What is Asthma (Dr. Guy Marks)
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Transcript of What is Asthma (Dr. Guy Marks)
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What is asthma?
Guy B. Marks
www.woolcock.org.au
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Symptoms
Wheeze, chest tightness, shortness of
breath, cough (usually dry)
Episodic Triggered
Reversible
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Diagnostic features
Typical symptoms and episodic nature
Airflow obstructive
Variable Reversible
Inducible
Airway inflammation Special type of airway inflammation
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Major consequences
Distress due to symptoms
Exacerbations
Hospitalisation Death (rare)
Disability
Impaired quality of life
Adverse effects of treatment
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Life Course
May start at any age
Typically, in childhood
Childhood asthma may remit
Typically, if mild and not associated with allergy
Asthma persisting into adulthood rarely remits
May wax and wane during life
Some cases progress to chronic airflowobstruction
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Associated illnesses
Atopy (allergy)
This, in turn, associated with eczema and
allergic rhinitis (hayfever)
Nasal polyps
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Causes
Generally not known
Occupational sensitisers cause occupational
asthma Maternal smoking during pregnancy
increases risk of childhood wheezing
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Triggers and exacerbating factors
Viral respiratory tract infections
Most commonly, the common cold
Also influenza, RSV, others
Allergens, if sensitised
HDM, grasses, animal danders, moulds
Occupational sensitisers
Exercise, laughter, rapid breathing (anxiety) Irritants
Insect sprays, perfumes, cigarette smoke
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Other triggers less common
Food additives
Only in some people
Aspirin Rarely
Other medications
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Epidemics
Thunderstorms
Grass pollens
Moulds
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30/31 October 1997, Wagga
ED attendances for asthma 215
Hospital admissions for asthma 41
Intubated in ICU 2
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12 13 14 15 16 17 18 19 20 21 22 23 24
Grains/m
3
0
20
40
60
80
Wind
speed
Wind
direction
Rainfall
Time (hrs)
Wagga Wagga
30th October 1997
12:00 - 24:00
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Variation in asthma
Age of onset and life course
Severity and prognosis
Type of inflammation
Association with allergy
Response to treatments
Triggers and exacerbating factors
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Treatment for asthma
Suppress inflammation
Steroids
Other non-steroid agents that target components of the
inflammatory response
Relax airway smooth muscle and allow airways to
open
Short-term, rapid onset
Longer-term (12-24 hours)
Various methods of delivery
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How common is asthma?
ISAAC data reported in The Global Asthma Report, the UNION, 2011
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Prevalence of current asthma by age and
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Prevalence of current asthma by age andNational Health Survey, Australia
Source: National Health Survey
P l f h b i i
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Prevalence of current asthma by socioeconomic status
Source: National Health Survey 200708
Recent trends in deaths due to asthma by sex
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Recent trends in deaths due to asthma by sex,all ages and people aged 534 years. Australia
Source: AIHW National Mortality Database
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Deaths due to COPD and asthma, by sex.Australia
Source: AIHW National Mortality Database
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The ACAM team
Report and slides available at: www.aihw.gov.au and www.asthmamonitoring.org
http://www.aihw.gov.au/http://www.asthmamonitoring.org/http://www.asthmamonitoring.org/http://www.aihw.gov.au/