If you can avoid exposure to factors that trigger your asthma, you will need less medication. It may not be always possible to identify the factors that worsen your asthma. This is mainly because you may not remember all the factors you were exposed to before the attacks. It is therefore desirable that you maintain a diary in which to record all the triggers you were exposed to, about twelve hours before each asthmatic attack. This will help you and your doctor identify the asthma triggers.

Detailed below are some measures that can reduce the risk of asthmatic attacks.

Foods: Once you have identified the foods such as eggs, wheat, milk, etc, as asthma triggers, it is easy to avoid them. If you are allergic to some specific food additives, read the list of ingredients before buying ready-made food products. Avoid them if they contain an allergen you are sensitive to. In case the ingredients list is absent or is not complete, simply avoid foods that had triggered an asthmatic attack in the past.

Many people are allergic to foods belonging to the same family. For example, if you are allergic to orange, you are likely to be allergic to sweet lime too. Allergy to foods of the same family is called cross-reaction. You may also develop allergic reactions when two different types of food you are not allergic to are combined.
It is important to learn about substances contained in common food that may cause allergies. For example, if you are allergic to milk, you need to avoid anything that contains casein, calcium caseinate or whey. Similarly, if you are allergic to corn, you need to avoid country alcohol prepared from grain, corn syrup, and corn starch or medicines bound-with corn flour.
Dust mites: These are very small insects that are related to ticks. Dust mites live on flakes of dead skin, known as dander. They thrive in moisture and are normally present in large numbers on bed-sheets, mattress, pillows and upholstered furniture. Both the dust mites and their feces can cause allergy. It is often difficult to eliminate dust mites from the house completely. You can however reduce their number by taking some special precautions: use of air conditioners in humid climate; regular dusting and cleaning of mattresses, pillows, bed linen, etc; avoiding use of carpets; cleaning, furniture, curtains and other household items.

Cockroaches: Cockroach droppings and their decayed body parts are a major cause of asthma, especially in children. Keeping the house cockroach-free requires regular and meticulous cleaning of the entire house.

Avoid insect repellent sprays as they may irritate your airways and worsen asthma. Use insecticides such as chalks, pellets, boric acid, etc. In case you must use a spray insecticide, ask someone else in the family to spray it in your absence. Leave the windows and doors of the house open for a few hours after spraying. Use a wet mop to clean the floor to remove the dead body parts and droppings of the cockroaches. Store left-over food and garbage in sealed containers. Clean utensils before preparing or eating food and before going to bed at night. Keep your kitchen clean, ventilated and well lit.

Moulds: Moulds grow throughout the year in dark and moist places. Wash the floor, fixtures and tiled walls with a soap solution regularly and dry them with a wet cloth. Make sure that there is no seepage in the walls. In case there is, identify the cause of the seepage and get it repaired immediately. Some other measures that can be taken to prevent the growth of moulds are - keeping leather products clean; reducing excessive humidity by installing dehumidifiers; cleaning refrigerators and damp areas with bleaching powder and water; using sprays that destroy moulds in sinks, bathrooms, air-conditioners, etc.

Pets: Fur, saliva, urine, dander, etc, of all pets and rodents can trigger asthma. Avoid keeping pets and any articles prepared from pure or synthetic fur. Animal dander can remain in the house for several months after you have given your pets away. This is why you regularly need to clean all areas where animal dander is likely to be present with chemicals that can remove them.

If you must keep pets at home, practice the following guidelines to reduce allergic reactions:

• Keep the pets outside the house. In case this is not possible, do not allow them to enter the bedroom.
• Do not keep the animals near you at night. This is because the risk of developing asthmatic symptoms is higher at night.
• Wash your hands with soap solution every time you touch the pet.
• Bathe your pets once a week. Cats normally do not like water, but can get used to it over a period of time.
• Do not travel with the pets in the car, as their dander can remain in the car upholstery for a long time.
Indoor air pollution: Several allergens are either generated while cooking, smoking, etc, or may enter the house with the wind. These allergens pollute the air in the house and therefore increase the risk of asthma. Indoor air pollution can be kept in check by regularly dusting and cleaning the house and furniture; avoiding, sprays, kerosene stoves, charcoal cooking fumes, cosmetics, etc, that trigger asthma. Installing air purifiers in the kitchen and electrical chimneys help in reducing the risk of asthma.

Smoking: Tobacco smoke is the most important cause of indoor air pollution and increases the risk of asthma.

General guidelines for preventing exposure to tobacco smoke include the following:

• Avoid smoking.
• Request people not to smoke near a person suffering from asthma. In case you are in a group where people smoke, move away from them while they smoke.
• Avoid traveling in a vehicle with smokers
• Insist on using non-smoking sections in hotels, restaurants and theatres.

Outdoor air pollution: Asthmatic symptoms worsen during some seasons because of the presence of pollen grains and spores. You cannot completely avoid them but can change your lifestyle to reduce contact with them.
The following are a few options on how to reduce the effect of outdoor air pollution.

• Stay indoors for longer hours during the seasons when types of pollen grains you are allergic to are present in the air.
• Avoid spending long hours outdoors on windy days.
• Exercise very early in the morning before pollution levels increase. Avoid exercising outside the house. In case you cannot avoid exercising outdoors, do it in parks and places where pollution is less.
• In case you need to work in the garden or tend to your plants, wear a pollen mask and take a bath as soon as you complete the work. This is essential for washing off pollen and plant particles from your body.
Occupational exposure: If your doctor has confirmed that some substances or conditions in your work environment trigger asthma, you need to avoid them. Try to change the type of your work and if it is not possible, wear protective equipment to reduce exposure to allergens. Maintain a healthy work environment and plan alternative ways of production and / or use of alternative substances.

Respiratory infections: It is difficult to prevent respiratory infections such as common cold.

You can however reduce the risk by adopting healthy lifestyles. You need to:

• Consume a balanced diet without any additives and processed foods. Eat larger portions of fresh fruits and vegetables.
• Prepare a personal exercise plan in consultation with your doctor and follow it strictly. Regular exercise will increase your lung capacity and reduce the risk of common infections.
• Drink plenty of water in order to keep your body well hydrated. Inadequate water in the body can make the mucus secreted by the inner lining of the respiratory passages thick. Thick mucus cannot remove inhaled allergens effectively.
• Do not practice self-medication, even if it is for minor ailments such as common cold or cough. This is because some anti-allergy medicines and cough syrups can react adversely with asthma medicines.
• Avoid the company of people who have common cold.
• Take influenza vaccine if you have moderate or severe asthma. The effect of influenza or flu vaccine lasts for a short time and the structure of the virus keeps changing regularly. You therefore need to take these vaccines every year.
• Wear warm clothing in winter or on windy days. Cover your mouth and nose during windy and cold days.
Heartburn: Heartburn is the common term for gastric reflux, a condition in which the acids from the stomach enter the food pipe and cause a burning sensation in the stomach and chest. It can also cause frequent belching or regurgitation of food back into the food pipe. Heartburn occurs when the one-way valve at the junction of the food pipe and the stomach becomes defective. It is more common at night and when you lie down. Thus, asthma due to gastric reflux is also more common at night.

You can reduce heartburn by taking the following simple measures:

• Keep the head end of the bed elevated by about six inches.
• Eat small meals at frequent intervals so that you do not feel full after any meal and do not develop indigestion.
• Do not smoke, because smoking can adversely affect digestion.
• Have dinner about three hours before going to bed.

• Eat larger portions of high fibre foods.
• Avoid rich and spicy foods.
• Avoid alcohol, tea, coffee or any soft drink with caffeine.