If you have asthma, you already know that things like cigarette smoke, animal dander, and dust can trigger a dangerous attack. But there are many other—often unexpected—triggers of asthma flares.

  1. Thunderstorms

During a thunderstorm, rain and lightning split pollen grains open and expose the peptides inside. Winds and downdrafts then spread those tiny particles widely. Normal, intact pollen grains measure 20 to 100 microns and settle to the ground, but these fragments, at less than 2.5 microns, remain in the air, where they can easily be inhaled deeply into the lungs.

In 2016, Melbourne, Australia, witnessed the world’s most extreme case of thunderstorm asthma. Within 30 hours, more than 3,000 people went to emergency rooms for asthma attacks, 35 were admitted to intensive care units, and 10 died. Researchers note that as global temperatures rise, thunderstorms are expected to become more common, making this a more widespread trigger.

  1. Food additives

When nitrites, nitrates, and sulfites are used as added food preservatives, sensitive people can experience worsening respiratory symptoms. (Foods that contain these compounds naturally generally do not trigger asthma.)

Common culprits include sauerkraut, deli and cured meats, wine, beer, cider, dried fruits and vegetables, packaged potatoes, bottled lime and lemon juice, and pickled foods.

  1. Volcanoes

If you’re planning a trip to Hawaii or any other place with active volcanoes, pack extra medication and have a rescue plan in place. Volcanic ash releases sulfur dioxide, which can cause significant injury to the lungs when inhaled and trigger an asthma attack. Some people may also be sensitive to the sulfur dioxide released from natural hot springs.

  1. NSAIDs

Nonsteroidal anti-inflammatory drugs, like aspirin, ibuprofen, and naproxen, worsen asthma symptoms in about one in five people with asthma. If you notice symptoms after taking any of these drugs, opt for acetaminophen (Tylenol) instead.

  1. House plants

Asthma attacks can be caused by mold spores that are often found in the soil of many household plants. Minimize indoor plants and keep them out of rooms in which you spend a lot of time. English ivy, a peace lily, or a rubber plant are safer options, but keep them out of the reach of children and pets.

  1. Cleaning products

Cleaning away dust and dirt can hurt asthma more than help it if you use certain products. Avoid cleaners that contain peroxyacetic acid, peracetic acid, and fragrances (including candles and air fresheners).

Don’t use bleach (sodium hypochlorite) or quaternary ammonium compounds in enclosed spaces. Instead, opt for soap and water, vinegar, lemon, hydrogen peroxide (no stronger than 3%), ethanol (ethyl alcohol), or premade products certified by the EPA Safer Choice Program.

  1. Living near a major road

People who live, work, or go to school near a major road have higher rates of asthma and more symptoms. The closer to the road, the stronger the effect.

A study published in the American Journal of Respiratory and Critical Care Medicine reported that long-term exposure to traffic air pollution also may increase the risk of developing chronic obstructive pulmonary disease—especially among people who had asthma or diabetes, and researchers reported in Environmental Health Perspectives that traffic-related pollution decreased lung function in urban women.

Reduce risk with good control

While you can’t avoid things like thunderstorms, you can protect yourself by working with your physician to make sure your asthma is well controlled. If you’re using a rescue inhaler, such as albuterol, more than a few times a week, talk to your doctor about your medication regimen.

Many new medications can reach deeper into the lungs and treat your symptoms using different mechanisms.

It’s also important to have a spirometry test at least once per year to measure and monitor your lung function and capacity. If your family doctor doesn’t offer spirometry, make an appointment with an allergist or pulmonologist to supplement your asthma care team.

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