Lung fibrosis, also called pulmonary fibrosis or interstitial lung disease (ILD), is a progressive, life-limiting disease causing lung tissue thickening and scarring, resulting in decreased lung function over time.

The disease usually develops in adults aged over 60 years and causes breathlessness, fatigue and chronic cough, severely affecting the patient’s quality of life. While lung fibrosis can result from various causes, idiopathic pulmonary fibrosis (IPF), a subtype with no known cause, is the most common form and can be difficult to diagnose and treat.

Lung fibrosis prevalence and progression

In recent years, it’s believed that lung fibrosis prevalence is rising in Ireland, potentially linked to Covid-19 but also possibly due to improved diagnostic methods and an ageing population. Data from the Irish Thoracic Society indicates that up to 5,000 people in Ireland may have lung fibrosis, but the real figure could be higher. It’s impossible to know the exact number as there is no disease registry.  The disease progresses rapidly if left untreated. The average lifespan following diagnosis can be just three to five years, but this varies widely from patient to patient.

Lung fibrosis treatment options

Treatment options for lung fibrosis focus mainly on managing symptoms and slowing disease progression. There are two antifibrotic medications available in Ireland, Pirfenidone and Nintedanib, which can slow disease progression for some people, but they do not cure lung fibrosis. For some people, a lung transplant might be an option.

The average lifespan following diagnosis
can be just three to five years, but this
varies widely from patient to patient.

Research and education initiatives

Research into lung fibrosis is ongoing in Ireland. There are a number of Irish universities and institutions taking part in global research efforts, investigating genetic and environmental factors contributing to the disease and developing new therapies. Research aims to improve early diagnosis and create more effective treatments, offering hope for individuals affected by lung fibrosis.

The Irish Lung Fibrosis Association (ILFA), a national organisation founded in 2002, has offered resources, information and direct support to patients and caregivers for over 20 years. ILFA also advocates on behalf of the lung fibrosis community for more equitable access to healthcare services and promotes research into causes and treatments. Additionally, ILFA helps educate the medical community and raises awareness of the disease.

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The Irish Thoracic Society, Ireland’s national body for health professionals working in respiratory care, is calling attention to the significance of clean air for lung health.

With latest figures showing an estimated 380,000 people living with Chronic Obstructive Pulmonary Disease (COPD), approximately 450,000 people living with doctor-diagnosed asthma¹ and almost 2,700 people being diagnosed with lung cancer each year,² the importance of breathing clean air and maintaining healthy lungs has never been more crucial.

Indeed, people with lung conditions such as COPD and asthma are more in danger from air pollution, which can give rise to worsening symptoms, more hospital visits and a risk of dying. In addition, exposure to air pollution during pregnancy is associated with low birth weight and pre-term birth, while children living in polluted areas are more likely to suffer from coughs, wheezes and asthma more likely to develop low lung function as teenagers.

Need for screening programme

Prof Marcus Kennedy, President of the Irish Thoracic Society and consultant respiratory physician, comments: “Exposure to air pollution is responsible for some 1,400 premature deaths in Ireland each year³ — more than seven times the number of people who died on our roads last year.⁴ Other than prevention through clean air legislation, one of the ways that we can work to reduce this number is to screen for lung disease. This also provides an ideal opportunity to screen for Chronic Obstructive Pulmonary Disease (COPD) in parallel through spirometry.

The European Union has called for lung cancer screening to be introduced in every member country, while the United Kingdom has already introduced it with data until the end of August 2024 showing 5,037 lung cancers detected. Over 75% of the cancers detected by the programme had been diagnosed at stages 1 or 2 (over 60% at stage 1). This compares to fewer than 30% of lung cancers being diagnosed at stage 1 or 2 before the rollout of the lung checks.

Lung cancer screening for ages 55–75

“The Irish Thoracic Society is advocating for a lung cancer screening programme for people aged 55–75 years with a history of smoking a pack a day for 30 years or a current smoker. This screening would involve a low-dose CT scan to catch these diseases early and improve outcomes. While, admittedly, there are some delays for current symptomatic patients in getting through the healthcare system, we can’t let that stop us from doing what’s right for the public in introducing screening measures now,” adds Prof Kennedy.

Dangers of air pollution for lungs

Ms Orla Veale, Chief Executive of the Irish Thoracic Society, adds: “Air pollution can be as dangerous as passive smoking, with those living along a busy road carrying about the same risk as passively smoking 10 cigarettes a day. Because children are generally more active, they are also prone to inhaling more pollution, which has been shown to impair the growth of their lungs.

