Asthma Canada is pleased to see recognition for pharmacare in the Federal budget released yesterday. We applaud the Federal government’s support for the establishment of the Canadian Drug Agency which will oversee the development of a new national formulary of prescribed drugs and provide additional support for Canadians with rare diseases. We look forward to integrating the perspectives of patients and the health charity sector as we work with the Federal Government to implement these investments.
We would like to thank the asthma community for helping put pharmacare on the map as a political priority. Thank you for sharing your stories and experiences; for writing to your elected representatives through our ongoing letter-writing campaign; and for joining Asthma Canada as we went to Parliament Hill and met with countless policy makers to reinforce our demand for equitable access to medication.
It is too early to say how the Federal government’s plans will roll out but it is definitely a positive step forward. As we move ahead, it will be essential to ensure that we, the asthma community and the patient community at large, continue this momentum and continue to speak out and make ourselves heard. We must ensure that pharmacare becomes a commitment across party lines and remains a key political priority regardless of election outcomes. We invite you to join us as we continue our efforts to ensure that all Canadians have equitable access to prescription medication and that patient choice is included in all pharmacare solutions.
To participate in our letterwriting campaign in support of pharmacare, visit: https://asthma.ca/access-medication-campaign/
To read more about the Federal proposal, visit: https://www.budget.gc.ca/2019/docs/themes/pharmacare-assurance-medicaments-en.html
For Immediate Release
September 6, 2018
TORONTO, ON, September 6, 2018 – September is when thousands of school-aged children end up in hospitals and emergency rooms as a result of asthma-related issues. The third week of September, in particular, is known as the September Asthma Peak.
Hospital admissions for children with asthma rise 20% to 25% in September.
At the start of a new school year, kids are in close proximity with each other and many germs, increasing their exposure to viral infections and colds. Viral infections are significant triggers of asthma symptoms in school-aged children, being the primary cause of up to 85% of childhood asthma exacerbations. In addition, more than 60% of children who were admitted to emergency rooms with asthma also suffered from rhinovirus (the common cold). For children living with asthma and especially Severe Asthma, a simple cold can lead to life-threatening symptoms and unscheduled emergency room visits.
Asthma exacerbations during the September Asthma Peak are associated with a rise in seasonal allergens along with the reduced compliance with asthma controller medications. Classrooms expose children to common asthma triggers such as dust mites, moulds, and animal dander while weed pollens tend to peak outside. Furthermore, summer tends to disrupt the routine of regular controller usage, leaving children more susceptible to asthma attacks in the fall.
The good news is, with correct management, most asthma-related hospitalizations can be prevented altogether.
“As children start returning to the classroom, a few simple precautions can prevent a trip to the emergency room,” said Vanessa Foran, President & CEO of Asthma Canada. “The common-sense tips that we suggest can drastically increase the likelihood of a safe and symptom-free return to school.”
Asthma Canada encourages parents of children living with asthma to develop a personalized Asthma Action Plan for their kids with their doctor. The plan is used to identify early warning signs of an asthma exacerbation and is proven to help better manage a child’s asthma. A fillable template can be downloaded for free from our website.
Asthma Canada also recommends parents follow these tips:
- Share a copy of your child’s Asthma Action Plan with school officials and teachers.
- Help your child understand their asthma triggers and teach them how to avoid them.
- Make sure your child takes their asthma-prevention medication as prescribed, even when they are symptom-free.
- Make sure your child knows how to use their puffer by themselves (if old enough), or when to ask an adult for help.
- Ask school officials about rules for asthma medications and ensure your child is able to carry their medications on hand at all times.
- Teach your child proper hand washing techniques and stress the importance of frequent hand-washing to avoid catching a cold.
- Make sure your child and other family members get the seasonal flu shot every year.
A number of September Asthma Peak resources are available on Asthma Canada’s website to help parents prepare their children for a safe and healthy return to school.
About Asthma Canada
Asthma Canada is a national organization that provides evidence-based, asthma information, education, management tools and support programs for all Canadians living with asthma. Asthma Canada continues to expand and improve its collection of educational resources for campaigns such as the September Asthma Peak. More information about Asthma Canada’s programs and services can be found at www.asthma.ca.
