Q J Med 2002; 95: 485-486
© 2002 Association of Physicians
Correspondence |
Asthma attacks and thunderstorms
Suffolk Nuffield Hospital, Ipswich
This letter was previously published in the April issue, but the references were unfortunately omitted. We reproduce the entire letter here, with apologies to Dr Paulley.
Sir,
The hard evidence provided by Anderson et al.1 for increased asthma admissions during thunderstorms is important, as was their finding that it was unrelated to increased pollen or fungal spore counts.
Hurst,2 himself a life-long asthmatic, wrote in 1924 that a common trigger for asthma attacks was the realization by sufferers that they had forgotten their inhaler, and that others had attacks ‘with any little excitements, business worry or annoyance, but a severe fright is more likely to stop an attack than cause one’. Research workers and medical school teachers have for many years played down the role of such emotional triggers in asthma. As a result, many patients with asthma, and their relatives, are failing to receive valuable advice. During a carefully-taken history, some asthma patients will recall how a relative conveyed anxiety during thunderstorms, for example by hiding under the stairs. It is also possible that today's radio reports of high pollen counts may lead parents to communicate their anxiety to an asthmatic child, verbally or non-verbally. That noise, or emotion evoked by noise, can trigger an asthma attack, was suggested by Mason in 1967 in a report on the increased perception of high-frequency sound in asthmatics.
People with asthma are often sensitive to feeling crowded.4 Doctors taking a history are more likely to be rewarded with memories of childhood events if they sit at a distance from the patient, and talk calmly and quietly.
References
1. Anderson W, Prescott GJ, Packham S, Mullins J, Brookes M, Seaton A. Asthma admissions and thunderstorms: a study of pollen, fungal spores, rainfall and ozone. Q J Med2001; 94:429–33.
2. Hurst AH. Medical Essays and Addresses. London, Heinemann, 1924.
3. Mason RK. Asthma and high frequency sound perception. Nature1967; 214:99–100.[Medline]
4. Paulley JG, Pelser HE. Psychological Managements for Psychosomatic Disorders. Springer Verlag, 1989: chapter 7.
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