“For adults, the possible long-term effects include chronic cough, phlegm, wheeze, accelerated loss of lung function and potentially serious respiratory disease. For those with existing lung diseases, air pollution can give rise to asthma attacks or a flare-up of COPD. If you have a persistent cough for three months or longer, shortness of breath and wheezing and recurrent chest infection, you really should see a GP. Unfortunately, there are no safe levels of air pollution.”

Make sure your home is well-ventilated.

Top tips for taking a breath of clean air

1. On the home front: Make sure your home is well-ventilated. Air your house for 5–10 minutes several times a day, especially during and after cooking, taking a shower, vacuuming or cleaning with disinfectants and sprays. Maintain gas appliances and make sure that chimneys are cleaned and well-ventilated, burning only dry and untreated wood. Install alarms for smoke and carbon monoxide. Be aware of allergens and dusts generated from pets, plants, carpets and damp mould. Smoking should never be permitted indoors. Consider purchasing an air purifier to clean the air.
2. On the trot: Make sure to exercise every day, but avoid exercising during rush hour or on busy streets with lots of traffic fumes. Keep a healthy distance from the road or junctions where cars are idling. Seek out green spaces and public parks if you can. For daily air pollution updates, check out www.airquality.ie.
3. On the road: If you’re a car driver, think about purchasing a vehicle that uses the least fuel or is least polluting. Car sharing will also ease the pressure of the school run or work commute. Turn your engine off when stationary, reduce your speed and have your car serviced regularly. If possible, walk, cycle or use public transport instead of driving.
4. On the shop floor: A total of 15–20% of COPD cases are thought to be work-related. Consider if you are inhaling dust, gases or fumes at work. From building sites to garages, factories to farms, think about how your work environment can be made safer for you, and ensure you wear any recommended personal protective equipment. Companies might consider periodic screening of exposed workers to identify any early signs of adverse respiratory effects. Take the Your Lungs at Work test, which assesses the impact of your workplace on your lung health.

Support to quit smoking

If you smoke, the most important step that you can take to breathe clean air is to quit. Containing at least 250 carcinogenic or toxic chemicals, second-hand smoke can also harm people who do not smoke. In addition, vaping impairs respiratory health and is particularly risky at a younger age, as addictive nicotine exposure can lead to long-term tobacco use. Vaping in children also impacts concentration and can negatively impact the developing brain.

To order a quit smoking kit or talk to an HSE stop smoking adviser, see www.quit.ie or Freephone 1800 201 203.

About the Irish Thoracic Society

The Irish Thoracic Society is the national organisation representing respiratory healthcare professionals throughout Ireland. The society is dedicated to championing excellence in the prevention, diagnosis and clinical care of respiratory disease through its work in advocacy, education and research. For more information, visit www.irishthoracicsociety.com

The Irish Thoracic Society is a member of the Irish Lung Health Alliance which works to promote healthy lungs. For more information, visit www.lunghealth.ie

[1] Department of Health: National Healthcare Quality Reporting System Report, 2021/2022 https://www.gov.ie/pdf/?file=https://assets.gov.ie/236763/88ff5f95-b41e-467f-aac9-e6a7a07490fe.pdf
[2] National Cancer Registry of Ireland, Cancer Factsheet, 2018-2020 https://www.ncri.ie/sites/ncri/files/factsheets/Dashboardv3.3_allcancers_update.pdf  
[3] Government of Ireland: Clean Air Strategy for Ireland https://www.gov.ie/pdf/?file=https://assets.gov.ie/255392/efe212df-d9a7-4831-a887-bea2703e2c64.pdf#page=null
[4] Road Safety Authority press release https://www.rsa.ie/news-events/news/details/2024/01/01/road-deaths-in-2023-increase-by-19#:~:text=24%20.,in%20149%20collisions%20in%202022

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Dr Leanne Hays

Respiratory and PPI Programme Manager, Irish Critical Care-Clinical Trials Network

Research networks advance innovation for ICU lung failure patients requiring mechanical ventilation by enhancing biological insights, conducting adaptive trials and involving patients and the public.

Often, ICU patients need breathing support, known as mechanical ventilation. Research on treatments for acute respiratory distress syndrome (ARDS) is often complicated due to its diverse causes, broad definition and varying patient responses.

