NEW YORK (AAAAI) -- Asthma is a chronic lung disease that affects more than 17 million Americans. Characterized by coughing, chest tightness, shortness of breath and wheezing, asthma is the most common serious chronic disease of childhood, affecting nearly 5 million children in the United States.

Adolescents are the most at risk, as the near fatal asthma episodes are highest among adolescents age 12-15, according to Renee Theodorakis, MA. Asthma often goes untreated in teenagers due to the teen's lack of knowledge about asthma and delays in recognizing the seriousness of their deterioration. A lack of compliance to an asthma management program is also responsible for the high numbers of asthma attacks in this particular age group. Peer pressure and acceptance are very important among adolescents; teens would rather be thin and popular than deal with medication side effects. Good management of asthma usually requires multiple medications and tools, and for teens, this is often too complicated to fit into their busy lifestyle.

Asthma in the Elderly: Evaluation and Management

People over 65 compose the fastest growing age group in the United States. In the 20-year period between 2010 and 2030, the population over the age of 65 will increase by 75%. The asthma mortality rate of older patients is much higher than for younger patients with asthma. The older patient with asthma deserves particular attention from asthma specialists, according to James Li, MD, PhD, FAAAAI.

People over the age of 65 who have asthma often have special needs and concerns. Scientists are only beginning to understand how the basic pathophysiology and immunology in this group differs from younger patients with asthma. It is well recognized that older patients have more complicating medical problems (such as hypertension, glaucoma, heart disease, diabetes and emphysema) and are taking more medications than younger patients. The older patient with asthma also has particular psychosocial needs.

Asthma and Allergic Disease in Women

Asthma may worsen during pregnancy. It is particularly important for pregnant women who know they have asthma to manage her symptoms, for her health and her baby's health. Uncontrolled asthma can be a threat to maternal well being and fetal growth and survival, according to Michael Schatz, MD, MS, FAAAAI.

When a woman is pregnant, she is breathing for two. If she is not getting enough oxygen, the baby may not get enough oxygen. Avoiding asthma triggers is particularly important during pregnancy in order to reduce asthma symptoms and the need for medications. The risks associated with uncontrolled asthma are greater than the risks of asthma medications that have been carefully chosen based on the individual's situation and the track record of those medications during pregnancy.

Risk Factors for the Onset of Asthma

Asthma is the most common chronic childhood disease, affecting nearly 5 million children in the United States. In infants and children, asthma may appear as cough, rapid or noisy breathing in and out, or chest congestion, according to James Gern, MD, FAAAAI.

Most children who have one or two wheezing episodes in childhood associated with a viral infection do not go on to develop asthma. However, children who have several episodes of wheezing in infancy are more likely to develop asthma if they have other allergic diseases, such as atopic dermatitis (eczema), food allergy, or allergic rhinitis.

Asthma also may be triggered by a family history of allergy and the child's exposure to allergens-any substance that can trigger an allergy. Common allergens include dust mite and cockroach droppings, animal dander (saliva and dead skin flakes), pollens and molds. So far, there is no sure way to prevent asthma in children who have a strong family history for this disorder. However, it is essential that children be protected from irritants such as tobacco smoke, since this causes chronic irritation of the airways. Studies have documented that children born to a mother who smokes or who live with a smoker have a much higher incidence of asthma and respiratory infections.