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DURHAM, N.C. -- While winter's colder temperatures can
intensify or aggravate the symptoms of asthma, Duke University
Medical Center pulmonary specialists say that there are some
simple strategies for preventing attacks.

"The breathing in of colder air itself can actually cause
constriction of the airway, leading to the shortness of breath
and wheezing typical of an asthmas attack," explained Monica
Kraft, M.D., director of the Duke Asthma, Allergy and Airway
Center (DAAAC).

"When we breathe normally, our noses warm and humidify the
air before it enters the lungs," Kraft continued. "When the air
is cold, as in the wintertime, the nose has a more difficult
time warming the air, or we tend to breathe through our mouths
if we have a cold. The inhalation of cool dry air can lead to
the production of a chemical that can cause constriction of the
bronchial tubes. This same inflammatory response occurs to our
skin when exposed to the cold – it gets raised and
inflamed."

To combat the effects of cold air, Kraft recommends wearing
a ski mask or scarf around the mouth and nose. However, she
cautions, the covering needs to remain loose, so as not to
increase the resistance to breathing. Also, taking a
preventative dose of a bronchodilating inhaler before going out
into the cold could help lessen the likelihood of symptoms, she
said.

The adverse effects of cold breathing air can also be
heightened during exertion, Kraft explained. Interestingly, it
is during winter sports that many children often exhibit the
first signs of having asthma.

"We have found that kids playing such sports as soccer,
hockey or football in the cold can suffer from the symptoms of
asthma that are noticed for the first time," Kraft said. "For
this reason it is important for not only parents, but coaches
and teachers, to be sensitive to the symptoms. One of the
projects we are planning at the DAAAC is educating coaching and
physical education staffs what to look for and how to
respond."

Asthma is characterized by inflammation --redness and
swelling -- of airways, which lead to the well-known symptoms
of wheezing and shortness of breath. However, the actual
trigger for this inflammation can vary, ranging from allergy to
respiratory infections to irritants in the air.

So remaining indoors to avoid the cold can pose its own
risks, depending on the underlying triggers of an individual's
asthma, Kraft said.

"If dust mites or dander are triggers, remaining inside in a
hermetically sealed house can increase the likelihood of an
attack," Kraft said. "Also, people tend to have more colds and
upper respiratory infections in the winter, so being around
such people in close quarters can increase the chances of an
infection."

According to the American Lung Association, more than 20
million Americans have asthma, with about 6.2 million of those
being under the age of 18.