Few advances in ICU care for lung failure

Professor Alistair Nichol, Director of Irish Critical Care-Clinical Trials Network (ICC-CTN), explains: “There have been few, if any, new therapies brought to the ICU to improve outcomes for patients needing respiratory support, particularly those with ARDS,” he says. “We are looking into optimal ways to manage mechanical ventilation and identify drug therapies for ARDS patients.”

Adaptive trial design for precision medicine

The ICC-CTN coordinates all-Ireland research and collaborates internationally to enhance ICU respiratory care. “We are seeking to overcome the limitations in methods of existing research by using adaptive platform trials, allowing us to ask multiple questions for the same disease at the same time with quicker answers within one established trial infrastructure,” says Prof Nichol.

We are seeking to overcome the limitations
in methods of existing research by
using adaptive platform trials.

“Trials require collaboration to answer questions globally and efficiently, which was highlighted at our recent meeting with organisations InFACT, ISARIC and attendees from platform trials and all continents,” he adds. Different patient groups exhibit varying responses to the disease and its treatments, highlighting the potential for precision medicine, led by Professor Danny McAuley in Northern Ireland.

Patient and public involvement (PPI)

Dr Leanne Hays, Respiratory and PPI Programme Manager, highlights how active partnerships between researchers, patients and the public, are essential for meaningful progress. “We have established a programme of PPI, which is an extremely important part of how we inform our research,” she says.

Julianne Ahern, a member, shares her and husband Paul Deane’s experience with the PPI. “Over six years ago, I found myself in ICU by my husband’s bed; he was in a coma with an uncertain outcome,” she explains. “PPI gives patients and families a voice and an opportunity to ask questions, voice concerns and, importantly, shed light and provide valuable input into trials. It’s always patient-first with the PPI team: Kathy, Leanne and Alistair.”

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Cystic fibrosis (CF) is a progressive, genetic disease caused by mutations in cystic fibrosis transmembrane regulator (CFTR). Defective CFTR causes a salt/water imbalance, leading to a buildup of mucus in the lungs.

As part of a clinical/translational research programme at the Royal College of Surgeons in Ireland and the Children’s Health Ireland, Dr Judith Coppinger and her research team have been investigating new mechanisms of inflammatory cell communication in respiratory diseases such as CF and chronic obstructive pulmonary disorder (COPD).

Lung inflammation and neutrophil damage

Although very different causes, CF is a rare genetic disease, and COPD is caused primarily by smoking. Respiratory symptoms, such as mucus buildup and coughing, are common in both diseases. Both are characterised by inflammation in the lung airways and a high number of white blood cell cells called neutrophils, which help fight bacteria. Neutrophils are key to a healthy immune response. However, they behave abnormally in diseases such as CF and COPD, causing damage to the lungs.

Understanding how EVs recruit neutrophils
now helps us therapeutically target
them and reduce inflammation.

Targeting neutrophils with EVs

Our research group focuses on discovering new ways to target neutrophils and reduce lung inflammation using small particles called extracellular vesicles (EVs). These are small sacks of protein and RNA released by every cell containing information about that cell. When EVs come from diseased cells, we can gain important insights into that disease.

Our group has shown EVs are higher in number in lung samples from persons with CF and COPD undergoing exacerbation (worsening) of symptoms. We have also shown that EVs can attract neutrophils in the lungs. Understanding how EVs recruit neutrophils now helps us therapeutically target them and reduce inflammation.

Future therapeutic solutions

New CF therapies like Kaftrio have been crucial in targeting the CFTR defect in CF, but they do not fully reduce inflammation or reverse existing lung damage. Our research shows that Kaftrio can alter vesicles, suggesting that EVs could serve as markers of therapeutic response for patients on these treatments. With help from the Science Foundation of Ireland and CF Foundation, we investigate these EVs both as biomarkers of treatment and therapeutic targets to reduce neutrophil inflammation in CF and COPD.

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Asthma is a common condition in Ireland, affecting nearly half a million people, which makes the country one of the hotspots for asthma globally.

Asthma is responsible for over 80 deaths per year and although it is a relatively rare event, one of the major factors is poorly controlled asthma and overuse of reliever ‘blue’ inhalers. Managing asthma well is crucial to avoid flare-ups and trips to the hospital and to help people live life without constant interruptions from their symptoms.

Overuse of SABAs to manage asthma

Recently, there’s been a big change in how experts recommend treating asthma; it’s something everyone should know about — especially if you or someone you know uses an inhaler. A lot of people rely on short-acting beta-agonists (SABAs), like the blue reliever inhalers, for quick relief when symptoms flare up. While these inhalers work fast, overusing them can actually make asthma worse over time and increase the risk of serious attacks.

