Prevention of Asthma

How to prevent asthma?

Development of asthma has two distinct bases: Hereditary and Environmental. For the prevention of the development of asthma we should manipulate these two factors. Regarding hereditary factors, we have yet nothing to do practically. Genetic engineering is a future probability. What we can do is to manipulate the environmental factors. Effort should be concentrated on primary prevention of asthma.

What is primary prevention?

"What we mean by primary prevention is intervening even before we can see any form of sensitization in the individual we are investigating". The four key areas in primary prevention are: -

-Timing of hyperresponsiveness

- The level to which allergen concentrations must be reduced to prevent the development of hyperresponsiveness

- The necessary duration of allergen avoidance

- Adjunct factors involved in triggering the disease

for these, following two things are to be done:

- Identification of the asthma prone persons
- Well defined prevention program for the asthma prone persons

How to identify asthma prone persons?

Period before and immediately after birth is very important for the future development of allergic diseases, such as asthma. Identification of the high-risk newborns can be done by a family allergy scoring system (FAS). FAS is based on the number of immediate (first degree) family members (mother, father, brothers and sisters only) who suffer or who have suffered from one or other allergic condition.

Scoring system:

Two points are scored for each immediate family member who has definite, medically confirmed allergic disease. (Positive history along with clinical evidence).

One point is scored for each family member who has possible or suspected allergic disease but which has not been medically confirmed. (Positive history without clinical evidence).

One point is scored for persons exposed to occupational hazards (occupational asthma).

No point is scored for the members with no allergic disease.

Interpretation of the score:

0 - 1 : No prevention is necessary.

2 - 3 : Serum IgE estimation, raised value indicates preventive program.

4 or more : Strongly advocate preventive program.

Program for primary prevention

Program for primary prevention of asthma vary from person to person. It is difficult to chalk out an universal program. However on the basis of recent knowledge asthma prone persons, that is, persons who have more e chance of developing asthma, may be given the following advice in the form of DOs and DON’Ts :

DOs DON’Ts

• Babies should be exclusively breast-fed until the age of six month. • Lactating mother should not eat or drink any allergy producing food or beverage.

• Weaning should be delayed, if possible until six month of age, particularly allergy producing solids. • Prevent high risk babies being exposed to high allergic foods and inhaled substances during first year of life.

• Encourage low salt diet . • Avoid carpeting, stuffed furnishing, household pets, stuffed toys (teddy bears) and furry dresses.

• Encourage more fish and less meat in diet. • Try to avoid broad-spectrum antibiotics for viral R.T.I.

• Encourage outdoor sports in summer and indoor sports in winter. Swimming is best exercise for asthmatics. • Try to avoid outdoor air pollution - pollen, dusts, smoke etc.

• Try to establish proper ventilation at home. • Quit active smoking and avoid indoor passive smoking.

• Try to change the job if occupational asthma is suspected. • Try to avoid spending 3 hours or more at a stretch in a day in front of the television or computer.