Patients who suffer from Asthma and Allergic Rhinitis have very sensitive nasal & bronchial airways that are affected by several environmental allergens (things that you are allergic to) or trigger (factors that aggravate your condition). The first step in controlling your condition is to identify these allergens and triggers and learn how to stay away from them!
To know what it is you are allergic to & what are your triggers, your doctor will start by a thorough review of your medical history. Allergy testing can be performed by either a blood test or by a specialized procedure called allergy skin testing. Asthma triggers can also be identified with a carry on breathing test (peak flow meter). Ask your doctor when further testing should be done.

1. HOUSE DUST MITES
   These are tiny insects found in house dust; they increase with moisture in the air. Dust mites are plentiful in mattresses, pillows, carpets, bed covers, stuffed animals and upholstered furniture. Dust mites contain a protein in their secretions that is actually responsible for the allergic reaction.
   Solution:
   • You can control dust mites by washing the bed pillows, sheets, and covers every week in hot water (>550 C).
   • Use a special allergy-proof mattress and pillow covers.
   • If possible, get rid of carpets and upholstered furniture, especially in the bedroom and living area.
   • Get rid of stuffed animals in children’s rooms.
   • Use a dehumidifier in your bedroom.
2. HOUSE PETS
   All warm-blooded animals, including birds and small rodents, produce dander (shedded skin, fur, and feathers), urine, saliva, and droppings to which you may be sensitive. Ask your doctor if he or she can check whether you are sensitive to a specific pet.
   Solution:
   • Don’t keep pets at home.
   • If that’s not an option, keep pets out of your bedroom. Keep your bedroom door closed (and preferably well sealed).
   • Keep your pets away from carpet and upholstered furniture as much as possible.
3. MOLDS (fungus)
   Indoor molds grow easily if you have a damp environment. Outdoor molds fly in the air in the form of invisible spores and are difficult to avoid.
   Solution:
   • Repair leaks and clean with fungicide or bleach and water solutions where mold is visible (when the allergic person is not around).
   • Keep humidity at less than 50%, using a dehumidifier if necessary.
4. OUTDOOR TRIGGERS
   Outdoor mold spores can cause allergies and are scattered in the air throughout the year but are more plentiful during days of high humidity. Tree, grass, and weed pollen can also be a major problem and not just only in the spring, since pollen can be in the air at different times throughout the year. Air pollution, industrial and tobacco smoke, and car exhaust can significantly aggravate your condition as well.
   Solution:
   • Keep your doors and windows shut, when possible, during times when outdoor triggers are present.
   • Avoid outdoor activity during high pollen or ozone hours, or take your medication prior to activity.
   • Shower and shampoo after being outside.
5. STRONG SMELLS
   Painting, cleaning fluids, garden chemicals, perfumes, lotions, hair sprays, and deodorants can trigger your allergies.
   Solution:
   • Stay away from the house or apartment when these chemicals and sprays are in use, and stay away until the smell clears.
6. SMOKING
   Cigarette, pipe, narjile, and cigar smoke can trigger your allergies severely. Children in homes with adults who smoke are far more likely to have asthma problems and ear infections.
   • If possible, smokers in families with asthma should quit.
   • Smokers should never smoke indoors, in cars, or around people with asthma.
   • Smokers should wear a removable shirt or jacket while smoking that can be taken off upon returning inside.
7. INFECTIONS
   Viruses and infections of the sinuses can also make asthma worse. Viral infections are the most common triggers in young children and also cause attacks in adults.
   Solution:
   • Get your flu shot every year.
   • See your doctor for proper treatment.
   • Ask your doctor for asthma medicine prior to flu season to prevent an asthma attack if your child gets a viral infection every year.
8. SINUS PROBLEMS
   Drainage from colds and other sinus problems can make asthma worse.
   Solution:
   • Don’t ignore a drippy nose.
   • Talk to your provider about medicines you can take to reduce the drainage.
   • Wash hands frequently.
   • Don’t share toothbrushes or toothpaste when you have a cold
9. WEATHER
   Weather changes can affect the lungs and airways of people with asthma—usually very hot, humid weather or very cold, dry weather
   Solution:
   • Avoid doing much outdoors when the weather is very hot or cold.
   • Wear a scarf around your mouth and nose to protect your airways when you must be out in cold, dry weather.
10. EXERCISE
    Many people with asthma can have attacks during exercise or during times of high stress.
    Solution:
    • If exercise is one of your triggers, your provider can give you medicine to take 15 to 30 minutes before exercising to prevent an asthma attack.
    • Do warm-up exercises 6 to 10 minutes prior to exercise.
    • If you are still experiencing asthma symptoms, see your provider, as you may need additional medicines.
      Remember:
      • Even though asthma can affect exercise, you should not avoid it. Regular exercise can improve your lungs and overall health. It’s an important part of controlling your asthma. Ask your provider to help you plan a safe exercise program.
11. REFLUX
    Acid reflux or GERD occurs when a muscle in the esophagus (food pipe) relaxes and opens at the wrong time, allowing food or stomach fluids to splash up into the esophagus. You experience a burning sensation (heartburn) because of this occurrence. This is present in children and adults with asthma more than other people.
    Solution:
    • You may need to make some lifestyle changes, such as avoiding certain foods, alcohol, or tobacco or medicine.
    • You may need to take medication to control acid in your stomach.
    • Ask your provider for guidance.