In Ireland, there’s a real issue with people using way more SABAs than they should. If you’re going through more than three inhalers a year, it’s a sign that your asthma might not be well-controlled. This is where new advice comes in: instead of reaching for that blue inhaler, focus on using preventer inhalers — those containing low-dose steroids (called ICS). These work to calm the inflammation in your airways, which is the root cause of asthma.

While these inhalers work
fast, overusing them can
actually make asthma worse.

Management of milder asthma

For people with milder asthma, the experts recommend using a combination inhaler with both steroids and a fast-relief medication when needed. This approach not only helps with symptoms right away but also keeps the condition in check long-term, reducing the chances of a serious asthma attack.

In Ireland, healthcare professionals are encouraging patients to rethink how they manage their asthma. This means talking to your doctor about how often you use your inhaler, learning the risks of overusing relievers and sticking to a routine with your preventer medication. It is also worth looking at the Asthma Society of Ireland website for resource videos on how to use your inhalers correctly. The vast majority of patients have incorrect inhaler techniques, and hence are not getting the benefit of the drug.

Speak with a doctor for best asthma approach

By making these changes, people with asthma can avoid scary hospital trips, take better control of their symptoms and feel more confident about their health. So, if you’re reaching for that blue inhaler a little too often, it might be time for a chat with your doctor.

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For people affected by lung cancer, early detection is key to improving treatment options for patients and ensuring better survival outcomes.

Typically diagnosed at an advanced stage, lung cancer is the leading cause of cancer-related deaths in Ireland and worldwide, killing more people every year than breast, prostate and colorectal cancer combined.

Lung cancer research investment

In recognition of the importance of catching lung cancer early, the Irish Cancer Society is providing a groundbreaking €4.9 million in funding to the Beaumont RCSI Cancer Centre for a pioneering lung cancer research programme, marking the largest single investment in lung cancer in Ireland’s history.

This six-year programme will advance cutting-edge cancer care, focusing on early detection, advanced diagnostics and innovative treatments across four key lung research projects.

This six-year programme will advance
cutting-edge cancer care, focusing on
early detection, advanced diagnostics
and innovative treatments.

Four key lung research project areas

1. Lung Health Check: Beaumont Hospital and RCSI will run Ireland’s first-ever mobile Lung Health Check pilot, with funding from the Irish Cancer Society and support by the EU4Health SOLACE consortium. This clinical trial will target select high-risk individuals, particularly current or former smokers in North Dublin and the North-East region, inviting them for a check for early detection of conditions (including lung cancer) before symptoms appear.
2. Improving primary care pathways for lung cancer: The team will work closely with GPs to improve lung cancer detection, diagnostics and survivorship pathways.
3. Rapid blood tests to determine best treatment options: A blood sample will be tested to identify whether patients with newly diagnosed lung cancer may benefit from more tailored treatments. This approach could speed up access to life-saving care.
4. Immunotherapy for the treatment of lung cancer: New research will test immunotherapies (treatments that harness the power of our immune system) to treat patients with a specific, hard-to-treat form of lung cancer, which is common in Ireland.

Advancing lung cancer care

This partnership between the Irish Cancer Society and the Beaumont RCSI Cancer Centre brings together cancer specialists, primary care leaders and patient advocates. They are united by a shared goal of advancing world-class cancer care, as well as improving cancer outcomes and the quality of life of people affected by lung cancer.

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Stigma surrounds lung cancer due to its association with smoking, leading many smokers to blame themselves for their diagnosis. However, former smokers, occasional smokers and even non-smokers can also develop lung cancer.

Lung cancer still claims more lives in Ireland each year among both men and women than any other cancer. In Ireland, more than 2,500 people receive a devastating lung cancer diagnosis each year. Overall, 24% of those diagnosed with the disease will survive more than five years. Most lung cancer patients are diagnosed at stage 3 or stage 4, meaning that treatment options are limited, and survival rates are lower.

Lung cancer risks

Tobacco use is the leading cause of lung cancer, responsible for approximately 85% of all cases. People who used to smoke, smoked occasionally or never smoked can also get lung cancer. Approximately 10–15% of lung cancers in Western countries occur in non-smokers. Some of the other risk factors and causes of lung cancer include exposure to passive smoking, exposure to chemicals and radon gas, family history and genetics.

Stigma also intensifies
the already challenging
experience of living with cancer.

