Bushfires + wind + pollen spell bad news for asthmatics

Australians may be at risk of serious asthma and hayfever episodes given the forecasted strong wind, thunderstorms and bushfires across the eastern states in addition to a high pollen alert, said the National Asthma Council Australia.

Asthma Council Chief Executive Siobhan Brophy said that as well as the usual seasonal triggers, with Victoria already on alert for grass pollen and thunderstorms, this week’s severe bushfire and wind warnings are a potent reminder that the dangers are real.

“A high price has been paid and tragic lessons learned about prevention and awareness following Victoria’s epidemic thunderstorm asthma event. That event took 10 lives and resulted in thousands of people presenting to emergency departments, general practices and pharmacies with breathing difficulties on 21 November 2016,” Brophy said.

She urged healthcare professionals to ensure their patients understand the risks and how to protect themselves and others, as well as how to apply asthma first aid.

Thunderstorm asthma is a well-documented phenomenon not just in Melbourne but across south-eastern Australia with Wagga Wagga, Newcastle and Canberra all having had events in the past.

Thunderstorm asthma occurs when a storm hits on a hot and windy day when there are high levels of pollen grains in the air, which soak up moisture and ‘explode’ into smaller particles that are easily dispersed by windy conditions and can be inhaled deep into the lungs.

Prevention of asthma triggered by thunderstorms includes:

• year-round asthma control, including regular inhaled corticosteroid-containing preventers where indicated (applies to most adults with asthma);
• seasonal preventative treatment for people who are allergic to grass pollens but are not already taking regular medication: intranasal corticosteroids for people with allergic rhinitis and inhaled corticosteroids for people with asthma, ideally starting six weeks before exposure to springtime high-pollen concentrations, and continuing throughout the grass pollen season to 31 December; and
• advice for at-risk patients to avoid being outdoors just before and during thunderstorms in spring and early summer — especially during cold wind gusts that precede the rain front.
   

Management of an asthma attack triggered by a thunderstorm is the same as for any sudden asthma flare-up. The patient should follow their written asthma action plan (if they have one) and the First Aid for Asthma steps if necessary. Health professionals should follow the treatment guidelines for acute asthma in the Australian Asthma Handbook.

The Asthma Council has a suite of thunderstorm asthma resources to help healthcare professionals identify and manage patients at risk during the grass pollen season.

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