Dr Dermot Nolan
GP in Tramore, Co Waterford, and the HSE/ICGP national clinical lead for asthma
Eight per cent of adults and 10 per cent of children have asthma and Ireland has the fourth-highest rate of asthma in the world. The cause of asthma is not fully understood, but is thought to be multifactorial, with genetics, environment and possibly increased hygiene playing a part. We do know that children growing up on farms have lower rates of asthma. It's important for children to play outdoors and get exposed to the usual germs.
Asthma affects the airways from the tip of the nose to the bottom of the lungs and many people with asthma also suffer from bad hay fever (rhinitis). Treating this with a nasal spray before the onset of symptoms is a good idea.
Good asthma control means no flare-ups and minimal symptoms allowing patients to live life to the full. Many people overuse their bronchodilators (Salbutamol inhalers/"blue" inhaler) because they don't take their preventative treatment (corticosteroid inhalers) to control the inflammation in their lungs. Ideally blue inhalers should be used very infrequently and the device should last for one year. Most patients don't use their asthma device correctly which results in poor control and often more side effects. (See asthma.ie for videos on correct use of inhalers.)
People with asthma need to live in a smoke-free house because their airways are sensitive to tiny particles of smoke on hair or clothes. Sufferers of chronic obstructive pulmonary disease – which is the other most common respiratory condition – shouldn’t smoke. They need to manage their weight, get exercise and ensure they get their flu and pneumonia vaccines. Pulmonary rehabilitation with a physiotherapist can be hugely beneficial.
Johanna O’Callaghan
Respiratory health specialist nurse practitioner
The lungs are different from most other organs in your body because their delicate tissues are directly connected to the outside environment. Anything you breathe in – germs, tobacco smoke, dust and chemicals – can affect them.
Cigarette smoke is a major cause of lung cancer and chronic obstructive pulmonary disease, which includes bronchitis and emphysema, so stop smoking if you smoke and stay away from secondhand smoke. Air pollution, chemicals in the home and workplace can also cause or worsen lung disease. So, while it's good to take exercise and maintain a healthy weight, avoid exercising outdoors on "bad air days" (see airquality.ie).
To protect yourself from respiratory infections in general, frequently wash your hands with soapy water, avoid crowds during the cold and flu season and if you get sick, stay home from work or school until you feel better.
There is a thin lining of mucus inside your lungs and drinking plenty of water throughout the day helps keep this lining thin, which in turn allows your lungs to do a better job. Make sure your healthcare provider checks your breathing when you attend for an appointment as lung disease can go undetected in the early stages.
Dr Mohammad Tariq
Consultant paediatrician with an interest in respiratory and allergy conditions
Young children who have dry skin (eczema) are at risk of developing hay fever and/or asthma and other allergies. It’s important to treat dry skin with an emollient but it’s also important to prevent allergies from developing by introducing potentially allergenic foods such as milk, peanuts, eggs and other nuts before children reach their first birthday.
Breastfeeding is the best way to prevent allergies but it’s also important to encourage children to eat a wide variety of foods and spend time outdoors in the fresh air to build up their immune system.
If a child has hay fever, try to identify the triggers. If they have watery, itchy eyes and nose, blotchy cheeks and an itchy nose during the pollen season (March to September), then it’s important for the child to take antihistamine tablets after consultation with their doctor. If the hay fever gets worse, they will need to talk to their doctor about getting a nasal steroid spray and if it’s very bad, they will need both.
Immunisation is also important because this protects children from becoming very ill if and when they pick up different viral or bacterial infections. Every child with asthma should have a written asthma action plan so that they can learn to self-manage their asthma and recognise when it's getting worse (see asthma.ie and ifan.ie).
Dr Des Murphy
Consultant respiratory physician at Cork University Hospital
Exercise is extremely important for lung health. Pulmonary rehabilitation programmes, which help people with respiratory disease to exercise in a safe and effective way, are currently available through acute hospitals and soon will be available in community-based, chronic-disease hubs. I advise people with severe respiratory symptoms to walk where there are park benches so that they can sit down when they feel breathless, discreetly take a break and go again. That way, they can measure their performance against how many times they need to sit down.
House-dust mites are a major source of irritation for people with asthma. They thrive in warm centrally-heated environments so I advise patients to leave bedroom windows open at night to reduce the temperature of the room, to vacuum clean mattress when changing bed linen and use mattress protectors. People with chronic respiratory illness should get the flu vaccine annually and the Covid vaccine.
There are certain symptoms that might signal respiratory disease which shouldn’t be ignored. Anyone who coughs up blood, has a persistent cough or unexplained weight loss should see their GP to rule out or seek further treatment for conditions such as lung cancer or tuberculosis.
Dr Jurgita Ovadnevaite
Deputy director of the Ryan Institute's Centre for Climate and Air Pollution Studies at the National University of Ireland Galway
The quality of the air we breathe is one of the most important factors influencing the health of our respiratory system. Pollutants in indoor and outdoor air such as tiny particles (known as particulate matter) and toxic gases can cause direct physical harm to the cells in the respiratory system. Cooking (particularly frying with oils), candle burning, cigarette or incense smouldering, and smoke from open fires and stoves contaminate the air we breathe. My advice is to stop burning stuff or at least realise the damage it does. Since we can’t stop cooking, it’s important to have proper ventilation and use extractor fans when doing so. Open windows can effectively reduce indoor air pollution if the outdoor air quality is good. If you lack alternative heating sources to solid fuel fires or stoves, make sure your chimney is clean, burn only certified logs, don’t let fires smoulder and open stove doors infrequently.
To avoid high levels of traffic pollution, choose less congested streets for walking and exercising to limit your exposure. Don’t leave your car engine running while waiting and encourage traffic-free zones at school gates.
Five experts, five tips
- GPs
- Heart
- Musculoskeletal
- Digestion
- Respiratory