Awareness, access and stigma barriers

There are several barriers to diagnosis. Common barriers include limited awareness of lung cancer’s signs and symptoms, restricted access to healthcare and the persistence of stigma. Stigma exists around lung cancer and its link with cigarette smoking. People who have smoked often blame themselves for their diagnosis and fear others will judge them. Stigma has a serious effect on people with lung cancer.

People who smoke may avoid seeking healthcare precisely when it could be most beneficial. Stigma also intensifies the already challenging experience of living with cancer. No one deserves lung cancer, and everyone with lung cancer deserves compassionate and equitable care.

Support for quitting smoking

We need to work together as a nation to help reduce the stigma around lung cancer and provide more supportive information about how an individual can quit smoking without feeling ashamed or blamed for their habits. Smoking is addictive, and some people who smoke may need professional support to quit.

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Richard Costello

Professor of Respiratory Medicine at the RCSI, and Consultant Respiratory Physician at Beaumont Hospital

Killian Hurley

Associate Professor at RCSI, and Consultant Respiratory Physician at Beaumont Hospital

Gerry McElvaney

Professor of Medicine, and Head of the Department of Medicine and Respiratory Research Division at Beaumont Hospital

Gerard Curley

Professor of Anaesthesia and Critical Care at the RCSI, and Consultant in Anaesthesia and Intensive Care at Beaumont Hospital

The collaborative efforts of experts in anaesthesia, critical care and respiratory medicine are leading groundbreaking discoveries, driving innovation and improving patient outcomes.

Seeking commercialisation to bring technological advances into clinical practice, Professor of Respiratory Medicine Richard Costello discusses his innovative approach to the management of asthma, which affects around 1 in 13 people in Ireland alone. “There is no simple test for asthma, and we typically still use traditional testing methods — but our understanding is more advanced now,” he says.

“We are using the strengths of new digital technologies for home monitoring, which enables us to see the lived experience of the patient, including their response to treatment,” he adds. “Through the use of digital technology, we reduce the cost of prescribing by 60%, but we need more funding to bring this technology into practice.”

Award-winning respiratory health discoveries

Professor of Medicine Gerry McElvaney’s work has been instrumental in advancing the understanding and treatment of respiratory diseases, such as cystic fibrosis and alpha-1 antitrypsin (AAT) deficiency. His team’s work on genetic therapies, particularly altering the faulty genes responsible for severe forms of AAT deficiency, has been not only groundbreaking but award-winning.

“As a direct result of our discoveries, we have spearheaded the national targeted detection programme for alpha-1 antitrypsin deficiency, providing free diagnostics for individuals with chronic obstructive pulmonary disease (COPD), asthma or unexplained liver disease,” cites McElvaney. “The potential to cure diseases rather than merely alleviate symptoms is within reach, but we need more support for sophisticated clinical trials. We need the government to look at areas of excellence and support them if we are to integrate key developments into our health system.”

Key innovations in critical care

Making considerable progress in key areas of critical care medicine, Professor of Anaesthesia and Critical Care Gerard Curley is focusing efforts on acute respiratory distress syndrome (ARDS), a condition affecting approximately 10% of all patients admitted to the ICU. “This condition has a high mortality burden, and survivors tend to have neurocognitive and physical disabilities,” explains Curley. “Unfortunately, there is no magic bullet for the condition, and current treatment remains supportive.”

You can’t take new technology and
discoveries into clinics without
first asking: does this work?

He adds: “Our primary focus is on the development of therapies, particularly through the use of translational medicine or ‘bench to bedside’ approaches, which use a detailed study of patients to identify characteristics that might better predict responses to specific therapies. These precision medicine strategies will help to improve patient outcomes. We’re exploring alpha-1 antitrypsin as a potential treatment in specific cohorts of patients with ARDS, leveraging ex vivo lung perfusion models to test and refine therapies.”

Focusing on pulmonary fibrosis

Focusing on the genetic and molecular complexities of pulmonary fibrosis, Consultant Respiratory Physician Killian Hurley discusses his work, exploring why some families are genetically predisposed to the condition in an attempt to shape potential treatment approaches. “These patients have an extremely poor prognosis, and new treatments typically work to slow disease progression rather than cure the disease,” says Hurley.

“Working closely with patients and patient advocacy groups, our primary goal is to find new, less toxic treatments, which could significantly improve patient outcomes” he adds. “For patients with pulmonary fibrosis, a comprehensive national care programme is essential if they are to access the support they need. This type of national approach could coordinate efforts in research and treatment development and facilitate the advancement of potential new therapies.”