President & CEO, Asthma Canada
Findings from a research study suggests a relationship between lack of day-to-day physical activity, or sedentary lifestyle, and development of new and ongoing asthma in Toronto children.
Children may be more likely to develop asthma if they live in neighbourhoods where it’s difficult to get around on foot, a new study suggests.
Researchers analysed data from more than 326 000 children in Toronto who were born between 1997 and 2003, and followed them until the ages of eight through 15.
Twenty-one percent of the children developed asthma, and low walkability in a child’s neighbourhood was associated with an increased risk of asthma, the findings showed.
The study findings were published in the Annals of the American Thoracic Society
Low walkability a problem
“We found that children living in neighbourhoods with low walkability were more likely to develop asthma and to continue to have asthma during later childhood,” said study author Dr Elinor Simons. She’s a paediatric allergist at the University of Manitoba and Children’s Hospital Research Institute of Manitoba.
“These findings show a relationship between lack of day-to-day physical activity, or sedentary lifestyle, and development of new and ongoing asthma in Toronto children,” she explained in a news release from the American Thoracic Society.
But the study did not prove that a lack of walking caused asthma risk to rise.
“Other large cities may have neighbourhood walkability patterns that are similar to Toronto’s, and may see similar associations with childhood asthma,” the study authors noted.
The researchers suggested that walkability can be improved “by greater placement of services – such as grocery stores – within residential neighbourhoods, and adding pedestrian paths between roads to improve street connectivity.”
Dr Simons added that “it is important to note that this study measured physical characteristics and did not look at social characteristics, such as neighbourhood crime and safety, or cultural reasons for walking rather than using another means of transportation. These characteristics also need to be studied and taken into account.”
A research study from the University of Birmingham suggests that vaping can damage vital immune system cells and may be more harmful than previously thought.
Researchers found e-cigarette vapour disabled important immune cells in the lung and boosted inflammation.
The researchers “caution against the widely held opinion that e-cigarettes are safe”.
However, Public Health England advises they are much less harmful than smoking and people should not hesitate to use them as an aid to giving up cigarettes.
The small experimental study, led by Prof David Thickett, at the University of Birmingham, is published online in the journal Thorax.
Previous studies have focused on the chemical composition of e-cigarette liquid before it is vaped.
In this study, the researchers devised a mechanical procedure to mimic vaping in the laboratory, using lung tissue samples provided by eight non-smokers.
They found vapour caused inflammation and impaired the activity of alveolar macrophages, cells that remove potentially damaging dust particles, bacteria and allergens.
They said some of the effects were similar to those seen in regular smokers and people with chronic lung disease.
They caution the results are only in laboratory conditions and advise further research is needed to better understand the long-term health impact – the changes recorded took place only over 48 hours.
An independent review of the latest evidence on e-cigarettes was published by Public Health England in February.
The review concluded there was “overwhelming evidence” they were far safer than smoking and “of negligible risk to bystanders” and advised they should be available on prescription because of how successful they had been in helping people give up smoking.
Prof Thickett said while e-cigarettes were safer than traditional cigarettes, they may still be harmful in the long-term as research was in its infancy.
“In terms of cancer causing molecules in cigarette smoke, as opposed to cigarette vapour, there are certainly reduced numbers of carcinogens,” he said.
“They are safer in terms of cancer risk – but if you vape for 20 or 30 years and this can cause COPD [chronic obstructive pulmonary disease], then that’s something we need to know about.
“I don’t believe e-cigarettes are more harmful than ordinary cigarettes – but we should have a cautious scepticism that they are as safe as we are being led to believe.”
Martin Dockrell, tobacco control lead at Public Health England, said: “E-cigarettes are not 100% risk-free but they are clearly much less harmful than smoking.
“Any smoker considering e-cigarettes should switch completely without delay.”
Researchers from AllerGen’s CHILD Study have found that the Lung Clearance Index (LCI), a measure of ventilation distribution, can detect lung problems in children as young as four months old.
Conventional lung function tests used to diagnose asthma and other childhood breathing problems may not detect subtle tell-tale changes in the small airways of very young children. Now, researchers from the CHILD Study have studied the Lung Clearance Index (LCI) measurement and found that it can detect lung problems in children as young as four months of age.
