October 7, 2024

It’s Thunderstorm Asthma Season

The arrival of October brings the start of grass pollen season, generally lasting until 31 December.

Warmer weather, increased amounts of grass pollen in the air and certain types of thunderstorms, when combined, can result in an Epidemic Thunderstorm Asthma (ETSA) event triggering severe asthma.

Thunderstorm Asthma can cause serious health impacts for people with known and unknown conditions of asthma, therefore it is incredibly vital to be aware of the Thunderstorm Asthma procedures and how to be prepared for a potential ETSA event.

Symptoms of ETSA include an itchy and runny nose, sneezing, coughing, wheezing and/or chest tightness. Some of these symptoms can become very severe, very quickly, and may require urgent medical assistance.

Extreme ETSA events, like that experienced on 21 November 2016, can result in large numbers of people with sudden onset asthma in temporal and spatial relation to the storm, and large geographical areas affecting multiple health services, with a resultant strain on health and emergency services.

Sharon Rukavina, Respiratory Clinical Nurse Consultant – Asthma and Allergy, said during the 2016 event, thousands of people suddenly had asthma attacks, therefore, finding it hard to breathe.

“Some had never had asthma symptoms before,” she said.

“In Victoria, from October to December, thunderstorm asthma results from a combination of high grass pollen counts, such as ryegrass, and specific weather conditions. Strong winds carry the pollen, while storms or moisture break open the pollen grains, releasing ultrafine particles into the air.”

“These particles are small enough to penetrate the lower airways, potentially triggering severe asthma symptoms in those that are susceptible.”

“A comprehensive review of the 2016 Melbourne thunderstorm asthma incident revealed that it primarily affected individuals sensitive to grass pollens.”

“Consequently, those with springtime hay fever or poorly controlled asthma – characterised by asthma symptoms on many days of the week or frequent ongoing use of a reliever inhaler – will require additional protection against thunderstorm asthma. If you think your asthma may not be controlled or you have spring hay fever, then please see your GP as soon as you are able.”

Sharon urges everyone in the community to be able to recognise the symptoms of someone having an asthma attack and to know the four steps of asthma first aid.

“It is very important not to ignore any symptoms of asthma such as wheeze, persistent cough or unexplained breathlessness. Everyone should be able to recognise the symptoms of someone having an asthma attack and to know the four steps of asthma first aid,” she said.

Step 1: Sit person suffering the attack upright.

Step 2: Shake the blue/grey reliever puffer and give them four separate puffs using a spacer if available.

Step 3: Wait four minutes and give four more puffs if the person cannot breathe normally.

Step 4: Call an ambulance if they still cannot breathe normally and keep giving reliever puffs as above until an ambulance arrives.

Completely avoiding pollen can be difficult during the pollen season but the following steps may help reduce your exposure if you are sensitive:

• For individuals with known asthma, it is important to use your prescribed preventer inhaler as directed, even in the absence of symptoms.

• Carry a blue/grey reliever inhaler such as Ventolin or Asmol at all times and ensure you are familiar with its proper use

• Avoid going outdoors on days with high pollen counts,  high winds or after thunderstorms. Stay inside with the windows shut and the air conditioner switched to recirculate/recycled.

• Check weather forecasts and pollen levels

• It may be prudent to manage hay fever symptoms with a daily steroid nasal spray during pollen season, although its effectiveness in preventing thunderstorm asthma remains uncertain.

Jason Amos, Director Emergency Management, is encouraging staff to become aware of Northern Health’s emergency plan for such events including ETSA.

“Northern Health has a Code Brown Subplan – Thunderstorm Asthma procedure and the Code Brown – External Emergency procedure. Both are available on Prompt and have been updated to include Kilmore District Hospital following the recent amalgamation,” he said.

The Northern Health Simulation and Safety Team is facilitating a Multiagency Thunderstorm Asthma Simulation on 17 October, 1 pm – 3 pm at NCHER. Representatives from Northern Hospital Epping, Kilmore District Hospital Urgent Care Centre, Epping and Craigieburn Priority Primary Care Centres and Ambulance Victoria will be in attendance.

You can access daily forecasts for ETSA events here.

For more information on asthma first aid, please click here.

Featured image: Jason Amos, Director Emergency Management and Sharon Rukavina, Respiratory Clinical Nurse Consultant.