Indoor air can be a silent threat to those living with asthma, filled with pollutants that trigger or worsen their condition.
In November, we worked with our #EFACommunity of asthma members to contribute to the draft Guidelines of the European Academy and Allergy and Clinical Immunology (EAACI). The guidelines aim to bridge the gap between the latest scientific developments and their application for better asthma care, and we thank the medical society for this opportunity.
Science meets real-life challenges
Scientific guidelines are international medical consensus documents developed using a strict scientific methodology. The ones from EAACI therefore reflect the perspective of allergologists on how indoor air quality (IAQ) impacts asthma, including new-onset asthma and disease-related outcomes. They focus on four major pollutants: Volatile Organic Compounds (VOCs), dampness/mould, pesticides, and cleaning/disinfecting products.
While acknowledging that asthma arises from a complex interplay of genetic factors and environmental exposures, the guidelines seek to improve prevention, care and mitigation measures. This is pursued in the shape of recommendations addressed to healthcare professionals, patients, policymakers and citizens, alongside research priorities for the future.
Patients’ input for a solid IAQ framework that improves asthma prevention and care
Recognising the guidelines as a thorough, science-driven reference tool, we welcome its potential to fill critical knowledge gaps on asthma triggers and improve individualised management plans.
Asthma patients live with the reality of polluted indoor air every day. EFA’s review of the draft guidelines brought the the different perspectives of asthma patients’ organisations to the core of the research. EFA highlighted the need to expand the scope of the guidelines by including significant pollutants currently overlooked, including emissions from heating and cooking, house dust mites and tobacco smoke. Everyday products like perfumes, hair care, baby products are also linked with asthma.
Practical measures for real impact
EFA strongly supported EAACI’s recommendation to incorporate assessments of indoor exposure into individual asthma management plans. We emphasise that the critical clinical history factor (indoor air quality as a trigger of their disease or worsening) must be communicated to patients, empowering them to take proactive risk-reduction steps. EFA therefore encouraged EAACI to include clear guidance on implementing avoidance or reduction strategies.
For patients and healthcare professionals, simple, affordable tools to measure, record and monitor indoor air quality are essential. These tools would be especially beneficial in the primary care settings, where initial asthma management often begins.
Focus on ventilation
Ventilation systems, particularly demand-driven ventilation (DCV), play a crucial role in mitigating indoor air risks. However, EFA stressed the importance of evaluating their effectiveness and identifying potential downsides. This issue is particularly urgent in schools, where children spend long hours in closed spaces, sharing the same air. A well-functioning ventilation system could significantly reduce their exposure to asthma triggers.
The draft EAACI guidelines represent a crucial step toward addressing the impact of indoor air pollution on asthma. By prioritising clear, actionable guidance and considering real experiences of patients with asthma, we can create indoor environments that support health for all. EFA office thanks its members Longfonds from the Netherlands, Allergy UK and the Swedish Asthma and Allergy Association for their valuable contributions enriching the EFA input to the draft Guidelines, despite the short timeframe for comments.
We look forward to continue collaborating with EAACI and for the publication of the guidelines.