Aggravation of Asthma by Cold, Fatigue, Stress, or Discontinuation of Medicines: What Should We Measures and Prevents Worse of Asthma Control Induced by the Aggravation of the Environmental Hygiene and/or the Stopping Medicine?
Bronchial asthma can be exacerbated by many factors, the most important of which are airway infection, including upper respiratory tract infection. However, in times of disaster, changes in temperature (cold air), fatigue, mental stress, and discontinuation of medicines can also exacerbate asthma and cause acute symptoms. In such situations, clinicians often encounter the exacerbation of asthma symptoms by cold air, which is thought to affect the immune and nervous systems through contact with the airway mucosa. Deterioration of asthma due to fatigue and mental stress is also common. In particular, evacuation after disasters causes great mental stress, as do loss of home, uncertainty about the unpredictable future, etc. Medical system collapse and subsequent discontinuation of drug treatment are serious problems for patients with chronic disease. In particular, inhaled corticosteroids are critical medicines for asthma patients. Maintaining a system of drug supply after major disasters is a challenge in Japan, which experiences many natural disasters, including earthquakes.
KeywordsCold air Physical fatigue Mental stress Inhaled corticosteroid Asthma death
- 3.Yamanda S, Hanagama M, Kobayashi S, Satou H, Tokuda S, Niu K, et al. The impact of the 2011 Great East Japan Earthquake on hospitalisation for respiratory disease in a rapidly aging society: a retrospective descriptive and cross-sectional study at the disaster base hospital in Ishinomaki. BMJ Open. 2013;3(1) https://doi.org/10.1136/bmjopen-2012-000865.CrossRefGoogle Scholar
- 8.Lam HC, Li AM, Chan EY, Goggins WB 3rd. The short-term association between asthma hospitalisations, ambient temperature, other meteorological factors and air pollutants in Hong Kong: a time-series study. Thorax. 2016;71(12):1097–109. https://doi.org/10.1136/thoraxjnl-2015-208054.CrossRefPubMedGoogle Scholar
- 14.Parsons JP, Hallstrand TS, Mastronarde JG, Kaminsky DA, Rundell KW, Hull JH, et al. An official American Thoracic Society clinical practice guideline: exercise-induced bronchoconstriction. Am J Respir Crit Care Med. 2013;187(9):1016–27. https://doi.org/10.1164/rccm.201303-0437ST.CrossRefPubMedGoogle Scholar
- 19.Sakuma A, Takahashi Y, Ueda I, Sato H, Katsura M, Abe M, et al. Post-traumatic stress disorder and depression prevalence and associated risk factors among local disaster relief and reconstruction workers fourteen months after the Great East Japan Earthquake: a cross-sectional study. BMC Psychiatry. 2015;15:58. https://doi.org/10.1186/s12888-015-0440-y.CrossRefPubMedPubMedCentralGoogle Scholar
- 29.Centers for Disease, Control Prevention (CDC). Self-reported increase in asthma severity after the September 11 attacks on the World Trade Center—Manhattan, New York, 2001. MMWR Morb Mortal Wkly Rep. 2002;51(35):781–4.Google Scholar
- 32.Mindlis I, Morales-Raveendran E, Goodman E, Xu K, Vila-Castelar C, Keller K, et al. Post-traumatic stress disorder dimensions and asthma morbidity in World Trade Center rescue and recovery workers. J Asthma. 2017;54(7):723–31. https://doi.org/10.1080/02770903.2016.1263650.CrossRefPubMedGoogle Scholar
- 38.Japanese Society of Allergology. Risk factor of asthma. In: Asthma Prevention and Management Guideline 2006 (in Japanese). Tokyo, Japan: Japanese Society of Allergology; 2006. p. 29–41.Google Scholar