Try this: Put a straw in your mouth and start breathing through it. Then, slowly pinch the straw to restrict the airflow. Finally, pinch the straw tightly, so it takes all your effort to get some air. Keep it up for awhile. This exercise may give you some idea of what a person with asthma experiences when having an attack.

Asthma is a chronic lung disease, usually with constant underlying inflammation and lung damage. Asthmatics also suffer acute attacks during which air passages in the lungs narrow and breathing becomes difficult. Attacks can vary from mild to life threatening and can be triggered by things people are allergic to (allergens) or things that irritate the lungs.

Asthma is the leading cause for hospitalization of children at MetroHealth and University Hospitals. Nationally, over the past 20 years, asthma rates have increased 74% and deaths have increased by 50%. Asthma is also a major reason for school absences.

No one knows why asthma rates have been increasing, particularly among children. However, whatever the cause, many more people are now sensitive to indoor and outdoor pollution.

Indoor Triggers
Some of the strongest environmental asthma triggers are found indoors, especially in the home. Here is a list of indoor asthma trigger sources and tips for controlling them.

• Tobacco smoke: Do not allow smoking in the house or in the car.
• Dust mites: Special mite-proof pillow and mattress covers and frequent washing of bedding in hot water can prevent accumulation of dust mites.
• Cockroaches: Deny roaches food, water, hiding places and entry. Don't use pesticide sprays, fogs or bombs - they are not effective and can expose you to dangerous pesticides. Gel baits, bait stations and boric acid are effective and, if used properly, minimize pesticide exposure.
• Mold: Throw out things that are moldy or have been soaked for more than a couple of days. Get information on cleaning mold safely. The key to reducing mold is reducing excessive moisture.
• Rodents: Use snap traps, not poisons.
• Combustion Products: Home appliances that burn fuel produce irritant gases and fine particles that, if not properly vented, can trigger asthma attacks. Have the furnace, water heater, flues and chimney inspected each year, don't use unvented (non-electric) space heaters, and do use exhaust fans vented to the outside.
• Household Products: Avoid pesticides, solvents, building materials and cleaning products with strong odors.

Since excessive moisture helps mold, mites and roaches flourish, take steps to reduce moisture. Triggers accumulate in dust and dirt on surfaces, so keep dust levels down, using wet cleaning and vacuuming (with an allergen-proof or double bag). Too much to do? Start with the bedroom and make it as free as possible from triggers.

Outdoor Asthma Triggers
The EPA estimates that the chance that a child with asthma will have an attack is 40% greater on high outdoor pollution days. A recent study that followed 3500 children for up to five years found that time spent playing outside was associated with a higher rate of asthma in communities with high ozone pollution, but not in areas of low ozone.

Outdoor asthma triggers include fine particulates (soot), ground level ozone (smog), diesel exhaust, sulfur dioxide, nitrogen dioxide and carbon monoxide, as well as pollen and mold. The major sources of outdoor pollutants associated with asthma are power plants, passenger vehicles and diesel buses and trucks.

Division of Responsibility for Control of Asthma Triggers
There is a division of responsibility for the control of indoor and outdoor pollutants that trigger asthma attacks. Parents can take actions to reduce their children's exposures to tobacco smoke, roach dust, dust mites and molds. Landlords have a responsibility to provide housing that is free of roach infestation, water leaks and other defects that give rise to asthma hazards. However, neither parents nor landlords control outdoor pollution (except in their role as motor vehicle drivers, of course). That must be done by government and industry.