Disinfecting commonly touched surfaces was highly publicized during the early days of the COVID-19 pandemic, but cleaning chemical fumes and fragrances may contribute to breathing problems and asthma attacks.

“We want to be clean, but we need a balance,” said Dr. James Hoyt, a pulmonologist who sees patients at the UCHealth Pulmonology Clinic in Steamboat Springs. Asthma is a chronic lung disease that causes persistent airway inflammation making it hard to breathe and worsens when triggered by allergens or irritants, according to UCHealth asthma educators.

Airway irritants can cause immediate breathing problems for asthma sufferers, yet many community members do not have a high awareness of those triggers, ranging from air fresheners in public restrooms to tobacco smoke, Hoyt said. Experts say other environmental triggers for asthma include harsh chemicals, vehicle exhaust, strong perfumes, animal dander, dust mites, mold, pollen, wood-burning stoves, scented candles, fire smoke and spray-on products ranging from hairsprays to deodorants.

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“It’s really a challenge to avoid airway irritants,” Hoyt said. “It’s really important to identify triggers and avoid them as possible. Avoidance of triggers is one hallmark of asthma management.”

Many workplaces may include asthma triggers such as solvents, glues, harsh chemicals and building products such as western red cedar, Hoyt said.

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The American Lung Association notes asthma exacerbation and attacks cause significant absenteeism for school students and workers. According to U.S. Centers for Disease Control and Prevention statistics from 2020, 5.8% of children in the U.S. suffer from asthma and 8.4% of adults. In Colorado, 9.6% of adults have asthma.

Since avoiding environmental triggers can be tough, Hoyt recommends patients keep a rescue inhaler available at all times especially when traveling to different environments and locations. Patients whose asthma may be easily controlled at home can encounter different allergens or environmental triggers in other locations that could impair breathing. He advises asthma patients to maintain two up-to-date rescue inhalers, if possible, one at home, and one always with the patient in a purse, backpack or vehicle glove box.

“Better baseline control of asthma should help in terms of severity of asthma exacerbation and sensitive of triggers,” Hoyt said.

The pulmonologist sees patients on the Front Range and two days a month in Routt County, and each community can have different airway irritants. The Front Range has more air pollution, for example, but Routt County has its share of forest fires, he said.

“Going to higher elevation can expose asthmatics to different allergens, pine pollen, for example,” Hoyt noted.

Higher elevation itself should not worsen asthma, but asthma can be exacerbated by cold, dry air. So, the physician encourages patients outdoors at colder, higher elevations to wear a buff, neck gaiter, scarf or quality reusable cloth mask to filter air going into the lungs.

Altitude does not change the percentage of oxygen in the air, which is always 21%, so Dr. Hoyt does not recommend that low-land tourists visiting Routt County buy canned oxygen. Less oxygen or “thin air” at higher elevations is due to lower barometric or atmospheric pressure, he said. Experts explain that air molecules in lower-pressure altitudes are less dense because the molecules are not being pushed together by as much barometric pressure, resulting in fewer oxygen molecules per breath.

“Asthmatics aren’t going to end up on supplemental oxygen. Canned oxygen is a waste of money. You are far better off making sure you have a rescue inhaler,” Hoyt said.

More information is available at lung.org/asthma or at UCHealth.org/diseases-conditions/asthma.