ACTIVE

asthma.ie

ASTHMAWITH

CONTENTSTop Tips for being Active with Asthma 2

5 Step Rule for dealing with an Asthma Attack 4

Exercise Induced Bronchoconstriction 5

Choosing a type of exercise that suits you 6

Field Sports 7

Athletic Sports 8

Swimming 8

Scuba Diving 9

Mountaineering & Skiing 9

Skydiving & Bungee Jumping 9

Special Considerations 10

Choosing the Right Environment in Which to Exercise 10

Diet & Asthma 11

Competitive Sport & Asthma 11

Before You Exercise 12

Asthma Information for Coaches & PE Teachers 14

Before training/physical activity 14

During training/physical activity 15

Frequently Asked Questions 16

About the Asthma Society 18

Our Services to You 18

Support 18

Quick Asthma Facts 19

Further Information 20

INTRODUCTIONHaving asthma should not stop you from being active. In fact, it makes it even more important.

Regular physical exercise is an important part of a healthy lifestyle.

Exercise is of particular benefit to people with asthma because it improves lung capacity, boosts immunity and increases overall physical fitness, meaning that exercise reduces asthma symptoms.

As long as you’re looking after your asthma well, and your symptoms are under control, you can enjoy any type of exercise, including athletics and team sports.

Follow the tips in this booklet, control your asthma well, carry your reliever inhaler and get active!

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TOP TIPS FOR BEING ACTIVE WITH ASTHMA

Maintain good asthma control by:

• Taking asthma medication as prescribed.

• Managing your asthma triggers.

Develop an asthma management plan with your healthcare professional.

Always warm up gently for approximately 15 minutes before more vigorous exercising and cool down afterwards.

This helps your body and in particular, your lungs, to get ready for the upcoming, more strenuous exercise..

Always have a reliever inhaler (usually blue) with you when you exercise.

If your asthma is triggered during exercise take your reliever inhaler approximately 15 minutes before warming up. (2 puffs of a Metered Dose Inhaler or one puff from a Discus or Turbohaler)

Tell people you have asthma.

• If you are exercising alone, make sure someone knows where you are and what time you are due to return.

• Make sure that your coach and the people you exercise with know you have asthma.

Physical activity improves lung function and is an important part of a healthy lifestyle. Adults (aged 18+) should be active for at least 30 minutes a day 5 days a week and children and young people (aged 2-18) should be active for at least 60 minutes every day. Asthma symptoms shouldn’t stop you taking part in sport or physical activity once you follow the Top Tips for being Active with Asthma.

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Adults (18+)30 mins per day / 5 days a week

Children & Young People (2-18)60 mins every day

Carry an Asthma Attack Card with you at all times, especially when you exercise.

If your asthma is triggered by pollen, you may wish to:

• Check the pollen forecast at www.asthma.ie.

• Avoid exercising outside when the pollen count is high.

• Make sure you are taking the right medication to manage your hay fever as well as your asthma.

Wear a scarf or facemask in cold weather to help warm and humidify air.

Avoid exercising when you have a viral infection.

If it is very cold and you know cold air triggers your asthma, it might be better to choose indoor activities.

It may also be better to exercise indoors if humidity levels are high or there are strong winds.

Avoid exercising when pollution levels are high and try to pick a cleaner outdoor environment where possible. e.g. run in the park rather than along a roadside.

IF YOU HAVE ASTHMA SYMPTOMS WHEN YOU EXERCISE...

STOP!

TAKE YOUR RELIEVER MEDICATION

WAIT 5 MINUTES until you can breathe easily and you are symptom free before starting again.

IF YOUR SYMPTOMS DO NOT STOP OR RETURN when you start exercising again

STOP!and follow the ASTHMA EMERGENCY PLAN ‘5 STEP RULE’

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5 STEP RULE FOR DEALINGWITH AN ASTHMA ATTACK

1

2

3

4

5

TAKE TWO PUFFS OF RELIEVER INHALER (USUALLY BLUE) 1 PUFF AT A TIME USE A SPACER IF POSSIBLE

SIT UP AND STAY CALM

TAKE SLOW STEADY BREATHS

IF SYMPTOMS DO NOT IMPROVE AFTER 10 MINUTES OR YOU ARE WORRIED

CALL 999 OR 112 Repeat STEP 4 if an ambulance does not arrive within 10 minutes

REMEMBER:• Use a spacer if possible, a spacer helps deliver more treatment to the lungs

than the simple inhaler, this is very important if your are experiencing an attack.• Extra puffs of the reliever inhaler are safe.• Do not lie down or let someone put their arm around you

