Hidden population at thunderstorm asthma risk

heavy clouds

New research presented at a lung health conference in Canberra today has identified “a potentially hidden and significant population susceptible to thunderstorm asthma”

The research is being presented for the first time today at the Thoracic Society for Australia and New Zealand (TSANZ) Annual Scientific Meeting in Canberra.

“This is a wake up call for all of Australia, but particularly Victoria as it prepares for its next pollen season,” says TSANZ President Professor Peter Gibson.

“Many more people than previously thought are at risk of sudden, unforeseen asthma attack. It is essential that we invest more research into this phenomenon and educate our health services and public to take preventative and preparedness measures.”

Nine people died in Victoria late last year and more than 8500 required emergency hospital care when a freak weather event combining high pollen count with hot winds and sudden downpour led to the release of thousands of tiny allergen particles triggering sudden and severe asthma attacks.

Those most seriously affected were people who were unaware they were at risk of asthma and therefore had no medication to hand.

Some Melbourne pharmacies were inundated with people seeking reliever puffers; a significant proportion of these people were experiencing their first asthma attack.

In this study of over 500 healthcare workers lead by the Department of Respiratory and Sleep Medicine, Eastern Health, Victoria, almost half the respondents with asthma experienced symptoms during the thunderstorm event. Most took their own treatment, a few sought medical attention and one was hospitalised.

However, more alarming was the 37% of respondents with no prior history of asthma who reported symptoms such as hayfever, shortness of breath, cough, chest tightness and wheeze during the storms.

The study also found that people with a history of sensitivity to environmental aeroallergens (such as rye grass or mold) were far more likely to report symptoms than those with a history of either no allergy or allergy to dust mite/cats.

Physical location, described as predominantly in- versus out-doors, was not a risk factor.

“This study gives us an indication of the proportion of our population that might be at risk of thunderstorm asthma, but is unaware of it as they have no history of asthma. It also suggests that a history of hayfever is one of the greatest risk factors,” says lead researcher Dr Daniel Clayton-Chubb.

The key message from our work is that anyone with hayfever should ensure that they have ready access to quick acting asthma treatments such as bronchodilators at all times, but particularly in pollen season or if thunderstorms are predicted. Severe thunderstorm asthma symptoms can strike rapidly and without warning.”

Professor Guy Marks, whose research on thunderstorm asthma events in Wagga Wagga has led to public message alerts reminding people with asthma in the region to use their preventer inhaler during spring and summer, emphasised the importance of being prepared.

“In areas at risk of thunderstorm epidemics (south-eastern Australia) people who “wheeze and sneeze” during spring should take regular inhaled corticosteroids during this time to reduce their risk of experiencing severe attacks during thunderstorms,” he advised.

However, Professor Marks warned that this is just one of several potential respiratory events that governments need to plan for and the public should be aware of.

“Epidemics of acute respiratory illness can occur unpredictably and have the capacity to spread rapidly over a wide area.

“A range of environmental causes may trigger these (thunderstorms, influenza and other infectious agents, forest fires and hazard reduction burns, bioterrorism episodes). We need to develop capacity within the health system to respond rapidly and effectively to these. This needs to be coordinated at a national level,” he says.

 “This research further highlights the urgent need to ramp up asthma management efforts and increase research funding in this area,” says TSANZ President Professor Peter Gibson.

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