A trigger is anything that causes your COPD symptoms to flare up or get worse. Triggers include:

• Illnesses like colds, the flu, or pneumonia.
• Poor air quality, such as indoor and outdoor air pollution, smoke, or smog.
• Tobacco smoke.
• Cold, dry air; hot, humid air; or high altitudes.
• Cleaning supplies or other chemicals.
• Pollen, mold, and dust mites.
• Pet hair, skin, or saliva.
• Gases, particles, or fumes from wood or kerosene home heaters.
• Not taking or running out of your medicines.

Not all people have the same triggers. What may cause a flare-up in one person may not be a problem for another person.

Flare-ups of COPD can greatly limit your activities. You may even need to stay in the hospital. By avoiding flare-ups, you may feel better, be more active, and reduce the impact of COPD on your life.

So it is important to pay attention to your symptoms. You can tell you're having a flare-up when your usual symptoms suddenly get worse. For example:

• You may wheeze or be more short of breath than usual.
• You may cough more than usual. Your cough may or may not bring up mucus. Or you may notice a change in the color or amount of mucus you cough up.
• You may have a fever, have trouble sleeping, or feel very tired. Or you may feel depressed or confused.

With treatment, many people are able to breathe as well as they did before a flare-up.

There are many things you can do to avoid triggers and stay as healthy as you can.

Avoid triggers in the air

• Quit smoking. This is the most important thing you can do. Also stay away from other people who are smoking.
• Use an air conditioner or air filter in your home.
• Cook near an open door or window, or turn on your kitchen fan.
• If there is a lot of pollution or dust outside, stay at home and keep your windows closed.

Protect your health

• Get a flu shot each fall.
• Talk to your doctor about getting a shot for pneumonia.
• Wash your hands to avoid infections.
• Eat healthy foods, exercise, and get enough rest.
• Refill your medicines before you run out.
• Take extra medicines with you when you travel.

Now that you have read this information, you are ready to start identifying and avoiding triggers for COPD.

Talk with your doctor

If you have questions about this information, print it out and take it with you when you visit your doctor. You may want to use a highlighter to mark areas or make notes in the margins of pages where you have questions.

Be sure to let your doctor know if you notice changes in your symptoms. Talk with your doctor about what might be triggers for you. Ask about ways you can avoid those triggers.

Online Resource

Smokefree.gov
Smokefree.gov
Web Address:	www.smokefree.gov
This Web site was created by the Tobacco Control Research Branch of the National Cancer Institute with important contributions from other national agencies such as the Centers for Disease Control and the American Cancer Society. It offers an online guide to quitting smoking, including online messaging and telephone support from the National Cancer Institute.

Organizations

National Jewish Medical and Research Center
1400 Jackson Street
Denver, CO  80206
Phone:	1-800-222-LUNG (1-800-222-5864) (303) 388-4461 (outside the United States)
E-mail:	lungline@njc.org
Web Address:	http://www.njc.org or http://www.NationalJewish.org
The National Jewish Medical and Research Center is devoted to treatment, research, and education in chronic respiratory diseases. It also publishes a newsletter and pamphlets; maintains the LUNG LINE, a free call-in information service for consumers; and has a patient referral center (inpatient and outpatient services).
American Lung Association
61 Broadway, 6th Floor
New York, NY  10006
Phone:	1-800-LUNG-USA (1-800-586-4872) 1-800-548-8252 (to speak with a lung professional) (212) 315-8700
Web Address:	www.lungusa.org
The American Lung Association, along with its medical branch, the American Thoracic Society, provides programs of education, community service, and advocacy. Some of the topics available include asthma, tobacco control, emphysema, asbestos, carbon monoxide, radon, and ozone.
American Thoracic Society
61 Broadway
New York, NY  10006-2755
Phone:	(212) 315-8600
Fax:	(212) 315-6498
E-mail:	atsinfo@thoracic.org
Web Address:	http://www.thoracic.org/
The American Thoracic Society provides information to professionals and consumers on the prevention and treatment of lung diseases. It provides educational material for the consumer through its Web site.