Viscount Simon And Fragrance Asthma

DAILY MAIL – 9 March 2004

Whiff of perfume could kill me

by Amanda Cable Daily Mail

Viscount Simon: asthma attacks can be triggered by smokers in passing cars.

Despite being one of the Deputy Speakers in the House of Lords, I often find myself being reduced to silence. Not pausing for the right words to add gravitas to the latest political debate, but gasping for breath in the grip of an acute asthma attack.

Like five million other people in this country, I suffer from asthma. In my case, allergic reactions to perfumes, tobacco smoke and chemical fumes have forced me to make huge changes to the way I live.

The last time I went to the cinema, for example, was to see Crocodile Dundee in 1986, and I can't remember when I last sat in a crowded restaurant, or took a train or bus
.
Any of these "normal" activities will expose me to triggers which could set off a potentially fatal attack. Just the slightest whiff of a woman's perfume, some aftershave or someone's cigarette can bring on an attack in 20 seconds, and leave me fighting for breath.

Safe setting in which to work

It's ironic that a job I inherited rather than chose - being a peer in the House of Lords - has provided me with one of the safest settings in which to work. The high ceilings allow air to circulate, and the many corridors mean I can duck and dive my way out of trouble.

But it is still not always enough. Three years ago, I collapsed and needed oxygen simply because a Baroness tried to sit beside me after washing her hair that morning with a perfumed shampoo.

And last October it even caused a sitting of the House to be adjourned - something which normally only happens when a Lord dies during the session.

I was Deputy Speaker that day when a message was handed across the chamber. It was on a piece of faintly perfumed paper - and I inhaled a tiny whiff of the scent.
In an instant, I was gasping for breath, as the bronchioles - the small airways that carry air in and out of the lungs - became inflamed and swollen.

The Duty Whip saw me struggling for breath and announced: "I think Lord Simon is ill." I had to pull myself up and gasp "House adjourned" before being helped out and given oxygen.

Attacks come and go quickly

My attacks aren't typical. They come quickly and they go quickly. Last week, I had seven separate attacks.

The most serious one was as I left a Deputy Speakers' meeting and walked past a room where a peer's guest was enjoying a cigar. I took half a breath before I realised, and the familiar tight feeling in my chest began
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I started taking Ventolin through my inhaler - to relax the muscles surrounding the airways, making it easier to breathe - and went straight to the nurses' station for oxygen. It was six hours before I could breathe easily again.

Ironically, the problems which now rule my life didn't start until a serious chest infection nine years ago, not long after I inherited the title from my father.

I became ill with a chest infection in Christmas 1994, and by January 1995 the constant coughing and wheezing hadn't cleared up. My GP quickly diagnosed asthma.

Of the five million people in the UK affected by asthma, around one in ten are adults, but only a third of these cases develop later in life.

The most likely explanation in my case is that my chest infection damaged the cells lining my airways, making them sensitive and inflamed.

When I come into contact with something I am allergic to - a trigger - the muscles around the walls of my airways tighten, the lining becomes inflamed, and sticky mucus or phlegm is produced, sparking an asthma attack.

Triggered by fumes and smoke

Like many sufferers who develop late-onset asthma in their 50s, 60s and 70s, my triggers are cigar smoke, perfumes and chemical fumes.

I take five daily medications to stabilise my condition - a combination of drugs known as preventers and relievers.

The steroid-based preventers quell swelling and inflammation in the airways and reduce mucus. Taken daily, they reduce the sensitivity of the airways. Relievers are drugs which relax and open up the airways. These relieve symptoms during an attack.

As a result of my condition, nothing is left to chance. I have an oxygen tank and mask in my office at the House of Lords, another in my bedroom at home and one behind the driver's seat of my car.

A couple of years ago, I was travelling along the motorway when someone smoking a cigar overtook me. Even with my car windows up, my chest started to tighten. I had to take a number of puffs of Ventolin immediately.

Then I reached behind my seat, grabbed the oxygen mask and had a whiff as I was driving along.

Can not fly or use public transport

Although I live a full and very active life, asthma has changed my existence beyond measure. I can no longer fly or travel on public transport. I cannot stay in a hotel in case a smoker is in the room next door, or the pillowcases contain residues of dry cleaning fluid.

I can't go to the theatre, restaurants or the cinema. My wife, Mary Elizabeth, has had to change every brand of shampoo, deodorant and make-up which she used to use.