The research, published in the June 2018 issue of Thorax, was led by CHILD Study Director Dr. Padmaja Subbarao. Dr. Subbarao is a staff respirologist at The Hospital for Sick Children (SickKids) and an associate professor in the Departments of Paediatrics and Physiology at the
University of Toronto. “Asthma is the most common chronic disease of childhood and detecting airway changes early is critical so that doctors can provide appropriate treatment before lung damage occurs,” says Dr. Subbarao.
“LCI has been shown to be a sensitive marker of early airway disease in children with cystic fibrosis, so we set out to see if it would also be useful to identify infants with recurrent wheezing who are at risk of developing asthma.”
The researchers tested LCI in 37 infants with a history of wheezing who were referred from a hospital outpatient clinic and 113 healthy infants who are participating in the CHILD Study—a national health research project involving nearly 3,500 Canadian children and their families.
“We detected elevated LCI scores in 19% of the infants with recurrent wheeze, even though theyhad no chest symptoms at the time of measurement, while only 1.8% of the healthy infants had elevated LCI scores,” comments Dr. Subbarao.
LCI was measured using a technique called the Multiple Breath Washout (MBW), in which theinfant breathes quietly through a face mask while sleeping. The mask delivers a special air mix containing oxygen and a tiny amount of a “tracer” gas, which has no effect on the body. Doctors measure how efficiently the lungs are working by tracking the time it takes for the tracer gas to “wash out” of the body during normal respiration.
“Unlike other lung function measures, LCI is highly sensitive to a narrowing of the small airways, where lung disease often starts,” says AllerGen trainee and study first-author Zihang Lu, a PhD candidate at SickKids. “Higher LCI values indicate more severe lung disease. We found that LCI was elevated in kids with wheeze even when they had no symptoms, suggesting that the test could be useful at routine clinic visits when the child is well.”
This study is unique in that most previous papers describing lung function in infants with airway disease have not compared them to healthy controls, according to the study authors. By comparing both groups, these results indicate that “LCI may be effective in detecting early lung disease, even before symptoms are apparent.”
“We are incredibly fortunate to have the CHILD Study right here in Canada to help us understand how chronic diseases, including asthma and other respiratory diseases, begin in early life,” adds Dr. Subbarao. “CHILD has been following thousands of Canadian children since before birth, which means that we can undertake continuous assessments of lung growth and development from infancy, offering us invaluable information on the progression of lung disease.”
Everyone knows what remodelling is, we remodel our kitchens, our bathrooms and our homes, but very few people know about airway remodelling. Airway remodelling isn’t nearly as exciting as remodelling your home, but it does affect the way you breathe, which is why we feel it is important to explain the mechanisms.
What is it?
Airway remodelling is an ongoing structural change caused by asthma that leads to thickened airway walls and the narrowing of the airway. The phenomenon shouldn’t be taken lightly, as it can cause irreversible changes to the structure of your airway, possibly leading to blockages and long-term loss of lung function.
How Does It Happen?
Just like renovating your house takes time, so does airway remodelling. Over time, as your asthma symptoms are left uncontrolled or untreated, the actual structure of your airway will change; the longer you leave your asthma untreated the more likely it is that airway remodelling will occur.
Airway remodelling happens when your asthma triggers inflammation in your lungs and your body tries to repair itself. Imagine it like a cut on your arm; your body mends the cut by forming scar tissue. With airway remodelling the cells in your airway are damaged and so your body tries to heal by thickening the membrane below those cells. More blood vessels form and the layer of smooth muscle surrounding the airway increases, altering the structure and function of your airway, possibly leading to bronchoconstriction and an irreversible decrease in lung function.
How Can I Prevent It?
Airways remodelling is a real concern for anyone who has asthma. Leaving your symptoms unchecked can have lifelong consequences. The good news is that airway remodelling may be somewhat reversible and preventable.
The best way to prevent airway remodelling is to control your asthma symptoms. Following a treatment plan and using a controller medication that reduces airway inflammation will result in less remodelling. The less asthma symptoms you experience the less airway remodelling will occur. It all comes down to controlling your asthma and keeping your symptoms in check.
