Asthma and Chronic Obstructive Pulmonary Disease
Asthma
Asthma is a condition lung disease that makes it hard to breathe. During an asthma attack airways become narrow making breathing difficult. Asthma attacks can vary in severity. Symptoms of an attack may include coughing, wheezing, or chest tightness. There is no cure for asthma, but it can be managed through proper medication and by avoiding things that trigger your asthma. An asthma attack usually begins with exposure to a "trigger," which is exposure to something (usually an external allergen or irritant) that causes the airways to react. Asthma triggers vary from person to person. Some common triggers include:- secondhand smoke
- dust mites
- outdoor air pollution and smoke
- pests (e.g., cockroaches, mice)
- pets
- mold
- pollen
- strong fragrances
- chemicals (e.g., household cleaning products)
- strenuous exercise
- hyperventilation
- stress
The CDC National Asthma Control Program reports that 1 in 12 children and adults have asthma. Based on the most recent data available, there were 2.0 million emergency department visits and 3,615 deaths due to asthma across the U.S. in 2014.
Since there is no cure for asthma, it is a health burden that stays with people for their whole lives. This translates into lifelong costs for medication and treatment, as there are many direct and indirect economic costs associated with asthma. The CDC reports asthma costs Americans about $56 billion per year. In Utah, it is estimated that asthma-related emergency department visits and hospitalizations cost $27.6 million in 2013. For a complete report on the costs of asthma in Utah, please see the Financial Burden of Asthma in Utah report.
Three things happen during an asthma attack that make it hard to breathe:
- The lining of the airways (bronchial tubes) become inflamed and swollen.
- The muscles around the airway tighten.
- Excess mucus is produced.
When this happens, the airways become narrow, making it hard to breathe. Symptoms of an asthma attack may include chest tightness, wheezing, shortness of breath, or coughing. Signs of an asthma emergency include: retractions (sucking in of the skin against the collarbone or ribs); the face becoming a pale gray or blue color; darkening of lips or fingernails to a purple or blue color; and struggling to talk.
Although there is no cure, it is possible to reduce the risk of severe complications, hospitalizations, and death caused by asthma by properly taking prescribed medication and knowing possible triggers. When you know what triggers your asthma, you can take preventive action to avoid them, and prevent asthma attacks.
Once you are diagnosed with asthma, your healthcare provider will advise you on proper management. Asthma can usually be managed in an outpatient setting, reducing the need for emergency department visits. Effective management includes control of exposures to factors that trigger exacerbations, using medicine as prescribed, monitoring the disease, and patient education in asthma care.
People who work in school-based health centers may be able to help children manage their asthma. This includes helping reduce exposures to environmental asthma triggers, education, case management, improving indoor air quality, improving students' home environments, and improving outdoor air quality around the school and community. The Public Health Insitiute developed a guide for school-based health centers. For more information see the Asthma Environmental Intervention Guide for School-Based Health Centers.
There are many factors that influence the risk of developing asthma. The CDC reports that risk is increased in the following areas:
- Sex: Males are more likely to have asthma in children. However, for adults, females are more likely to have asthma.
- Age: Young adults ages 18-24 are more likely to have asthma when compared with older adults.
- Race and ethnicity: Black children are twice as likely to have asthma than White children. Multiracial and Black adults have a higher risk than White adults. Asthma attacks have decreased in children of all races since 2001.
- Education: Adults who did not graduate high school have a higher risk than adults who did graduate high school or college.
- Income: People with incomes below $75,000 per year are more likely to have asthma than those who have greater incomes.
- Behavior: Smoking increases the risk of asthma as does obesity.
Data regarding asthma hospitalizations and emergency department visits come from the Office of Health Care Statistics in the Utah Department of Health. Asthma prevalence data comes from the Utah Behavioral Risk Factor Surveillance System (BRFSS) survey. Asthma management data comes from the Asthma Call-Back Survey (ACBS). The BRFSS and ACBS are conducted by the Survey Center in the Office of Public Health Assessment.
