Types, frequency and impact of asthma triggers on patients' lives: a quantitative study in five European countries

J Asthma. 2014 Mar;51(2):127-35. doi: 10.3109/02770903.2013.846369. Epub 2013 Nov 4.


Objective: To identify the types, frequency and impact of asthma triggers and the relationship to asthma control among adults with asthma in Europe.

Methods: Adults with self-reported physician-diagnosed asthma receiving maintenance asthma treatment and self-reported exposure to known asthma triggers completed an online questionnaire; a subset completed a diary over 3-4 weeks. Information on asthma control (Asthma Control Test™ [ACT]), asthma triggers, frequency of exposure and behaviours in response or to avoid asthma triggers and the perceived impact on daily life was captured. A post-hoc analysis evaluated the impact of high trigger burden on the frequency of severe asthma exacerbations, hospitalisations and days lost at work/study.

Results: A total of 1202 adults participated and 177 completed the diary. Asthma was uncontrolled for the majority (76%) of participants and most (52%) reported exposure to 6-15 asthma triggers. As trigger burden increased, behavioural changes to manage trigger exposure had a significantly increased impact on daily life (p < 0.0001) and job choice (p = 0.002). Participants reporting a high trigger burden (>16) were more likely to report uncontrolled asthma than those with a low trigger burden (1-5). Participants with a high trigger burden had previously experienced on average two more severe asthma attacks during a lifetime (p < 0.001), two more hospitalisations (p < 0.001) and 3.5 more missed days at work or study in the last year due to their asthma (p < 0.001) than those with a low trigger burden.

Conclusions: Adults with asthma reporting a high trigger burden (>16 different triggers) experience more severe asthma attacks than those reporting lower trigger burdens.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Air Pollution / adverse effects
  • Asthma / epidemiology
  • Asthma / etiology*
  • Dust
  • Europe / epidemiology
  • Exercise
  • Female
  • Humans
  • Life Style
  • Male
  • Middle Aged
  • Quality of Life
  • Respiratory Tract Infections / complications
  • Risk Reduction Behavior
  • Self Report
  • Severity of Illness Index
  • Young Adult


  • Dust