Some remodelled airways have been found to return towards normal structure when proper treatment is followed. People with asthma already have enough trouble breathing; take control of your asthma to prevent airway remodelling.
Additional Research on Airway Remodelling
If you would like to learn more about the mechanisms of Airway Remodelling, we encourage you to check out the research of Diana Pham, one of the recipients of the Asthma Canada/AllerGen Goran-Enhorning Graduate Student Research Award.
Diana Pham is a Master of Science student at the University of Calgary with Dr. Richard Leigh. She is conducting research to expand our knowledge on the molecular mechanisms contributing to the development of asthma. Her findings will help determine an appropriate pharmaceutical target or preventative measure for the airway remodelling that occurs in early childhood asthmatics.
Click here to support asthma research
On June 30th, 2018, Christine Elliot, the newly appointed Ontario Minister of Health and Long-Term Care, released a statement outlining the proposed changes to the Ontario Drug Benefit program, OHIP+. The Ford government has announced their intentions to change OHIP+ by focusing only on children and youth in Ontario who do not have existing prescription drug benefits.
The newly changed program will no longer cover all Ontarians aged 24 and under but instead only cover eligible prescriptions of children and youth who are not covered by private benefits. Those with existing coverage through private plans would now bill those plans first, with the Ontario government covering all remaining eligible prescription costs.
Asthma Canada is hopeful that these changes will make it easier for all children and youth in Ontario to receive their prescription drugs. We urge the Government of Ontario to ensure a seamless transition that takes place with minimal disruption.
As the lack of access to prescription medications is one of Asthma Canada’s key advocacy priorities, we support movements to close gaps in the healthcare system. We continue to work towards closing all gaps in accessing prescription medications among all age groups in Canada.
At this time, no specific timelines have been provided about when these changes will come into effect. Asthma Canada will provide more information as it becomes available.
On the Federal stage, the Government of Canada is currently inviting all Canadians to join the discussion and share their thoughts and ideas on national pharmacare. If you support a national pharmacare program, we encourage you to:
- Read the discussion paper
- Participate in the online discussion forum
- Take the National Pharmacare Online Questionnaire
- Send a written submission to the council
Your participation will help inform and guide the Government on how best to implement a national pharmacare program.
If you are passionate about the issue of equitable access to prescription medications, we encourage you to share your story and add your voice to that of millions of Canadians demanding universal coverage of prescription medications. Please take part in Asthma Canada’s letter writing campaign by sending a letter to your government representatives letting them know how the lack of access to prescription medications impacts you and your loved ones.
When most of us think about air quality, we imagine plumes of smoke rising from factories or waves of pollen blowing in the wind. Canadians know that outdoor air quality matters and that pollution can impact their health, but very few people are concerned about their indoor air quality and how it affects their asthma.
These days, Canadians spend 90% of their time indoors, so making sure the air we breathe isn’t harmful is key to staying healthy. Here are our top three tips for improving your indoor air quality.
1. Avoiding Allergens:
Allergens are a major asthma trigger, and there can be many different types of allergens in your home. Common allergens include dust mites, pets, moulds and cockroaches.
The best way to neutralize allergens is to keep things clean. Dust mites thrive in soft-surfaced places where there is an abundant food supply, which just so happens to be shed human skin cells found in bedding, mattresses, pillows, sofas and carpets.
Keep your indoor spaces uncluttered, wash your sheets and bedding weekly in hot water (55 degrees C), and vacuum your floor and mattress often (find asthma & allergy friendly™ certified vacuums here)
Pro-Tip: Keep your windows and doors closed in the summer to avoid pollen and other outdoor allergy triggers from finding their way inside the house.
Other ways of minimizing indoor allergens include:
- Removing carpets and furniture that trap allergens
- Keeping pets out of the bedroom and off of furniture that collects pet allergens
- Encasing your mattress, pillows and box springs in allergen-resistant covers
- Reducing moisture in the bathroom and kitchen to prevent mould (use a dehumidifier)
- Cleaning showers, tubs, sinks, and toilets weekly to stop mould from growing
- Using an air cleaner with a HEPA filter to remove allergen particles from the air
- Not leaving out food, water or garbage that could attract cockroaches (if your home has cockroaches call a professional exterminator)
Minimizing your exposure to allergens will help you control your asthma symptoms and improve your indoor air quality.
