"An asthma attack feels like two walls drawn closer and closer until they are pressed together."

--John Updike

Most of us take breathing for granted. But for nearly 22 million Americans who have either allergic or non-allergic asthma -- including 6.8 million children -- an asthma attack can be life threatening. According to the U.S. Environmental Protection Agency, 12 million people reported having an asthma attack in the past year. Often considered a childhood illness, asthma can affect people of any age, gender or race.

Asthma in Montana is a growing public health concern. The Montana Department of Public Health and Human Services estimates 59,000 adults in Montana currently have asthma. According to a recently published state health department's report on asthma in Montana, one in five Montana high school students has been diagnosed with asthma and 11 percent currently have the disease.

Asthma is a chronic, long-term disease of the lungs in which the airways become blocked or narrowed. These effects are usually temporary, but can cause shortness of breath, coughing, wheezing, gasping, chest pain and chest tightness. The airways in the lungs of people with asthma are sensitive to various triggers, and the immune system overreacts by releasing different kinds of cells and other chemicals to the airways. These changes cause the airways to narrow and the muscles surrounding the airways to tighten up and make it difficult to breathe. Asthma can develop quickly and it can range from being a mild discomfort to a life-threatening attack if breathing stops completely. Asthma problems are often separated by symptom-free periods.

Doctors still don't know what causes some people to develop asthma. But, in addition to environmental causes, an important factor in the development of asthma may stem from genetics. For example, people with family history of allergies may have inherited a tendency to be allergic, and their chances of developing asthma are greater than normal.

Asthma is also on the rise. Experts believe that the prevalence of asthma is increasing for many reasons: poor asthma management and education, increased exposure to irritants and certain chemicals and air pollution (including wildfires). Additionally, over the years we have reduced ventilation in our homes and workplace to conserve energy, and we spend more time indoors, where asthma-triggering irritants and allergens are most common. Researchers also believe there may be a link between asthma and obesity.

This disease may affect athletes, both young and old. A study in the November 1998 Journal of Allergy and Clinical Immunology showed that one in six athletes representing the United States in the 1996 Olympics in Atlanta had asthma. Thirty percent of the asthmatic athletes took home individual or team medals. They did as well as the athletes without asthma. Twenty years ago, a diagnosis of asthma meant the end of many activities, including competitive sports, but medical advancements now allow athletes with asthma to compete at high levels.

May is National Asthma Awareness Month and public health organizations are working to develop programs that address the needs of those in our community with asthma. The Cooperative Health Center is in the early planning stages of developing an asthma collaborative program registry that will track and guide asthma patients' care that focuses on self-management support. Moreover, to keep the public informed of the current air-quality conditions (that may affect those with asthma), the health department maintains a 24-hour air-quality hotline, 447-1644. In 2007, the Montana Legislature provided funding for asthma control, allowing the formation of an Asthma Control Program. This program is responsible for developing an asthma surveillance system for the state and coordinates a statewide asthma-control effort.

Reduce exposure to triggers to decrease the frequency and severity of asthma attacks.

While there is no cure for asthma yet, it can be controlled by taking medication and recognizing, understanding and limiting exposure to specific factors that can "trigger" asthma attacks.

Common triggers to avoid include: allergens (pollen, pet dander, mold, feathers, dust mites, foods), household irritants (dust, perfume, cleaning products), medications (some over-the-counter pain relievers), weather (wind, cold air), air pollution (tobacco smoke, traffic fumes, high ozone levels, forest fires).

Having asthma used to mean living a life filled with "should nots." But now most people with asthma should be able to get their asthma under control and keep it that way for a lifetime. For more information on asthma call the Cooperative Health Center at 443-2584; or contact Katie Loveland, Asthma Control Program at 444-7304, kloveland@mt.gov; or check out these Web sites; www.lungusa.org, www.epa.gov/asthma.

Melanie Reynolds is the Health Officer at the Lewis and Clark City-County Health Department. The Health Department's mission is to improve and protect the health of all Lewis and Clark County residents.