She calls herself my "sniffer dog" because of her uncanny ability to detect a perfume which will cause me problems. Recently, she stepped into a taxi and quickly shouted at me to get back because the air freshener inside could have triggered an attack.

Any guests to our country home are given a list of strict instructions about what they can and cannot wear.

We had a couple of old friends to stay with us last Christmas, and although we had asked the wife not to wear perfume, deodorant or freshly dry-cleaned clothes, her husband arrived with aftershave on.

I immediately needed Ventolin - and my wife had to whisk him upstairs and get him to wash his face twice before every trace of the scent had gone.

Not scared of attacks

Am I ever scared by an asthma attack? I can honestly say that I never have been, because I've always convinced myself that it will pass and I will get better.

In asthma terms, I am the exception to the rule. Apart from the times when I have an asthma attack, I lead a normal life, and I know there are people who are a lot worse off.

Since my maiden speech in June 1994, which was the first time I attended the House of Lords, I live in London during the week so that I can attend debates and meetings and vote five days a week.

I am a Labour peer, and I have a keen interest in health matters.

It isn't only my life which has changed beyond recognition. Because of the asthma, my voice has, too. My natural booming tone has become soft and hoarse because of the steroids I take each day.

But the good news for my daughter and any future generations is that unlike my title, my asthma is not hereditary.


Read more: http://www.dailymail.co.uk/health/article-299652/Whiff-perfume-kill-me.html#ixzz1BJ7BWJt9

Genes And Asthma

This longish 1177 word item from escience dot com is about a possible genetic element in asthma in that some may be more vulnerable than others. If this is the case then it is likely that the more pollutants and the stronger in the air then the more the asthma. The study does not indicate whether amongst the remaining population there may be more people at the margins, but that is possible.

Quote:

Largest genetic study of asthma points towards better treatments

Published: Wednesday, September 22, 2010 - 16:32 in Health & Medicine

An international study looking at DNA from over 26,000 people has identified several genetic variants that substantially increase susceptibility to asthma in the population. The findings, published in the New England Journal of Medicine, will help scientists to focus their efforts to develop better therapies for the illness.

The study, which was co-ordinated by researchers from Imperial College London, was performed by the GABRIEL consortium, a collaboration of 164 scientists from 19 countries in Europe, along with other groups in the UK, Canada and Australia. It analysed DNA samples from 10,000 children and adults with asthma and 16,000 non-asthmatics.

The researchers performed more than half a million genetic tests on each subject, covering all the genes in the human genome. The study pinpointed seven locations on the genome where differences in the genetic code were associated with asthma.

One in seven children in the UK suffers from asthma. When the airway is irritated in a person with asthma, the airway narrows and the lining becomes inflamed, causing difficulty breathing. The causes of the disease are poorly understood, but genetic and environmental factors are thought to play roughly equal roles.

Today's research has a number of potential implications, according to the study team. It suggests that allergies are probably a consequence of asthma, rather than a cause of the disease. It also suggests that genetic testing would not help predict who is likely to develop the disease.

The new variants linked to asthma were found in more than a third of children with asthma in the study. The gene with the strongest effect on children did not affect adults, and adult-onset asthma was more weakly linked to other genetic differences, suggesting that it may differ biologically from childhood-onset asthma.

Childhood asthma, which affects boys more than girls and can persist throughout life, is often linked to allergies, and it has been assumed that these can trigger the condition.

However, the study found that genes controlling the levels of antibodies that cause allergies had little effect on the presence of asthma, suggesting that allergies are more likely to be a consequence of asthma than a cause.

Professor Miriam Moffatt, Professor of Human Genetics at Imperial College London and one of the study's leaders, said: "As a result of genetic studies we now know that allergies may develop as a result of defects of the lining of the airways in asthma. This does not mean that allergies are not important, but it does mean that concentrating therapies only on allergy will not effectively treat the whole disease."

Some of the genes identified are involved in signalling pathways that tell the immune system when the lining of the airways has been damaged. Other genes appear to control how quickly the airways heal after they have been injured. Identifying these genes should help direct research into new treatments for asthma, the researchers suggest.

"Asthma is a complex disease in which many different parts of the immune system can become activated," said Professor William Cookson, Director of Respiratory Sciences at Imperial College London, who co-ordinated the study.