IF THERE IS NO IMPROVEMENT

TAKE 1 PUFF OF RELIEVER INHALER EVERY MINUTEADULTS & CHILDREN AGED 6+ UP TO 10 PUFFS IN 10 MINSCHILDREN UNDER 6 YEARS UP TO 6 PUFFS IN 10 MINS

x2

1/MIN

999/112

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EXERCISE INDUCED BRONCHOCONSTRICTION

Previously known as exercise induced asthma

In asthma, the airways are over-sensitive and can react to things that wouldn’t normally cause a problem - these things are called triggers.

Some of the common asthma triggers include pollution, dust, pollen, smoke, mould, pet dander, stress and exercise. However, everybody’s asthma is different and different people will have different triggers. Some people may find their asthma has several triggers.

Vigorous activity is a particularly common asthma trigger, affecting 90% of people with asthma.

For others, asthma symptoms may appear only when they exercise. These people may have what is known as exercise-induced bronchoconstriction (EIB) (previously known as exercise induced asthma). In EIB, it is believed that the increased rate of breathing during exercise causes narrowing of the airways and other asthma symptoms. EIB symptoms can occur several minutes into exercise or up to 30 minutes after the end of the activity.

Asthma symptoms during exercise may include:

• Cough• Wheeze (whistle sound)• Shortness of breath/difficulty breathing• Chest discomfort or tightness• Tiredness & difficulty keeping

up with teammates

Asthma symptoms from exercise are often associated with poorly managed asthma.

If you find that exercise often triggers your symptoms, it could be a sign that your asthma isn’t as well-controlled as it could be. Schedule an asthma review with your GP to check your inhaler technique, make sure you are on the right treatment and update your Asthma Action Plan. You can also speak with one of the asthma specialist nurses on the Asthma Society’s free Adviceline by calling 1800 44 54 64.

Your GP can help you work out whether or not you’ve got exercise-induced asthma. If you do it doesn’t mean you can’t exercise at all, but you’ll need extra help to manage asthma symptoms when you do exercise and advice on the right types of exercise/activity for you; for example your GP might suggest you take your reliever inhaler before begging any activity.

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CHOOSING A TYPE OF EXERCISE THAT SUITS YOU

If your asthma is well controlled and you’re feeling fit and well there’s no reason to limit your choice of exercise. But if your asthma control is not so good at the moment, you’re new to exercise or haven’t done any for a while you might find that moderate intensity aerobic activities such as walking, swimming or yoga suit you better. See below for tips on taking part in different types of physical activity with asthma.

Always have your reliever inhaler and spacer to hand when you exercise and if physical activity triggers your asthma, take it approximately 15 minutes before you exercise.

Generally people with asthma can take part in any of the sports listed below once the following advice is followed:

• Discuss your chosen sport with your health care professional and have your asthma reviewed in advance.

• Be aware of your asthma triggers

• Have a written Asthma Management Plan

• Bring adequate medication and an Asthma Attack Card with you when you exercise

• It is beneficial to have a spacer with you in case of emergency

• Contact the relevant sporting body or team doctor to see if your use/requirement for asthma medication needs to be registered.

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FIELD SPORTS SUCH AS GAELIC GAMES, SOCCER AND RUGBY

Many leading GAA, soccer and rugby stars have asthma. It hasn’t stopped them excelling in their sport and it need not stop you. However, if you are taking part in field sports with asthma, you should:

• Inform your team coach that you have asthma and give them a copy of the Asthma Society’s ‘Active with Asthma’ resources, including an Asthma Attack card, so they know how to help you if you have an attack.

• Consider whether the environment in which you are playing may affect your asthma – particularly if it is triggered by cold air, pollen (from grass, trees or shrubs) or air pollution. If your asthma is triggered by pollen, talk to your doctor as they may prescribe medication to counteract this.

• Make sure that you warm up gently before a match or high intensity training, in particular ‘speed work’.