Chronic obstructive pulmonary disease (COPD)
COPD refers to a group of lung diseases that cause reduced airflow in the lungs, making it difficult to breathe. The most common lung conditions that make up COPD are emphysema and chronic bronchitis. Symptoms include coughing, shortness of breath, chest tightness, and wheezing. COPD is a progressive disease, which means that it gets worse over time. COPD also has no cure. For this reason, COPD can result in major long-term disability and can limit an individual's ability to perform routine activities. People who have COPD have a higher risk of getting respiratory infections such as colds, pneumonia, and the flu. COPD plays a large role in death and disability in the United States; in 2014, it was the third leading cause of death. Approximately 15.7 million Americans have been diagnosed with COPD. COPD cannot be cured and it gets progressively worse over time, resulting in major long-term disability. Treatment is necessary in order to reduce the symptoms and help slow down its progression. This can include medicine, surgery, and oxygen therapy. COPD can also lead to other health issues such as heart disease, lung cancer, and high blood pressure.Risk factors for COPD include the following:
- Smoking: Tobacco smoke is the greatest risk factor in developing COPD. The best way to prevent COPD is to not smoke or to stop smoking if you already do so.
- Secondhand smoke: Secondhand smoke is the smoke that comes from someone else's burning and smoking of tobacco products. Secondhand smoke can also increase the risk of COPD.
- Asthma: People with asthma, or who have had asthma, may have an increased risk of developing COPD.
- Genetics: Some people may have a rare genetic mutation called alpha-1-antitrypsin deficiency, which may cause COPD.
- Workplace exposure: People who work in certain settings may be exposed more frequently to chemicals, dust, or other irritants that can harm the lungs.
- The best way to prevent COPD is to quit smoking. Even if you have already been diagnosed with COPD, quitting smoking can improve symptoms and possibly avoid worse complications.
- Avoid secondhand smoke.
- Avoid other air pollutants and irritants. Use personal protective gear at work to limit your exposure to lung irritants and chemicals.
- Prevent and treat lung infections. Certain vaccines, like the flu vaccine and pneumonia immunizations, are important in preventing chronic lung infections. Current respiratory infections should be treated with antibiotics if possible.
If COPD can be caught and diagnosed early, treatment can begin earlier before progression worsens.
Asthma
- Asthma Hospitalizations
- Asthma Management
- Asthma: Adult Prevalence
- Asthma: Child Prevalence
- Asthma-related Emergency Department (ED) Visits
- Environmental Burden of Childhood Diseases
Chronic Obstructive Pulmonary Disease
Find additional links to data tables, charts, and more detailed information related to asthma and COPD on the Asthma and COPD topic pages of the Utah Environmental Public Health Tracking web portal.
Asthma - Adults (BRFSS)
Asthma - Adolescents (YRBS)
Asthma and Pregnancy (PRAMS)
Hospitalizations:
- Asthma, Diagnosis - NCHS 113 Leading Causes: Asthma- COPD, Diagnosis - ICD-9 Codes 490-492, 496
Emergency Department (ED) Visits:
- Asthma, Diagnosis - NCHS 113 Leading Causes: Asthma- COPD, Diagnosis - ICD-9 Codes 490-492, 496
Mortality:
- Asthma, NCHS 113 Leading Causes: Asthma- COPD, ICD-10 Codes J40-J44
Find additional links to data queries related to asthma and COPD on the Asthma and COPD topic pages of the Utah Environmental Public Health Tracking web portal.
- Asthma clinical quality improvement processes: evaluating successes and barriers to implementation and sustainability, August 2022
- Asthma Control and Cost Barriers to Asthma, July 2020
- The Utah Asthma Home Visiting Program: A cost effective way to help people better manage their asthma, May 2019
- Utah School Health Profiles 2018
- May 2019 Spotlight: The Utah Asthma Home Visiting Program: A cost effective way to help people better manage their asthma
- May 2018 Community Health Spotlight: A Partnership with Medicaid to Improve Prediabetes, Diabetes, and Asthma in Utah through the 6|18 Initiative
- Utah School Health Profiles Highlights 2016
- December 2016 Breaking News: Updated Utah Air Quality School Recess Guidance
- October 2016 Breaking News: Severe Respiratory Disease Outbreak in Southeast Utah
- Uncontrolled Asthma - from Utah State Health Assessment 2016 Report
- Utah School Health Profiles Highlights 2014
- Asthma Mental Health Report
- Asthma Emergency Department Cost Report
Resources
- Air Pollution and Asthma - Utah Environmental Epidemiology Program
- Asthma Environmental Intervention Guide for School-Based Health Centers
- Asthma's Impact on the Nation - Centers for Disease Control and Prevention
- Respiratory Diseases: Chronic Obstructive Pulmonary Disease - Utah Environmental Epidemiology Program
- Chronic Obstructive Pulmonary Disease home page - Centers for Disease Control and Prevention