Stay safe during thunderstorm asthma season

Asthma Australia is urging community members with asthma and hay fever to be prepared and take thunderstorm asthma seriously, with ryegrass pollen season well underway.

Ryegrass pollen is a significant trigger for both asthma and hay fever, and high levels of the pollen contributed to Victoria’s freak 2016 thunderstorm asthma (TSA) epidemic which saw more than 8,000 people present to emergency rooms across the state in respiratory distress.

Humid weather conditions at the time caused these pollen grains to rupture, making them small enough to be inhaled, while a thunderstorm brought those particles down to ground level.

The event was associated with 10 asthma fatalities.

Hay fever was present in almost 90 per cent of those who attended emergency departments with thunderstorm asthma during the event, however asthma was previously known to be present in less than 30 per cent of individuals.

Asthma Australia spokesperson, respiratory and allergy specialist and director of research at the Royal Melbourne Hospital, Professor Jo Douglas, said the TSA event revealed many people who believe they only experience hay fever actually have asthma.

“Evidence revealed that one third of people who described only having hay fever symptoms before going to hospital with thunderstorm asthma, actually experienced asthma symptoms but did not recognise them,” Professor Douglas said.

She said it was important to recognise the hay fever symptoms associated with asthma, such as night walking and morning wheezing, and to see a doctor for an asthma review.

“People with undiagnosed asthma need to receive a formal diagnosis so they can begin to manage their condition,” Professor Douglas said.

“This could help reduce their risk of an asthma attack or hospitalisation during future thunderstorm asthma events.”

In Victoria, pollen season runs from August to December.

Prior to the 2016, the state had experienced several less severe TSA events, with these typically occurring in November.

While asthma-related deaths in Victoria have seen a small seven per cent decline over the past year, in some cohorts these figures have risen.

Women over the age of 75 remain at the greatest risk, with 42 per cent of all Victorian asthma deaths coming from this age group.

National Asthma Council director and respiratory physician Professor Peter Wark said the majority of asthma deaths were preventable and serious ongoing problems with asthma management was a key factor in these deaths.

“More effort needs to be made in diagnosing asthma properly and emphasising to patients living with asthma the importance of using an inhaled preventer treatment,” he said.

“Asthma is a chronic disease of inflamed airways and needs to be treated with an anti-inflammatory corticosteroid preventer to control symptoms and reduce asthma deaths, not just use of a blue reliever puffer alone.”

Despite this, he said, the anti-inflammatory preventer treatment is under-prescribed in Australia.

“Until this changes, too many people will continue to over-use their blue reliever puffer with the increased risk of poor asthma control and an increased risk of asthma death.”

Community members are encouraged to check pollen levels, avoid being outside if those levels are high, ensure their asthma action plan is up-to-date and schedule an appointment with their GP for at least an annual asthma review.

“Check in with your doctor to review your written asthma action plan, make sure you are using your inhaler properly and that you know what to do for an asthma flare up or acute attack or in any asthma emergency,” Professor Wark said.

“It is important that anyone with asthma is especially careful during thunderstorms and when thunderstorm asthma warnings are issued.

“Using an anti-inflammatory preventer will reduce your risk with thunderstorm asthma.”