Triggers: Hiding in plain sight

Right inside your home

10/26/2017, 8:59 a.m.
Triggers are substances that increase the risk of asthma flare-ups. They differ from person to person and in intensity.
A trigger. Wikipedia

The Breathe Easy at Home program, a partnership between the City of Boston Inspectional Services Department and the Boston Public Health Commission, helps those with asthma discover and eradicate the triggers of asthma attacks in the home. More than 90 percent of one’s time is spent indoors, according to the Environmental Protection Agency. That means that a person with asthma is confronted with triggers basically all of the time.

Indira C. Alvarez, Chief of Staff, Boston Inspectional Services Department

Courtesy of Boston Inspectional Services Department

Indira C. Alvarez, Chief of Staff, Boston Inspectional Services Department

Make it at home

Asthma-friendly all-purpose “green” cleaner

1 2⁄3 cup baking soda

½ cup liquid Castile or Murphy’s soap

½ cup water

2 tablespoons vinegar

Source: Boston Public Health Commission

A trigger is a substance or condition that causes flare-ups in people with asthma. They differ from person to person and in intensity. According to Indira Alvarez, the chief of staff of the BIS, the department looks for four triggers in particular: mold, signs of moisture, roaches and mice. This choice is understandable. Researchers determined that cockroaches caused flare-ups in up to 60 percent of people with allergic asthma. In another study, scientists from the National Institute of Environmental Health Science found that 82 percent of homes in the United States — whether urban, suburban and rural — had mouse allergens.

Mold and moisture

Massachusetts law mandates that in new construction and updates, bathrooms be equipped with mechanical exhaust fans that prevent the buildup of steam, a precursor to mold. The exhaust fans should vent outdoors. “If there is no proper ventilation, open the window,” advised Alvarez.

Inspectors check under sinks, all ceilings, walls and areas where moisture can accumulate, including bathrooms and bedrooms adjacent to bathrooms. Kitchens are another source of moisture if the hood of the stove is not ventilated. Humidity, especially when higher than 50 percent, is the perfect environment for mold to accumulate. Mold is a fungus that can grow rapidly. Its spores travel through the air and are small enough to penetrate the airways.


Cockroaches are hardy insects. They preceded the dinosaurs, so they’re not going away anytime soon. Unfortunately, their saliva, shell and droppings can trigger an asthma attack. They can get into a home through vents or crevices, warned Alvarez, and have a penchant for stoves and under the sink. More often, however, you unwittingly invite them in through shopping bags and boxes.


As winter approaches, mice and rats head inside. “They’re trying to find a warm place,” said Alvarez. They’re also very determined. “They can bite through concrete,” she explained. They look for any tiny entrance through which to squeeze. The droppings and dander of rodents can trigger asthma and allergies, and are stronger predictors of asthma symptoms in young children than exposure to roaches, according to a recent study.

Integrated Pest Management

To eradicate mold, roaches and mice Alvarez advises Integrated Pest Management, which, according to the Environmental Protection Agency, is an effective and environmentally sensitive approach to pest management. IPM programs develop ways to manage pest control with the least possible hazard to people, property and the environment. For instance, traps are used instead of sprays and poisons.