Maintaining high standards of respiratory research

None of this would be possible without the RCSI Clinical Research Centre, which provides the facilities and expertise needed for investigators to conduct clinical research to the highest standard. “You can’t take new technology and discoveries into clinics without first asking: does this work? The clinical research centre is helping us to generate the proof,” insists Costello.

“The experienced nurses, administrators and trial experts add immeasurable value.” As McElvaney aptly describes in one of his many expert TED talks: ’Lung disease has Ireland fighting for breath,’ but with the help of the RCSI Clinical Research Centre, there is real hope.

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Respiratory diseases are conditions that affect the airways and other structures of the lungs. The leading cause of respiratory disease is smoking and exposure to secondhand smoke.

Respiratory diseases may include lung or upper respiratory cancers, chronic obstructive pulmonary disease (COPD), emphysema (air sacks in lungs are damaged), asthma, pneumonia, flu and many more.

Smoking causes severe respiratory harm

Each day, one in five people admitted with respiratory disease are in hospital because of smoking-related harm. People who smoke are almost twice as likely to have a long-standing illness compared to those who don’t.

Lung cancer is one of the most common cancers in Ireland. Smoking is the single biggest risk factor for lung cancer, known to cause 90% of lung cancers. Smoking can cause asthma attacks or flare-ups to happen more often, which can also be more severe and harder to control, even with medicine. There is a direct relationship between smoking and the development of COPD and its progression and treatment.

Secondhand smoke harms lungs

Secondhand smoke is also a risk factor for lung cancer and other respiratory diseases. It can exacerbate asthma and COPD and cause impaired lung function and lower respiratory illnesses in children.

Other respiratory conditions that are impacted by smoking are coughing, wheezing, phlegm and dyspnoea (a condition that causes the sensation of running out of air and not being able to breathe fast or deep enough).

Fortunately, even with an established respiratory disease, quitting at any point improves your overall breathing and health. In fact, the benefit to your health and improvement in symptoms from stopping smoking can often be greater than from medications.   

Smoking is the single biggest
risk factor for lung cancer.

Some benefits of quitting smoking

Ex-smokers report better physical and mental health than current smokers, at all ages. Here are some examples of the benefits of quitting smoking directly related to respiratory health:

• Within 72 hours, breathing gets easier and lung capacity increases.
• Within 3 weeks, mucous in the lungs loosens and lung function improves.
• Within 10–15 years of quitting, the risk of lung cancer falls to half that of a non-smoker.

Quit smoking with personalised support

The HSE has a wide variety of free support available for anyone who wants to quit smoking through the QUIT service. The QUIT service provides personalised, evidence-based plans, tailored to your needs, using any combination of the support options. You can access free Nicotine Replacement Therapy (NRT) through the service.

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This time of the year can be challenging for those with asthma. Here’s how you can manage your condition over the winter months.

Ireland has one of the highest rates of asthma in the world — approximately 450,000 people in the country currently have asthma, and almost 890,000 people will experience the condition at some stage of their life.

Effects of winter on asthma

Winter can be particularly challenging for people living with asthma, with cold weather triggering symptoms and an increased prevalence of other conditions such as flu, RSV and COVID-19, which can exacerbate the condition. This is why it is essential to monitor your (or your child’s) asthma and be aware of any changes, particularly over the winter months.

What to watch out for

If you have increased symptoms of cough, wheezing, shortness of breath, exercise intolerance or waking at night, this means your asthma is getting worse and you should see your doctor. If you are using your reliever inhaler more than twice a week, this means your asthma is poorly controlled and you need a review. If your symptoms worsen and do not respond to your reliever inhaler, this could be an asthma attack — follow the ‘5 Step Rule’ (a checklist for an asthma attack, available on asthma.ie) and seek medical help.

The Asthma Society is there for you, whether
you’re worried about your asthma or you
need help supporting someone with asthma.

Top asthma tips

1. Take your medications as prescribed, even when you are well 
2. Have an updated written Asthma Action Plan (available on asthma.ie)
3. Get your vaccinations as recommended by your GP
4. Get an asthma review and have your inhaler/spacer technique checked 
5. Eat a balanced diet
6. Exercise regularly
7. Don’t smoke
8. Wrap up well when out in the cold weather
9. Know the ‘5-Step Rule’

The Asthma Society is there for you, whether you’re worried about your asthma or you need help supporting someone with asthma. We have a team of expert nurses ready to provide free advice and support if you have any questions or worries over the Christmas period.

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