whittamore – Asthma + Lung UK’s clinical lead – outlines surprising asthma triggers you’ve never heard of.
1. Sausages, pickles, jams and wine
If you have asthma, you can be sensitive to sulphites and histamines, which can be present in certain foods and alcohol.
Ingesting these can trigger symptoms like coughing, wheezing, and breathlessness.
For 11 per cent of women and 6 per cent of men surveyed by Asthma + Lung UK’s 2024 Life with a Lung Condition Survey, food was trigger for their asthma.
So while it’s not common, it can pose a risk.
Sulphites are used in some processed meats like sausages and burgers, in pickled foods and vinegar, dried fruits, and vegetable and fruit jams, Dr Whittamore says.
Fizzy drinks, fruit juice concentrates like squash, cordials, and vegetable juices can also contain sulphites.
To check whether your food or drink contains sulphites, look out for E numbers E221 to E228 on the labels, the GP advised.
Histamine is a chemical released in your body when you have an allergic reaction and it’s actually found in many alcoholic drinks, as a product of the fermentation process.
Wine is one such drink and it’s the most common alcohol trigger for those with asthma, followed by beer and cider.
This is because all three can contain higher levels of sulphites and histamines.
The best way to know whether you are affected by either of these substances is to take note of any symptoms after you consume certain foods or drinks, Dr Whittamore advises.
If you experience wheezing, coughing, breathlessness or tightness in your chest, it’s best to avoid them.
2. Swimming
As the weather warms up, many of us will be looking forward to dips in the pool.
But for a small number of asthma sufferers, this staple summer activity could prove risky.
Pools contain chemicals such as chlorine to remove bacteria and other germs and keep the water clean.
But chlorine – as well as disinfectants like bleach – can also trigger an asthma attack.
Using pools, hot tubs and water parks might bring on asthma symptoms if you’re sensitive to this chemicals, but you can also be affected if you work in these environments too.
The charity found that cleaning products triggered asthma symptoms for 76 per cent of women and 26 per cent of men, which would include the chemicals contained in swimming pools.
So, if you notice your chest tightening while you’re sunbathing by the pool on holiday, it could mean you’re sensitive to these chemicals.
But Dr Whittamore notes that “swimming overall is a great form of cardiovascular exercise for those with asthma as it helps keeps the lungs in good condition”.
“So, if your asthma is well controlled and you aren’t triggered by chemicals used in pools, it shouldn’t be a problem.”
3. Your work environment
We spend a lot of time at work, so being in an environment that triggers asthma symptoms can be problematic.
Occupational asthma is a type of asthma caused by breathing in substances at work, like dust, fumes, chemicals, or even animal fur, Dr Whittamore explained.
You might not experience work-induced asthma symptoms straight away because it takes a while for the immune system to become sensitive to these triggers.
But once you do become sensitive to a substance at work, you might experience asthma symptoms the next time you come into contact with it.
If you notice that you have developed new asthma symptoms at work, such as coughing, wheezing, or shortness of breath, or your childhood asthma returns, make an appointment to see your GP who can help to identify whether it is occupational asthma.
You may be asked whether your asthma symptoms started as an adult, if your childhood asthma symptoms have returned since you started working, and whether your symptoms get better when you’re on holiday.
You might also be sent for tests.
The good news is that if you catch it soon enough, the symptoms of occupational asthma can sometimes go away completely as long as you stop being exposed to the trigger and get the right treatment.
4. Fear, anger and excitement
Have you ever been in the grip of a strong emotion, only to be struck by an asthma attack?
Strong emotions such as fear, anger, stress, excitement, and even laughing or crying can bring on asthma symptoms, explains Dr Whittamore.
This is because your body’s response to different emotions changes the way you breathe.
For example, you might start hyperventilate when you’re upset, taking fast, deep breaths, which can lead to asthma symptoms such as coughing, breathlessness, or a tight chest.
The Asthma + Lung UK survey found that emotions may have a bigger effect on asthma than we think, as 40 per cent of women said emotions triggered their asthma, compared to 25 per cent of men.
If you suspect emotions may be one of your asthma triggers, it’s a good idea to track your symptoms by writing them down in a notebook or on your phone as they occur.
Use a written asthma action plan, so that you know exactly what to do if your symptoms do come on.
Make sure you’re carrying your reliever inhaler with you at all times and taking your preventer inhaler daily as prescribed, even if you feel well.
It can also be helpful to speak to someone you trust if you feel overwhelmed or down.
5. Hormonal changes
As if you weren’t withstanding enough when you’re on your period, pregnant or going through the menopause, hormonal changes caused by these can be asthma triggers, though it is not yet clear why.
One theory is that they might increase inflammation in the airways, according to Dr Whittamore.
“We’ve found that as many as one in three women with asthma report worse asthma symptoms before or during a period,” he says.
While some women’s symptoms get worse during pregnancy, others notice theirs improve, and some don’t see any change at all.
During perimenopause – the period leading up to the menopause – some women with asthma notice their symptoms get worse.
Some may even develop asthma for the first time after menopause, which can be more difficult to control.
To help your GP or nurse identify whether your hormones are affecting your asthma, keep a diary of your symptoms to see if symptoms are worse at any particular point in your cycle.
Your risk of getting asthma for the first time around menopause can increase if you are overweight too, so it could be worth contacting your local NHS about options available to help you lose weight.
6. Scented candles and incense
Lighting a scented candle might seem like calming thing to do, but they emit particles and other pollutants when they burn which, when breathed in, can irritate the airways.
Burning just one candle in a room can substantially increase the particle concentration in the air.
Incense sticks may be even worse for your asthma, as they emit more than 100 times the number of fine particles as candles do.
There is even evidence that links burning incense sticks to lung disease, so using them regularly should be avoided.
Scented candles also contain a chemical called formaldehyde, but if you only use them occasionally, they are unlikely to pose much of a health risk.
Just make sure you don’t burn several candles or incense sticks in a small room at once.
What are the symtoms of asthma?
Most children and adults with asthma have times when their breathing becomes more difficult.
Some people with severe asthma may have breathing problems most of the time.
The most common symptoms of asthma are:
- wheezing (a whistling sound when breathing)
- breathlessness
- a tight chest – it may feel like a band is tightening around it
- coughing
Many things can cause these symptoms, but they’re more likely to be asthma if they:
- happen often and keep coming back
- are worse at night and early in the morning
- seem to happen in response to an asthma trigger like exercise or an allergy (such as to pollen or animals)
See a GP if you think you or your child may have asthma, or you have asthma and are finding it hard to control.
Source: The NHS