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©2013 UpToDate ® Print Email Assessment questions* for environmental and other factors that can make asthma worse Inhalant allergens Does the patient have symptoms year round? (If yes, ask the following questions. If no, see next set of questions) . Does the patient keep pets indoors? What type? Does the patient have moisture or dampness in any room of his or her home (eg, basement)? (Suggests house-dust mites, molds). Does the patient have mold visible in any part of his or her home? (Suggests molds). Has the patient seen cockroaches or rodents in his or her home in the past month? (Suggests significant exposure). Assume exposure to house dust mites unless patient lives in a semiarid region. However, if a patient living in a semiarid region uses a swamp cooler, exposure to house dust mites must still be assumed. Do symptoms get worse at certain times of the year? (If yes, ask when symptoms occur). Early spring? (Trees) Late spring? (Grasses) Late summer to autumn? (Weeds) Summer and fall? (Alternaria, Cladosporium, mites) Cold months in temperate climates? (Animal dander) Tobacco smoke Does the patient smoke? Does anyone smoke at home or work? Does anyone smoke at the child's daycare? Indoor/outdoor pollutants and irritants Is a wood-burning stove or fireplace used in the patient's home? Are there unvented stoves or heaters in the patient's home? Does the patient have contact with other smells or fumes from perfumes, cleaning agents, or sprays? Have there been recent renovations or painting in the home? Workplace exposures Does the patient cough or wheeze during the week, but not on weekends when away from work? Do the patient's eyes and nasal passages get irritated soon after arriving at work? Do coworkers have similar symptoms? What substances are used in the patient's worksite? (Assess for sensitizers). Rhinitis Does the patient have constant or seasonal nasal congestion, runny nose, and/or postnasal drip? Gastroesophageal reflux disease (GERD) Does the patient have heartburn? Does food sometimes come up into the patient's throat? Has the patient had coughing, wheezing, or shortness of breath at night in the past four weeks? Does the infant vomit, followed by cough, or have wheezy cough at night? Are symptoms worse after feeding? Sulfite sensitivity Does the patient have wheezing, coughing, or shortness of breath after eating shrimp, dried fruit, or processed potatoes or after drinking beer or wine? Medication sensitivities and contraindications

Has the patient had coughing, wheezing, or shortness of breath at night in the past four weeks? Does the infant vomit, followed by cough, or have wheezy cough at night? Are symptoms worse after feeding? Sulfite sensitivity Does the patient have wheezing, coughing, or shortness of breath after eating shrimp, dried fruit, or processed potatoes or after drinking beer or wine? Medication sensitivities and contraindications What medications does the patient use now (prescription and nonprescription)? Does the patient use eyedrops? What type? Does the patient use any medications that contain beta-blockers? Does the patient ever take aspirin or other nonsteroidal antiinflammatory drugs? Has the patient ever had symptoms of asthma after taking any of these medications? * These questions are examples and do not represent a standardized assessment or diagnostic instrument. The validity and reliability of these questions have not been assessed. Reproduced from: National Heart, Blood, and Lung Institute Expert Panel Report 3 (EPR 3): Guidelines for the Diagnosis and Management of Asthma. NIH Publication no. 08-4051, 2007.