"One of the problems with asthma research has been choosing where to intervene in the disease pathways. Our study now highlights targets for effective asthma therapies, and suggests that therapies against these targets will be of use to large numbers of asthmatics in the population. "

Professor David Strachan, Professor of Epidemiology at St Georges, University of London, who also co-authored the study, said: "Asthma has often been considered a single disease, but our genetic findings suggest that childhood-onset asthma may differ biologically from asthma that is acquired in adult life.

The GABRIEL consortium is now investigating whether the causes of asthma differ between people with and without these newly discovered genetic variants."

The study also found that the genes associated with asthma did not have strong enough effects to be useful for predicting early in life which children might eventually develop the disease. This indicates that environmental factors are also very important in causing asthma to develop.

The GABRIEL consortium is working to identify environmental exposures that could protect against the illness.

The study was primarily funded by the European Commission, the French Ministry for Higher Education and Research, the charity Asthma UK and the Wellcome Trust.

Although large multi-national collaborations are becoming the norm with the study of many complex genetic diseases, the GABRIEL study is unique in that nearly all of the 15 billion genetic tests were performed in a single institution, the Centre National de Genotypage near Paris.

Professor Mark Lathrop, the Director of the CEA-CNG and the Scientific Director of the Fondation Jean Dausset–Centre d'Etude du Polymorphisme Humain (CEPH), pointed out the crucial role of an integrated large-scale infrastructure like CEA-CNG which has the capacity to perform all the steps from receiving the biological samples, to high throughput genotyping, quality control and data analysis. The Fondation Jean Dausset – CEPH was also a major player in this study.

Professor Miriam Moffatt said: "It has been enormously gratifying to work with such a group of dedicated scientists from so many countries. This genetic study has taken five years from planning until completion, but it builds on many earlier years of work in which all the 26,000 volunteers were recruited and studied in great detail.

The study would not have been possible without the contribution of all of the GABRIEL members."

Professor Ivo Gut, former Deputy Director of the CEA-CNG and now Director of the Centro Nacional de Análisis Genómico in Barcelona, said: "These results constitute a huge leap forward in the understanding of asthma that will lead to major advances in the treatment and quality of life of people suffering from the disease. It has been an immense effort to get this far but is well worth it.

The generous support from the funding agencies, the kind donation of DNA by the research subjects and the huge personal dedication of the collaborators of the Gabriel consortium, have made this study possible."

Professor Florence Demenais, Director of the Genetic Variation and Human Diseases laboratory in Paris (UMR-946 Inserm-Université Paris Diderot, Fondation Jean Dausset), who led the statistical analysis that combined all of the data, said: "Large scale genetic studies, such as this one, provide a powerful tool to decipher the genetic mechanisms underlying asthma and to unravel different types of disease that make up the asthma syndrome."

Professor Erika von Mutius at the University of Munich and co-coordinator of GABRIEL said: "The puzzle now is to work out what is causing the damage to the airway lining in asthma.

The GABRIEL study has also been busy looking for clues as to the environmental causes of asthma, particularly by dissecting the strong protective effects of living on a farm.

In the next year we will be combining the results from the genetic and environmental wings of the GABRIEL study, and we are greatly looking forward to what we may find."

Source: Imperial College London

Unquote.

The rise in the numbers and severity of asthma cases promises to become a plague in the developed world, yet the authorities seem to be careless as to some of the most likely causes.

Coughing For Life

There is now a good deal of work being done on causes and nature of lung problems around the world. Unluckily, precious little in the UK where research is governed by the funding requirements for “added value” in strictly commercial terms and added shareholder value related to the relevant companies.

This item is one I found interesting in that an implication is that there could be numbers of people from a young age who already very vulnerable to a wide range of possible causes of inflammation.

Quote from esciencenews dot com:

Research and insights on severe asthma in children

Published: Thursday, September 9, 2010 - 10:18 in Health & Medicine

A subset of children with asthma suffers from severe, treatment-resistant disease associated with more illness and greater allergic hypersensitivity, according to the results of the National Heart, Blood, and Lung Institute's Severe Asthma Research Program (SARP), presented in a recently published article in Pediatric Allergy, Immunology, and Pulmonology, a peer-reviewed journal published by Mary Ann Liebert, Inc. (www.liebertpub.com).

The article is available free online at www.liebertpub.com/pai Asthma is the most common chronic lung disease of children, with more than 6.6 million affected in the U.S. Although relatively few children have severe asthma, they account for almost half of asthma related expenditures.

SARP compared severe, therapy-resistant asthma in children and adults and identified age-specific characteristics of the disease. The results suggest that there are distinguishable clinical features of severe asthma that can be identified early in life.