Ronan O’GaraIrish and Lions Rugby star

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ATHLETIC SPORTS SUCH AS RUNNING, JOGGING, WALKING AND LEISURE CYCLING

• Always make sure that someone knows where you are training and what time you will return.

• Consider covering your mouth and nose with a scarf when exercising in cold weather. This will warm and humidify the air going into your lungs.

• Make sure that you warm up gently before high intensity training, in particular ‘speed work’.

SWIMMING

Swimming is a recommended activity for people with asthma. Swimming can help build up stamina and strength, especially in the respiratory muscles. Indoor pools, with their warm, humid air, are ideal for people with asthma and several studies have shown that swimming is associated with improved lung function.

If you have asthma and go swimming you should:

• Know what triggers your asthma. Triggers which might affect you during swimming include; chemicals (e.g. chlorine) or sudden changes in temperature.

• Consider using salt water swimming pools or pools which use a chemical free water filtration system.

• Always warm up before swimming.

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SCUBA DIVING

Medical opinion has changed in recent times to acknowledge that people with asthma may be able to take part in scuba diving, in accordance with national regulations. Whether it is advisable for a person with asthma to scuba dive may also depend on factors such as triggers, use of reliever medication, how stable your asthma is and how severe your asthma is. Your lung function, medication requirements to stabilise your asthma and whether you are suffering or recenlty recovering from an attack are important determinants of whether you should consider scuba diving. It is important to check the local regulations of the country you are scuba diving in before your trip, and consult your doctor if in doubt. If you are experiencing asthma symptoms or if your asthma control is not as good as normal you should avoid diving until you return to your baseline.

MOUNTAINEERING & SKIING

The combination of altitude, cold/dry air and exercise mean that sports such as mountaineering or skiing may trigger asthma symptoms. Downhill skiing is generally better tolerated by people with asthma than cross country skiing.

SKYDIVING & BUNGEE JUMPING

You should speak with your health care professional and the relevant sporting body before taking part in skydiving or bungee jumping.

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SPECIAL CONSIDERATIONS

DIET & ASTHMA

A healthy balanced diet is recommended to ensure you get the nutrition you require. Research suggests that a diet high in fresh fruit and vegetables, and oily fish can have a beneficial affect on asthma symptoms, while eating processed foods, high levels of salt or saturated fat may increase inflammation in the airways and aggravate asthma symptoms.

Maintaining a healthy weight for your height is recommended as an important part of asthma management. It is now widely accepted that asthma symptoms and response to medication is poorer in those who are obese. Children who are overweight are less likely to exercise and their asthma is difficult to control.

CHOOSING THE RIGHT ENVIRONMENT IN WHICH TO EXERCISE

You should also consider your other triggers when deciding which type of exercise suits you best. For example:

• High levels of pollen, mould and pollution in your training environment may trigger asthma symptoms for certain individuals.

• Chemicals, such as those found in swimming pools or ice skating rinks, may also trigger asthma symptoms in some patients.

• People with asthma are sensitive to cold and dry air. We usually breathe slowly through our nose which filters, warms and humidifies the air. During exercise our breathing rate increases and we breathe more through our mouth. Asthma symptoms may be triggered by cold, dry air reaching the lower airways. Asthma symptoms are generally more likely to occur in cold, dry environments than in warm, moist environments.

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COMPETITIVE SPORT & ASTHMARegulations for the use of certain medications in sport may vary depending on the relevant sporting authority. For this reason, it is very important to check with the Irish Sports Council if a Therapeutic Use Exemption Certificate (TUE) is necessary, if in doubt complete the certificate process.

For more information visit www.sportireland.ie

None of the inhaled medications commonly used for controlling asthma are banned in competitive sport; however their use may be restricted. Check with the relevant sporting body for information on banned and restricted substances.

In order for competitors to use asthma medications during competition, many sporting bodies will require objective medical evidence of:

• Asthma• Exercise induced

bronchoconstriction (EIB)

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BEFORE YOUEXERCISE

2. ANSWER THESE IMPORTANT QUESTIONS

• Do you take your controller medication every day, as prescribed?

• Do you always bring your reliever inhaler with you when exercising?

• Do you know the signs and symptoms of an asthma attack?

• Do you know what to do during an asthma attack?

• Can you list your triggers?

