The signs of asthma

Australia has one of the highest rates of asthma in the world. We discuss the symptoms and triggers, and how to manage the condition.

Lucy E Cousins
October 2017

Surprisingly, Australia has more diagnosed cases of asthma than almost any other country in the world. In fact, asthma contributed to more than 400 deaths in 2014, and according to a 2015 report, it’s costing Australians almost $28 billion a year.

“My 2-year-old son was sleeping when he started coughing, but at first we ignored it,” says Sydney mother Caroline Jones. “Then as the coughing got worse and he woke up crying, my husband recognised he might be having an asthma attack.”

Both Caroline and her husband, Owen, were diagnosed with asthma as children and are among the 1 in 9 Australian adults who have the condition today.

Preventable deaths

According to the Australian Bureau of Statistics, of the roughly 10% of Australians with asthma, 54% are female and the majority are 55 years or over. In 2014 alone, there were 277 female deaths from asthma, compared to 142 male deaths.

“Many women don’t realise the potential seriousness of the condition because it’s so common, and they may not make asthma care a priority,” says Dr Jonathan Burdon AM, chair of the National Asthma Council Australia and respiratory physician, adding there’s no conclusive evidence as to why women die of asthma at 2-3 times the rate of men.

Almost two thirds of all asthma-related deaths are preventable, says former Asthma Australia chief executive Mark Brooke. "There’s certainly evidence being presented that about 60% of deaths could’ve been prevented. That's an alarming statistic.”

Asthma: the facts

Characterised by recurrent attacks of breathlessness, asthma is a long-term respiratory condition. People with asthma tend to have inflamed or hypersensitive airways, which are sometimes narrow and filled with mucus. This means you experience difficulty breathing as well as wheezing and coughing, and in some cases, chest tightness and chest pain.

The causes of asthma aren’t fully understood. A family history of eczema, food allergies or hay fever can all contribute to contracting asthma, as can being born prematurely or underweight. Another factor can be exposure to tobacco smoke as a child, or if your mum smoked during pregnancy.

Symptoms and triggers

Doctors look for a range of symptoms to diagnose asthma in children or adults, and will explore your family and medical history, assessing the frequency of symptoms as well as any triggers. These triggers can range from dust mites, pet fur, cigarette smoke, chemicals and pollution to certain painkillers, stress and even changes in weather conditions. And while most cases are diagnosed in childhood, it is possible to grow out of it only to have it reoccur in adulthood.

To help evaluate the severity of the symptoms, doctors usually advise you to do various breathing tests. These are relatively painless — you may be asked to blow into machines to measure lung capacity, inflammation and airway responsiveness, as well as how fast you can expel air from your lungs.

Managing the symptoms

While there’s no cure for asthma, there are ways to manage the disease and help prevent future attacks. Treatment includes a mixture of medicine and lifestyle changes as well as education about triggers and common causes of asthma attacks.

Caroline believes the key to living with asthma is managing the symptoms. “Having asthma isn’t the end of the world. It shouldn't worry you in any way so long as its managed well, which is easy to do. My husband and I live very normal lives and asthma isn’t really a big deal if it’s managed correctly.”

What to look out for

According to Asthma Australia, signs of a severe asthma attack are:

• obvious difficulty breathing
• can’t speak a full sentence in one breath
• tugging in of the skin between ribs or at base of neck
• may have cough or wheeze
• relief medication not lasting as long as usual.

Asthma Australia advises calling an ambulance as soon as symptoms appear and then starting Asthma First Aid treatment.