2. Control your Air
You have a lot of control over your indoor air quality. Staying smoke and scent free is an easy way to improve the air quality in your home or workplace. Cigarette smoke, wood smoke, and scented products like candles, flowers, perfumes, cleaning supplies, and laundry products can all be asthma triggers. You have the power to keep these triggers out of your indoor spaces.
Pro-Tip: Laundry detergents are an often overlooked asthma trigger. Opt for unscented and all-natural detergents instead of scented ones; your lungs will thank you for it!
3. Choose Safe Products
Just as you can choose to avoid smoking inside, so too can you decide to use asthma and allergy friendly products as much as possible. Chemical fumes from products like paints, cleaners, scented cosmetics, and laundry supplies can all trigger an asthma attack or worsening of symptoms. Finding products that don’t cause any symptoms is a great way to keep your indoor air free from asthma triggers. Look for products with the asthma & allergy friendly™ certification program logo to find products that have been scientifically tested and proven to be more suitable for people with asthma and allergies.
Indoor air quality is just as important as outdoor when it comes to managing your asthma. Always be conscious of the air you breathe and put your health first.
There’s beautiful weather, and then there’s melt your ice cream, instant sunburn kind of weather. Changes in temperature like heat waves are known to trigger asthma symptoms in some people.
Knowing how to manage your asthma in these conditions will help you avoid asthma symptoms and enjoy even the hottest summer days. Here are some tips to get you through even the worst summer scorchers.
1. Plan Ahead
Don’t let the heat catch you off guard. There are many ways you can get ahead of the hot weather, such as by checking the Pollen Count and your local Air Quality Health Index before venturing out and starting your day. If there is poor air quality or a high pollen count, it may be best to stick to indoor activities.
2. Be Prepared
When temperatures soar and you find yourself experiencing asthma symptoms, you want to have your reliever medication on hand. No matter the weather, keep your asthma reliever with you. You never know when asthma symptoms may strike, especially in extreme heat.
3. Be Smart
If you know you’re going to be outside when it’s stifling out it’s best to be smart about it. Keep your asthma medications out of direct sunlight and out of places known to get too hot, such as the glove compartment of your car. Your medication should stay close by and cool.
Know your limits when it comes to exercising outside and don’t over exert yourself. Take plenty of breaks and take your reliever medication if you need it. You can find more information about exercising with asthma here.
4. Stay Cool
Staying cool is crucial to controlling your asthma in warm weather. Try ducking inside in between activities and just sitting in the air conditioning to cool off. You can also consider going for a refreshing swim. Whichever way you do it, make sure you combat the heat and stay cool.
5. Stay Inside
On hot and humid days, it’s sometimes best to stay inside and avoid the heat altogether. This is especially true if the pollen count is high and you have allergies
6. Have an Action Plan
There are many benefits to having an asthma action plan. One of them is being able to identify when your asthma is flaring up and knowing what to do when that happens. Throughout the summer – and all year long – having an asthma action plan can be invaluable and help you manage your asthma safely. You can download our asthma action plan here.
7. Be Early
If you have outdoor activities planned it’s best to schedule them early in the morning to avoid the hottest parts of the day. It is also best to exercise earlier in the day when the air quality is better and the temperature is still tolerable.
8. Stay Hydrated
This tip may seem fairly obvious, but we can’t stress enough how important it is to drink lots of water and stay hydrated when you’re outside in hot weather.
9. Have A Chat
If you know your asthma is worse in the summer season or triggered by hot and humid weather, talk to your doctor about your asthma treatment and make sure it is right for you.
Heat and humidity also worsen allergies. Many allergy triggers like pollen, dust and mould are more prevalent and can trigger your asthma symptoms. It may be worth chatting with your doctor about having allergy testing done.
Whether you’re facing a sweltering heat wave that’s cracking thermometers or just a bright and sunny day by the pool, these tips will help you manage your asthma symptoms and breathe easy all summer long!