• If you answered NO to any of these questions you may not be able to be Active with Asthma. Follow our Top Tips for Exercising with Asthma (Page X) and make an appointment to see your healthcare professional for advice.

3. WE ALSO RECOMMEND THE FOLLOWING

• Have your asthma reviewed every 6-12 months.

• Develop a written Asthma Management Plan with your G.P.

• Have your lung function tested.

1. CHECK YOUR ASTHMA CONTROL

In the last 4 weeks:

• Have you had daytime symptoms (cough, wheeze, breathlessness) more than twice in a week?

• Has your asthma interfered with exercise or normal activity?

• Has your asthma interfered with your sleep?

• Have you used your reliever inhaler more than twice in a week?

• Have you have had an asthma attack?

• If you answered yes to any of the above your asthma is not controlled and you should contact your doctor or nurse.

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ASTHMAINFORMATION FOR COACHES & PE TEACHERS

Full participation in sport should be the goal for all except for those most severely affected by asthma. Coaches/teachers have an important role in supporting and encouraging people with asthma.

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BEFORE TRAINING/PHYSICAL ACTIVITYMake sure you know who has asthma.

Remind people with asthma that they may need to take their reliever medication approximately 15 minutes before their physical activity.

Discourage the use of aerosols and scents in changing rooms as these may trigger asthma symptoms.

Try to minimise exposure to other triggers such as dust, smoke and pollen.

Remind people with asthma to bring their reliever inhaler and spacer with them and to have access to them at all times.

Speak to parents of children/young people if you have concerns that a player has undiagnosed or poorly controlled asthma and advise them to visit their GP or call our asthma adviceline on 1800 44 54 64

Speak to parents or a GP to allay any concerns or fears about asthma and physical activity.

Always have a copy of the Asthma Attack Card with you during training sessions and an Asthma Attack Poster on display in the sports venue/ changing room.

DURING TRAINING/PHYSICAL ACTIVITYEnsure players always warm up before physical activity.

During physical activity try to avoid things that may trigger people’s asthma (e.g. dust, smoke, pollen).

Be aware that someone’s asthma may be more affected in cold, frosty weather.

Be encouraging and supportive to people with asthma.

Allow players to have a drink during activities.

If someone has asthma symptoms (cough, wheeze, chest tightness or shortness of breath) while exercising they should stop the activity, take their reliever inhaler (usually blue) and wait at least five minutes, until they feel better before starting again.

Be aware that asthma symptoms will vary with changes in pollen counts and air temperature. As a result, asthma can be unpredictable.

Allow a person with asthma to sit out for five minutes if necessary and try to keep them involved as much as possible, for example you can involve them in refereeing, coaching or taking notes.

During an Asthma Attack follow the Asthma Emergency Plan ‘5 Step Rule’ (page 4).

Give people with severe asthma the opportunity to participate in team sports or activities that are less strenuous.

Always end a session with warm down exercises.

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FREQUENTLYASKED QUESTIONS

I am a 16 year old girl who has asthma and I’m on the school camogie team. I recently started smoking and I’m wondering what effect this will have on my hockey training?

There is no doubt that smoking is bad for your health. Tobacco smoke is a common trigger for people with asthma and makes good asthma control harder to achieve. There is also evidence that the effectiveness of many of the medications we use to treat asthma is ‘blunted’ by smoking.

People with asthma can play, succeed and achieve optimal gains from their fitness regime if their asthma is managed properly; however if you smoke it makes exercising much more difficult and reduces your levels of endurance. If you quit smoking, your body begins to reverse the damage caused quickly and within a week or two your levels of endurance will be increased and you will find exercise much easier.

It is never too late to stop smoking and move towards health. Speak to your GP or contact the Asthma Society of Ireland for information on services and medication available to help you quit smoking. Go to quit.ie for more information and support.

My 13 year old son has been prescribed a medication called Singulair for his asthma symptoms which are triggered by exercise. How does Singulair work?

Singulair (or montelukast) is a type of common non-steroid controller medication, with specific benefits in exercise related symptoms. This type of medication blocks the action of naturally occurring chemicals in the lungs, called leukotrienes which are potent bronchoconstrictors and have a key role in causing the tightening of the airways.

The medication is available in tablets or granules. There is no way to tell who will respond to this type of medication and if there is no response in 4-12 weeks your GP may decide to discontinue the treatment.

