Asthma in the Fall

by Russell Traister, MD, Bloomfield Allergy

Many people look forward to

autumn, with the start of school, cooler weather, pumpkin spice, and of course, Steeler football. Though it is well known that asthma exacerbations can occur with the onset of the spring pollen season, many people forget that there is another peak for asthma exacerbations in the fall, typically sometime in September. Though the timing is different, symptoms of an asthma exacerbation are the same regardless of the time of year they occur and include shortness of breath, wheezing, and chest tightness.

Fall exacerbations can occur for several reasons. One main factor is the presence of ragweed pollen, a common allergy and asthma trigger that peaks in the fall and remains present until the first frost of the year. Ragweed pollen is difficult to avoid, but steps can be taken to minimize exposure. Keeping home and car windows closed and drying clothes in a dryer instead of hanging them on a clothesline can help.

Cold and damp weather in the fall can also increase mold spores, another common asthma trigger. If ragweed or mold are a significant trigger for your asthma, your allergist may suggest allergy shots, which could help decrease your asthma exacerbations.

Another major cause of fall asthma exacerbations is viruses such as the cold and flu. Often when school starts in the fall, children are around many other kids in class and viruses can spread more easily. If you have asthma, this is one of the major reasons your doctor recommends you receive the yearly flu shot.

Fall is also a time of quite dramatic weather changes, and change in temperatures from hot one day to cold the next can affect the airways of patients with asthma, leading to more symptoms. Regardless of the cause, it is important to be mindful of your symptoms and alert your doctor if any worsening of your asthma occurs.

Many patients and parents are unsure when they should contact their doctor or seek emergency care for their child when asthma symptoms flare. I typically advise families to administer albuterol, a rescue inhaler, providing 2-4 puffs. If symptoms are unresolved or not improving after 20 min, albuterol can be administered again. After that if symptoms are not improving/resolving, or if you cannot space the need for albuterol out to a minimum of 4 hours, emergency care should be sought. Additionally, it is important to recognize if your asthma is not under optimal control. If you or your child have asthma and are requiring albuterol more than twice a week (apart from exercise), are waking at night with asthma symptoms more than twice a month, or are requiring more than one course of oral steroids yearly, contact your doctor to discuss more optimal treatments for asthma control.