Trees decorated with pretty baubles and turkey with all the trimmings might be traditional highlights of December 25, but they can also be triggers for those with asthma, prompting a potentially serious asthma attack or resulting in a hospital stay, a leading lung charity has warned.
The most recent data shows that 7,110 people were admitted to UK hospitals with asthma attacks in Decemeber 2022. Here are the main triggers to look out for:
CHRISTMAS TREES
Christmas Tree Syndrome is the nickname given to the allergic reaction to a Christmas tree which can cause a range of symptoms such as coughing, sneezing, wheezing or a stuffy or runny nose. It can be a danger to people with asthma as it can cause the airways to inflame and tighten, potentially leading to a flare-up of symptoms such as breathlessness and coughing and causing a life-threatening asthma attack.
“Christmas Tree Syndrome can occur with both real and artificial trees for different reasons. Real trees can carry many different types of mould which you might not be able to see, and which can increase the levels of mould spores in your home,” says Dr Andrew Whittamore, Clinical Lead at Asthma + Lung UK, and a practising GP.
“Real Christmas trees and other seasonal plants like mistletoe can bring mould spores and pollen into your house. In a warm home, these spores can multiply. If you’re sensitive to mould and pollen, you may notice symptoms similar to hay fever when you get a real tree and your asthma symptoms getting worse.”
In a recent survey, Asthma + Lung UK found that a staggering 34% of people with asthma surveyed said they were triggered by mould and fungi. Artificial trees aren’t completely safe either, as the dust and mould from these accumulated during storage could prompt an allergic response too. And 55% of those with asthma surveyed said dust is a trigger for them.
FOOD AND DRINK
Care needs to be taken around food and tipples associated with this celebratory time of year as well, warns the charity – a simple nibble on a pig in blanket, gravy on the turkey, or sips of mulled wine could trigger an asthma attack for some people.
For 11% of women and 6% of men surveyed by Asthma + Lung UK, food was trigger for their asthma. This happens because people with asthma can be sensitive to sulphites and histamines, which can be present in certain foods and alcohol, such as processed meats like sausages, mulled wine, and gravy – all festive staples on the dinner table. Ingesting these can trigger symptoms like coughing, wheezing, and breathlessness.
“Sulphites are used in some processed meats like sausages and burgers, in pickled foods and vinegar, dried fruits, and vegetable and fruit jams,” says Dr Whittamore. Fizzy drinks, fruit juice concentrates like squash, cordials, and vegetable juices can also contain sulphites.
DECORATIONS
Other key triggers during the festive season can include dust mites, which multiply in warm conditions and in warm areas and can make asthma symptoms worse. People with asthma have sensitive airways. This means that when they come into contact with triggers like dust or mould, which can often linger in decorations that have been put away for the rest of the year, it can cause their airways to become more inflamed and tighten, causing coughing, wheezing and leaving them struggling to breathe.
Any attack can be life-threatening, whatever the trigger, and four people die from an asthma attack every day in the UK.
Dr Whittamore says: “Every person with asthma will have a different pattern of symptoms and triggers. Understanding your own personal triggers and keeping an eye out for symptoms can help you to keep on top of your asthma symptoms so that it doesn’t get in the way of your Christmas.
“This time of year, the cold weather and viruses are a major trigger but there are things closer to home that we can do something about. Wiping down decorations outside to get rid of dust before you put them up can help.”
STRESS
While the festive season may be the most wonderful time of the year, it can also be the most stressful. Bickering and disagreements among family members, not to mention the mammoth task of preparing the Christmas dinner and shopping for presents in busy, overcrowded high streets can all take their toll on your stress levels. Stress is a trigger for 36 per cent of people with asthma, and the panic of trying to get Christmas-ready can easily cause levels to soar.
“We know that stress can mean you’re more at risk of asthma symptoms,” says Dr Whittamore. “In fact, people with asthma dealing with ongoing or severe stress are more at risk of asthma attacks or going to hospital. You’re more likely to react to your usual triggers if you are highly stressed, including colds and respiratory infections, have worse symptoms, or your asthma may feel harder to manage. The important thing is to try and keep your stress levels under control. Things like eating well, doing exercise, getting enough sleep, and connecting with others can help as well as ensuring you are taking your asthma medications as prescribed.”
GIFTS
Some of the most popular gifts at Christmas time are scented candles, perfume, and aftershave. But while they may smell nice these products release particulate matter (PM) and other pollutants when they burn, « in some cases more than cigarettes, » says Dr Whittamore. « Many cosmetic products including perfumes and aftershaves also release pollutants like volatile organic compounds (VOCs) and these pollutants as well as PM can cause allergic reactions or headaches.
« They can also make your asthma worse. Asthma + Lung UK found four in 10 people surveyed said aerosols and perfumes triggered their asthma. To protect yourself, It’s a good idea to light candles in well-aired, large spaces instead of smaller spaces like bathrooms. Try opening windows while burning candles, if possible. Avoid perfumes if they are a trigger for you.
« Other gifts like clothing could also contain pet dander – another allergen common among people with asthma – if they come from a home where there are pets, so it may be worth giving loved ones and friends a list of ‘safe’ gift options. »
If you would like to receive tailored advice about how to look after your lung condition over winter, please visit: Asthma + Lung UK
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