Asthma affects over 25 million people in the United States.¹ Allergic asthma affects 60% of them. Despite its prevalence, most asthma sufferers are unaware that the most common form of asthma is triggered by allergens.
With that in mind, let’s start at the beginning.
First, what is asthma?
Asthma is a chronic respiratory disorder. More specifically, airflow is obstructed due to underlying inflammation, which leads to the most common symptoms: wheezing, shortness of breath, coughing, and chest tightness. These symptoms can occur a few times a day, a few times a week, or a few times a year depending on the severity of your condition. Asthma begins in childhood and is more common in younger males than females.² After puberty, females are more likely to develop asthma and the overall prevalence is more common in females when all ages are taken into consideration.³
Allergic asthma, the most common form of asthma, is triggered by airborne allergens (i.e. pollen, dust mites, mold, cockroaches). It’s estimated to affect 60% of all asthma sufferers in the U.S.⁴
What is the atopic march?
A major risk factor for developing asthma is a history of hay fever and eczema (for reference, atopic dermatitis is the most common form of eczema). The progression from one disease to the next is referred to as the atopic march.⁵ For example, 50% of children with severe atopic dermatitis are likely to develop asthma. And more than 20% of adults with atopic dermatitis also have asthma and are 2 to 4 times more likely to have allergic rhinitis and food allergies.
That said, this progression isn’t the same from person to person. In fact, the development of these diseases is primarily influenced by genetic and environmental factors.⁶
How do I know if my asthma is caused by allergies?
If your asthma symptoms flare up around environmental triggers such as pollen or pet dander, you may have allergic asthma. In order to confirm this, an allergy test would need to be taken (like Nectar’s Indoor & Outdoor Allergy Test to pinpoint the clinical triggers.
The National Asthma Education and Prevention Program Expert Panel guidelines also recommend taking an environmental allergy test if you require daily asthma medications.
Is asthma a problem around the world?
The short answer is yes. Asthma affects all races, ages, sexes, and ethnic groups, and the World Health Organization estimates that 262 million people suffer from it — a number that’s on the rise. Within the U.S., it affects 25.7 million people, including 7 million children. In fact, asthma is the most common noncommunicable disease among children (meaning it can't be directly transmitted between people), and it is the leading cause of school absences and hospitalizations for adolescents.⁷
Asthma is a significant health and economic burden, not just on patients, but on their families and society as a whole. Here are some of the most shocking statistics:
- Healthcare costs for asthma in the U.S. come out to $11.5 billion a year.
- Productivity losses amount to $4.6 billion.
- People spend $5 billion on prescription drugs to manage their asthma.
- Adults miss 10.1 million workdays a year because of the disease.
Every day, 40,000 people in America miss school or work, 30,000 people have an asthma attack, and 1,000 people are admitted to the hospital.
The numbers are staggering but it’s not all bad news. Hospitalizations for asthma attacks are declining, and treatment and management options are improving.
Speaking of which, what are my treatment options?
There are multiple treatment options for allergic asthma including avoidance measures, immunotherapy, and inflammation-fighting medications like glucocorticoids and biologics.
Avoidance measures depend on the allergen but here are some examples:
- Dust mite-proof covers on pillows, mattresses, and box springs
- Wash bedding frequently
- Keep windows closed during pollen season
- Wear a mask outside during pollen season
- Wash hands after petting a cat or dog
- Use dehumidifiers
While studies have shown that avoidance measures can decrease the number of days that asthma symptoms are experienced⁸ and decrease the number of hospital visits⁹, noticeable improvement is difficult to achieve in a normal, day-to-day environment, especially in areas outside the home where patients have little to no control over the conditions.¹⁰
An alternative long-term treatment option that has been more effective in treating allergic asthma is allergen immunotherapy (AIT).¹¹ Patients who embark on AIT may even decrease their risk of progressing along the atopic march, specifically from allergic rhinitis to asthma.¹² AIT may also decrease the risk of developing additional environmental allergies.
In short, patients with allergic asthma have options outside of simply managing their symptoms. Testing and treating the condition can offer long-term relief and allow for a more active, normal lifestyle.
¹ Chabra, Rina. and Mohit Gupta. “Allergic And Environmental Induced Asthma.” StatPearls, StatPearls Publishing, 20 May 2022.
² Miranda, Christina et al. “Distinguishing severe asthma phenotypes: role of age at onset and eosinophilic inflammation.” The Journal of allergy and clinical immunology vol. 113,1 (2004): 101-8. doi:10.1016/j.jaci.2003.10.041
³ Zein, Joe G, and Serpil C Erzurum. “Asthma is Different in Women.” Current allergy and asthma reports vol. 15,6 (2015): 28. doi:10.1007/s11882-015-0528-y
⁴ Lemanske, Robert F Jr, and William W Busse. “Asthma: clinical expression and molecular mechanisms.” The Journal of allergy and clinical immunology vol. 125,2 Suppl 2 (2010): S95-102. doi:10.1016/j.jaci.2009.10.047
⁵ Agache, I et al. “Untangling asthma phenotypes and endotypes.” Allergy vol. 67,7 (2012): 835-46. doi:10.1111/j.1398-9995.2012.02832.x
⁶ Bantz, Selene K et al. “The Atopic March: Progression from Atopic Dermatitis to Allergic Rhinitis and Asthma.” Journal of clinical & cellular immunology vol. 5,2 (2014): 202. doi:10.4172/2155-9899.1000202
⁷ Chabra, Rina. and Mohit Gupta. “Allergic And Environmental Induced Asthma.” StatPearls, StatPearls Publishing, 20 May 2022.
⁸ Morgan, Wayne J et al. “Results of a home-based environmental intervention among urban children with asthma.” The New England journal of medicine vol. 351,11 (2004): 1068-80. doi:10.1056/NEJMoa032097
⁹ Murray, Clare S et al. “Preventing Severe Asthma Exacerbations in Children. A Randomized Trial of Mite-Impermeable Bedcovers.” American journal of respiratory and critical care medicine vol. 196,2 (2017): 150-158. doi:10.1164/rccm.201609-1966OC
¹⁰ Akar-Ghibril, Nicole et al. “Allergic Endotypes and Phenotypes of Asthma.” The journal of allergy and clinical immunology. In practice vol. 8,2 (2020): 429-440. doi:10.1016/j.jaip.2019.11.008
¹¹ Cox, Linda et al. “Allergen immunotherapy: a practice parameter third update.” The Journal of allergy and clinical immunology vol. 127,1 Suppl (2011): S1-55. doi:10.1016/j.jaci.2010.09.034
¹² Tosca, Maria A et al. “Immunotherapy and Asthma in Children.” Frontiers in pediatrics vol. 6 231. 21 Aug. 2018, doi:10.3389/fped.2018.00231