It's the season for thunderstorm asthma

  • Lightning over mans face with tissue
Julia Ren-Daumas
National Asthma Council Australia

Spring has sprung and the pollen season is on the way.

The National Asthma Council Australia (NAC) is reminding health professionals around Australia to make sure their patients, whether they have asthma or just get sneezy in spring, are ready. Ideally, patients should have an up-to-date asthma action plan and know asthma first aid so they can better prepare for and manage events that might lead to thunderstorm asthma.

In Australia, one in 10 adults and children have asthma; around four out of five people with asthma also have allergies, such as pollen-related hay fever; and more than 400 people die from asthma each year.   

Most people with asthma can lead a normal and active life. One of the ways to do that is to understand and follow an up-to-date asthma action plan. However, research has shown that 45 per cent of Australians with asthma don’t follow their management plans, and nearly 40 per cent of them only use reliever medications when their symptoms worsen, which at times can lead to dangerous flare-ups and pose a real risk of winding up in hospital.

The 2016 epidemic thunderstorm asthma event in Melbourne was a cruel reminder that there can never be complacency in asthma.

The cause of an epidemic thunderstorm asthma is thought to be the combination of high grass pollen counts, unusual thunderstorm conditions that concentrate pollen grains/allergens, and grass pollen allergy in people. Thunderstorm triggered asthma can occur in people with allergies when they inhale air that contains a high concentration of pollen allergens during a thunderstorm.

Ryegrass, a common pasture crop in rural areas, has been identified as a culprit in all Australian thunderstorm asthma epidemics.

Tips to stay safe during thunderstorm asthma:

  • have an up-to-date asthma action plan and follow it all year round;
  • take preventative inhaled corticosteroid treatment as prescribed. It takes time for preventer medications to kick in, so you should start taking them now;
  • manage seasonal hay fever proactively, including using preventative intranasal corticosteroid treatment;
  • avoid exposure to thunderstorm asthma. Check the NAC’s website for pollen counts from around Australia from 1 October; and
  • have appropriate access to relievers during the grass pollen season.

People with hay fever (with or without known asthma), hypersensitivity to ryegrass pollen and poorly controlled asthma are at a heightened risk of attack during storms in the warmer months.

Further, a study published in The Lancet in June 2018 identified that people of Indian, Sri Lankan or south-east Asian ethnicity made up 39 per cent of hospital admissions related to the unprecedented epidemic thunderstorm asthma event.

The NAC has a range of resources on thunderstorm asthma to help health professionals to identify and manage at-risk patients. Resources include a recorded webinar (hosted by the Australian College of Rural and Remote Medicine), information papers and a pharmacy flowchart. Also offered are best-practice asthma and respiratory management education workshops which include a thunderstorm asthma component. Resources are available from the National Asthma Council Australia.


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