Jo Stredder, an Auckland mother of three boys, says she panicked when her eldest, Lucca, suffered his first "wheezing episode" at 21 months and was rushed to hospital. Now six years old, he seems to have grown out of his asthma - for now. "We still have a puffer [inhaler] on hand but, touch wood, he's not had an attack for 18 months," Jo says.
Now her youngest - Jacob (15 months) - poses a new problem. He has been in hospital three times in the past six months with an inflammation of the bronchioles in his lungs, called bronchiolitis. This often affects young children as their small airways can become blocked more easily than those of older kids or adults. Jo is unsure of what's ahead, and the difficulty here is that doctors are hesitant to diagnose asthma before the age of two.
It's a scenario played out in New Zealand more than in any other country besides the UK - we have the second highest prevalence of asthma in the world.
There are approximately 600,000 asthma sufferers in NZ - that's one in four children and one in seven adults, according to nurse manager Ann Wheat at Asthma NZ. This does not take into account any other respiratory illnesses.
The evidence for New Zealand's high rates of respiratory illness points to our housing stock - much of it damp and colder than recommended by the World Health Organisation. Those conditions create mould and airborne spores. Other factors include dust and dust mites, smoke and chemicals from construction materials and household products.
A 2012 report in the NZ Medical Journal found higher hospitalisation rates for Maori and Pacific children and those living in deprived neighbourhoods when it came to respiratory tract infections in children younger than two years old. They listed three causes - exposure to secondhand smoke, no source of heating, and overcrowding (living with four or more children).
To tackle the problem of insulation in a total of 69,000 state properties owned or managed by Housing NZ, $76m was invested in an Energy Efficient Retrofit Programme from 2009-2013 - 48,034 state houses were insulated nationwide.
The government has allocated $348m since 2009 in the Warm Up: Heat Smart scheme, insulating 235,000 homes. Funding runs out this year but a new scheme, Warm Up: Healthy Homes started in 2013 is targeting 46,000 low income households at higher risk of health issues - with a budget of $100m.
The medical costs of asthma are estimated by the Ministry of Health at $1200 per day to treat a child in hospital for asthma, while the economic burden has been conservatively estimated at $800m per year.
How to maintain healthy indoor air
• Ensure your house is warm and properly insulated.
• Use a dehumidifi er to reduce dampness.
• Invest in bedding - Asthma NZ recommends the Eco-Bed mattress protector range from Briscoes or the anti-allergic MiteGuard mattress, pillow and duvet covers range. A good option is a latex mattress, which naturally resists dust mites.
• Avoid sheepskin rugs on beds as they can harbour dust mites.
• Invest in a good vacuum cleaner and vacuum often - carpets as well as mattresses, pillows, curtains and rugs.
• Minimise exposure to house dust mites in bedding, soft toys and carpets by regularly airing the house by opening windows and freezing soft toys for 72 hours every three weeks.
• 'Damp' dust your home with a wet cloth to properly get rid of dust particles.
• Recognise your triggers (whatever sets off your asthma) and minimise your exposure to them; these can include pets, types of food and drink, stress, or even perfumes.
• Don't smoke inside.
• Avoid scented products. Wash clothes with unscented laundry detergent, or fabric softeners. Use unscented or non-aerosol versions of household cleaning products and avoid scented candles or room fresheners.
• Use VOC (volatile organic compounds) free paints and varnishes.
Look for the Sensitive Choice logo
A blue butterfly now marks products and services from companies that support asthma and allergy care. More than 300 products and services are carrying the blue butterfly - from bedding to building products, cleaning agents to carpets, air purifiers and vacuum cleaners to the paint you put on your walls.
For a list of these products and services, and where to find them, as well as more tips and advice, visit sensitivechoice.com/products-services.
On the web
• Kids Health: kidshealth.org/parent
• Asthma NZ: asthma-nz.org.nz
• Asthma Foundation: asthmafoundation.org.nz - includes a list of 15 local asthma societies throughout NZ
• Ministry of Health: health.govt.nz/your-health
• Housing New Zealand: hnzc.co.nz