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Why does rhinitis (hay fever) affect my asthma and cause a blocked nose?

Asthma and rhinitis (hay fever) are related conditions linked by a common airway. The air we breathe passes through our nose, at the start of our airway, and continues down the airway into the lungs. Anything that stops the free passage of air has the potential to cause problems with our breathing. A blocked or runny nose occurs because an allergen (e.g. pollen, dust mite) has triggered the inside of the nasal passage to become inflamed. There is no cure for allergic rhinitis, but in most cases symptoms can be controlled effectively by taking the following measures:

• Take an allergy test under medical supervision to try to determine the allergen

• Allergen avoidance (see our Asthma and Allergic Rhinitis booklet for more information)

• Take your medication correctly as prescribed

• Have an asthma management review with your GP. It is important to tell your GP that allergic rhinitis triggers your asthma.

• Ask your GP or Pharmacist to advise you on developing an allergic rhinitis treatment plan.

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ABOUT THE ASTHMA SOCIETY

The Asthma Society of Ireland is the national charity dedicated to saving lives and improving the lives of people with asthma.

We do this by:

• Providing services such as our free adviceline, workshops for parents and training for health professionals. Anyone can call our adviceline on 1800 44 54 64 and speak to one of our trained respiratory nurses about their asthma.

• Providing information about asthma management on our website and in printed booklets. Our booklet series includes information on controlling your asthma, managing your child’s asthma and exercising with asthma.

• Lobbying the Government to improve services for people with asthma.

• Supporting research into the causes and treatment of asthma.

OUR SERVICES TO YOU

Call the Asthma Society of Ireland today to get a free copy of our Active with Asthma materials or other publications or download them for free at www.asthma.ie

You can purchase discounted asthma devices, such as spacers and peak flow meters directly from the Asthma Society of Ireland.

Call us on 01 817 8886 to arrange for an Asthma Society of Ireland Nurse to speak at your school or sports club.

Free Phone our Asthma Adviceline on 1800 44 54 64 to speak in confidence to an Asthma Nurse.

SUPPORT

You can support us in the following ways:

Fundraising message tbc.

Call us on 01 817 8886 or email fundraising@asthma.ie

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60%

Percentage of people in Ireland who have uncontrolled asthma, meaning they are at risk of an asthma attack.

QUICK ASTHMA FACTS

470,000

90%1in10

1in526minutes

4

1210

The number of people in Ireland have asthma

Proportion of adults who have asthma

Percentage of asthma deaths that are preventable

Average number of days of work adults miss each year due to asthma

Average number of days

of school children

miss each year due

to asthma.

How often someone visits the Emergency Department because of asthma.

Ireland has the fourth highest prevalence of asthma in the world

oneApproximate number of people who die every week in Ireland

from asthma

Proportion of children who have asthma

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ACKNOWLEDGMENTS

The Active with Asthma resources would not have been possible without the hard work and co-operation of the following, to whom we express our sincere thanks:

Dr. Desmond Murphy Consultant Respiratory Physician, Cork University Hospital

Dr. Richard Costello Consultant in Respiratory Medicine, Beaumont Hospital

FURTHERINFORMATION

www.swimireland.ie

www.activeschoolflag.ie

www.communitygames.ie

www.healthpromotion.ie

www.getirelandactive.ie

www.hse.ie

health.gov.ie/healthy-ireland

www.sportireland.ie

www.gaa.ie

www.camogie.ie

www.fai.ie

www.irishrugby.ie

www.athleticsireland.ie

www.cyclingireland.ie

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The information contained in this publication is based on current medical knowledge, in accordance with international

best practice guidelines, at the time of publication. The information is intended for use as a general guide

and does not replace individual consultation by a health care professional on a case-by-case basis.

The Asthma Society of Ireland is not responsible for any injury, loss, damage or expense incurred by any individual or organisation resulting, either directly or indirectly, from any

information contained in this publication.

©2017

Asthma Society of Ireland 42-43 Amiens Street Dublin 1

Cumann Asma na hÉireann 42-43 Sráid Amiens Áth Cliath 1

Tel 01 817 8886 Email healthpromotion@asthmasociety.ie

Asthma Adviceline

1800 44 54 64

asthma.ie