Asthma is a condition wherein a person’s airways become inflamed and swell, procuring extra mucus, making breathing difficult. Getting rid of asthma triggers from one’s house and workspace and protecting against external triggers outdoors are crucial factors in managing and treating asthma. In critical cases, doctors may suggest relocating to a new city with fewer asthma triggers. Since there is no cure for asthma, effective management becomes key in ensuring that the condition doesn’t worsen.

What is uncontrolled asthma?
When asthma symptoms become severe and start interfering with one’s everyday life, they might indicate uncontrolled asthma. These symptoms need urgent treatment. If left untreated, they could cause severe damage to one’s lungs. 

Causes of uncontrolled asthma
Stress
Chronic stress could lead to flare-ups of asthma symptoms. One must make an attempt to reduce stress and anxiety in life. Meditation and yoga could help a person deal with stress.

Underlying health conditions
Certain health conditions like environmental allergies and GERD could lead to asthma flare-ups. Other respiratory conditions like sleep apnea could block the upper airway while sleeping, leading to an asthma flare-up. 

Weather change
Moving from warmer to colder air or drier to humid air can trigger an asthma flare-up. It could also be brought on by simple weather changes or moving out from a controlled environment.

6 cities with the most asthmatic emergencies
Springfield, MA
Springfield has recorded the highest number of asthma-related emergency visits and has consistently been ranked as one of the worst cities in the country for asthma patients. In most other cities, while air quality could be the biggest trigger, pollen and household triggers are the leading causes in Springfield. Springfield also has a very high volume of old housing stock. The climate is also extreme, with extremely warm summers and below-zero-degree winters. These are major asthma triggers. Springfield’s asthma prevalence and emergency room visit rates are more than three times higher than the national average. It also ranks high on seasonal allergies and asthma. Springfield’s air quality, however, is good and falls within the quality limits and standards set by the Environmental Protection agency. 

Detroit, MI
Detroit is considered one of the most unfavorable cities in the country to live with asthma. The city has about 46% more asthma cases and four times more cases of hospitalization than the whole of Michigan state. The number of children requiring emergency care is twice the state average, and more than 58% of children with asthma filled prescriptions for inhalers. Detroit has dangerous levels of sulfur dioxide from factories, industries, and old diesel engines of automobiles. Over 57% of the houses are old, increasing the risk of asthma triggered by dust, mold, and mildew. The city also has more than recommended levels of ozone. There is a lack of medical care access as emergency care gets overcrowded during peak asthma season in the city. 

Cleveland, OH
Cleveland has higher than average rates in asthma prevalence, emergency room visits, and asthma-related deaths. Cleveland has high air particle pollution caused by the presence of oil, gas, and manufacturing industries and vehicle carbon emissions. The city also has higher poverty rates and unsafe ozone levels that cause a worsening of uncontrollable asthma symptoms that require urgent medical attention. Aging buildings and the high presence of mold, dust, and lead paint are common indoor triggers in Ohio, as the cost of rehabilitation or rebuilding is too high for families and governments. 

Allentown PA
Allentown metropolitan area is ranked high on the number of asthma-related emergency visits in the country. Allentown is a valley situated between two mountain ranges. When the winds are high, the pollen gets dispersed across the area triggering uncontrollable asthma. In the absence of wind, the mountain pollen stays in the air. Heavy truck traffic emissions, fumes from cement companies, and other incinerators hang in the air without getting driven away. Allentown also ranks low on the air quality rankings. 

Richmond, VA
Richmond ranks high on springtime pollen prevalence, one of the biggest environmental triggers of springtime, and seasonal allergies and asthma. Richmond also has a high growth of ragweed, creating a risk of higher asthma-related emergency room visits in the fall. The city is surrounded by power plants emitting chemicals like sulfuric, hydrochloric acid, and ammonia. Poor ventilation, old school buildings, and poor air conditioning are significant causes of high asthma prevalence in children. Richmond’s average for emergency room visits exceeds the national average. The high presence of particulate matter, unsafe ozone levels, and hot and humid summers add to the woes of asthma patients. 

Baltimore, MD
The average of asthma patients in Baltimore is more than double the state and national average. The rate of young children with asthma is 33.3%, which is also higher than the state average of 25.9%. It also has the highest hospitalization and emergency room visits in the state. Old housing stocks and air pollution is extremely high in the city, significantly adding to Baltimore’s asthma prevalence. 

Environmental and outdoor triggers of uncontrollable asthma
Doctors and patients agree that outdoor triggers are more likely to trigger uncontrollable asthma rather than food or household allergens. Avoiding exposure to triggers is an integral part of asthma management. Identifying and taking steps to avoid the triggers are as crucial as the treatment. Doctors advise patients to maintain a daily journal that can identify potential triggers in the long term. They may also prescribe provocation tests and irritant challenges that expose a person to triggers like smoke, perfumes, or household chemicals and analyze how one’s breathing and lung function change. Apart from food and household allergens, some of the most common asthma triggers include:

Ragweed pollen
Mold 
Risk of flu and cold due to weather conditions
Air quality
Vehicular and industrial pollution
Wildfire smoke