title: Asthma triggers on the Cheyenne River Indian Reservation in western South Dakota: the Breathing Relief Education and Tribal Health Empowerment (BREATHE) Study.
abstract: BACKGROUND
  The purpose of this article is to better understand asthma triggers and possible causes of exacerbations among BREATHE participants on the Cheyenne River Indian Reservation in western South Dakota.
  
  
  METHODS
  To qualify for enrollment, participants had to have physician-diagnosed asthma, be uncontrolled and have persistent symptoms. Participants were asked to identify their top two asthma triggers throughout their one-year enrollment during initial visits and subsequent phone follow-ups. In addition, participant's medical records were reviewed for visits to the emergency department (ED) to demonstrate asthma exacerbations.
  
  
  RESULTS
  In 2008, 127 interviews were conducted with 45 enrolled participants for a total of 254 results. Overall, the three most common self reported triggers were cold air, dust and smoke and these comprised nearly half (48.4 percent) of all reports. Dust was reported in 16.5 percent of interviews and ranked among the top four for every season. Smoke (12.6 percent) and cold air (19.3 percent) were leaders in all seasons except summer, but humid air, pollens and strong odors were unique to summer. Exercise/activity ranked high during the winter and spring, but was reported less in summer and fall. There was no identifiable trend in ER visits by season.
  
  
  CONCLUSIONS
  People with asthma living on the Cheyenne River Indian Reservation or other locations with similar community and geographic demographics are most likely to suffer an asthma exacerbation from exposure to cold air, dust, smoke and exercise/activity. Asthma education is necessary on all levels, but information on avoidance and control of these most common reported triggers is especially important.
authors.affiliation: Missouri Breaks Industries Research, Inc., Cheyenne River Sioux Tribe, USA.
authors.forename: Rae
authors.initials: R
authors.lastname: O'Leary
authors.forename: James
authors.initials: J
authors.lastname: Wallace
mesh_terms: D000293:Adolescent; D000328:Adult; D001249:Asthma / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control*; D002648:Child; D004391:Dust; D005260:Female; D006801:Humans; D006813:Humidity; D007198:Indians, North American; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D009812:Odorants; D011058:Pollen; D015995:Prevalence; D012307:Risk Factors; D012621:Seasons; D012906:Smoke; D013023:South Dakota / Q000453:epidemiology; D014887:Weather
chemical_list: D004391:Dust; D012906:Smoke