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Useful facts on asthma (astma)

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What is asthma?

Asthma is a chronic inflammatory condition of the airways, which leads to increased irritability of the mucosa and episodes of shortage of breath or coughing.

Why does your chest get tight?

Asthma attacks are caused by various factors (allergies, tobacco smoke, dust, pollution, fog, damp air, cold, gases, strong odours, stress, medications, physical activity and viral infections)

What happens in the airways?

There are three factors in particular which individually trigger attacks;

  • Spasm of the musculature surrounding the airways.
  • Inflammation of the mucosa in the airways – not due to infection. The inflammation leads to swelling of the mucosa and hence the bronchi become narrower and tighter. The work of breathing is increased and the sufferer feels short of breath.
  • Collection of mucous in the airways.

Who gets eczema?

Asthma may be hereditary and often occurs together with eczema and allergy. Non-hereditary asthma may be a side-effect of airways infections, air pollution and tobacco smoke in individuals with a predisposition for the development of asthma.

Treatment of asthma

The aim of the asthma treatment is that the individual will be able to live a life with as few limitations to daily life as possible, the least possible number of asthma attacks and normal lung function.

Inhalation of asthma medicines is the preferred treatment for this disease. The treatment must be adapted to individual need in terms of dosage and frequency of inhalations.

  • Quick relief or rescue medicine should be used when one feels tight-chested and short of breath. The medicine may also be taken before exercise – based on prior experience of feeling tight-chested during physical activity. Remains effective for 3-4 hours.
  • Long-lasting or preventer medicine. Has a preventive effect and remains effective for up to 12 hours.
  • Preventive asthma medicine. Inhaled cortisone, taken morning and evening (daily). Cortisone given in this manner does not have the unwelcome side effects we associate with cortisone in tablet form.
  • Preventive asthma medicine. Leukotrien antagonists are only available in tablet form, taken once daily. May also have a beneficial effect on rhinitis.
  • Combination preparations are a mixture of preventer and rescue medicines in a single inhaler.
  • Individuals with severe asthma may need to use cortisone in tablet form. This is given in the form of time-limited courses of treatment or rarely as maintenance treatment in particularly severe asthma. Such treatment has a strong effect on inflammation in the airways. 2-week courses of treatment are most commonly used.

Prevalence

Asthma occurs in approximately 10-12% of Norwegian children and young people and approximately 8 % of adults.

The results from the large-scale environment and childhood asthma study at Ullevål University Hospital, which has followed close to 4,000 children in Oslo from the age of two years, shows however that 20% of the children have or have had asthma before the age of 10 years. There has been a steady increase in the occurrence of this disease over the past 40 years.

The figures are consistent with studies in several other European countries. None of these countries has an incidence higher than that in the United Kingdom, with an incidence of greater than 32% amongst 13-14 year-olds.

Cause/prevention

Development of asthma can have different causes. Allergy is an important factor and a large majority of children with asthma have co-existing allergy. This may be due to hereditary factors. Asthma debuting in early childhood has several differences in comparison to adult-onset asthma. Passive smoking and infection are a common risk factor.

Researchers do not yet know enough about why the occurrence of asthma is increasing. This may be due to both environmental factors and lifestyle. The so-called “hygiene hypothesis” is based on the observation that children who were subjected to early allergen exposure are believed to be protected against developing allergies as adults. This has primarily been discussed in connection with exposure to fur-bearing animals.

An important piece of advice in preventing the development of allergies, and subsequently asthma, in children is preventing their being exposed to passive smoking.

For children in so-called “high risk” families, where heredity appears to play an important role in terms of the development of asthma and allergy, it is still recommended that allergens (smoke, animals, mould from damp, mites, etc.) in the home environment be avoided.

Asthma schools

The Asthma Schools' (National Plan for Asthma Schools – NPAS) focus on education, treatment and prevention of the illness. The Asthma Schools struggle financially and one of NAAF’s key roles is to ensure continued operation of the asthma schools.

Treatment institutions

Geilomo children’s hospital is an NAAF-owned treatment/rehabilitation centre for children with asthma, allergies and eczema from throughout Norway.  Applications are made through general practitioners.

The Norwegian government offers funding for therapeutic travel assistance to 170 children with asthma/eczema annually. It is considered that the number recommended in NOU 2000:2 Therapeutic travel abroad (Behandlingsreiser til utlandet) should be increased to 1,000 places annually. Application forms (IK1167 and IK1167b) at National Insurance Offices. You can get an application via your doctor.

Det Norske Helsesenter, Valle Marina in Gran Canaria is owned and operated by NAAF. Trips to Valle Marina are ordered via Helsereiser A/S 22 79 92 00.

There are also other institutions for research, treatment and rehabilitation of patients with chronic airways disease. Selli, Granheim, Glittreklinikken, Valnesfjord, Røros etc. Contact NAAF (locally) for more information.