Authors Anne Fitzpatrick, PhD from Emory University (Atlanta, GA) and William Gerald Teague, MD from the University of Virginia (Charlottesville) review the highlights of the SARP findings in an article entitled "Severe Asthma in Children: Insights from the National Heart, Lung, and Blood Institute's Severe Asthma Research Program".

They conclude that children with severe, therapy-resistant asthma are more likely to have poorer lung function and higher levels of allergic sensitization and to be of African American or mixed ancestry.

Their findings suggest that children as young as 6 years with severe asthma may already have structural airway changes.

"Identifying the features associated with severe, treatment-resistant asthma in children will allow us to better understand this illness and develop better treatments for these children who spend so much time struggling to breathe," says Harold Farber, MD, MSPH, Editor of Pediatric Allergy, Immunology, and Pulmonology, and Associate Professor of Pediatrics, Section of Pulmonology, Baylor College of Medicine, Houston, TX.

Source – Mary Liebhart, Genetic Engineering News
http://www.liebertpub.com/

Unquote.

This all adds to the picture of complexity and uncertainty in relation to the developing problems. The more pollution and contamination the more serious and widespread the problems become.

Asthma, Inhalers & Cancer

The story below about Asthma Inhalers and Prostate Cancer was in a number of media outlets and the press. This copy below is from the Daily Mail, which was a little longer than some others.

As you may gather the connection is substantially statistical. The nature of the biochemical aspect is a matter for discussion.

What occurs to me is what the contents of the inhalers are in chemical terms and can there be one particular or several interacting chemicals that produce this effect?

Again the reaction from AsthmaUK is worrying. 25% is a large fluke and needs looking at. Clearly because of the risks of severe asthma the balance may be to keep using the inhaler.

Moreover, those of us with wider interests know too well that issues described as “marginal” in many fields other than medicine can all too easily become catastrophic.

In the case of any chemical issue it is possible that a chemical that causes asthma may well have causal effects on other parts of the body.

Quote

Asthma inhalers 'increase the risk of prostate cancer'

Drugs used by thousands of men in Britain to treat asthma may increase the risk of prostate cancer, according to research.

It shows men who regularly take inhaled steroids to keep their asthma under control are almost 40 per cent more likely than men without asthma to develop a tumour.

Those who regularly use another type of inhaler, a bronchodilator, to relieve wheezing are 36 per cent more at risk of the disease.

But the biggest danger appears to be among men with severe asthma who frequently need treatment with steroid tablets or injections.

Among this group, according to the study, the risk of cancer increases by up to 70 per cent.

Although the same research found even having asthma appears to increase the risk by around 25 per cent, it said the chances of a tumour are significantly higher in men taking medication.

Asthma sufferers using bronchodilators will usually have two types - one which provides instant relief from symptoms and another to use once or twice day to prevent them developing in the first place.

Cancer experts last night stressed findings were preliminary, from a small study, and needed to be confirmed by much bigger studies before any change in asthma drug use could be considered.

Dr Jodie Moffat, of Cancer Research UK, said: 'The results are quite weak and they could be a statistical fluke.

The researchers themselves note that further studies are needed.' And Dr Elaine Vickers, from Asthma UK, urged men with asthma not to stop taking medication on the basis of the results.

She said: 'This research suggests that there could be a weak association between asthma and prostate cancer risk. However, even if this is true, the association is marginal, and there is no reason for men with asthma to be concerned.'

The study was undertaken by a team of scientists in Melbourne, Australia. They decided to look at the link between asthma and prostate cancer because both arise from inflammation in the body.

The researchers studied 1,179 men who had been diagnosed with prostate cancer and analysed how many had a history of asthma.

The results, published in the journal Cancer Epidemiology, Biomarkers and Prevention, showed just having asthma meant a 25 per cent increase in a man's chances of a tumour.

But if he was on medication, the risks were even higher.


The researchers admitted it was 'difficult to disentangle' the effects of asthma drugs from the result of just having the condition itself.

But they said the concerns raised by their findings should be investigated in bigger follow-up studies.

Around 5.2 million people in Britain have asthma. According to Asthma UK, it kills one person every seven hours and leaves 70,000 a year needing hospital treatment.

Nearly 32,000 cases of prostate cancer are diagnosed every year in the UK and 10,000 men die from it

Unquote

Prostate cancer is something that can arise from several causes because of where the gland is in the body and the nature of its function. We would be wise not to be dismissive of any possibility.