Dr, Ajay Kevat, Queensland Health recently published a review of Thunderstorm Asthma - “presenting the epidemiological data underpinning previous thunderstorm asthma events and analyses what is known about the etiology of this unusual phenomenon”.
Interesting reading given although potential risks day’s are widely reported, not so much actual admissions here and across the globe.
Following their 23rd September interim paper, The TGA published their determination on the 21st December.
From 1 October 2021, the law for you to import nicotine e-cigarettes and liquid nicotine will align with the law for you to buy such products domestically. The gap between Commonwealth and state and territory law has been closed so that you will need a doctor’s prescription (script) to legally access nicotine e-cigarettes and nicotine liquids in Australia.
Click Here for the TGA Decision
The decision was also reported by The ABC (Click here).
There is still work to do in terms of formal review of appropriate products for prescription - and discussion regarding use of such products in terms of Smoking Cessation strategies given trials/review to date.
Government and News agencies are reporting a heightened risk of “Thunderstorm Asthma” in Western and Central Victoria.
The Age reports The Mallee, Wimmera and south-west regions of Victoria are predicted to be at high risk of thunderstorm asthma on Wednesday 11th November (Click here)
Melbourne Pollen, run out of the School of BioSciences at the University of Melbourne offers a service that forecasts the level of pollen in the air.
The forecast alerts those who suffer from hay fever and seasonal asthma of the likelihood of being exposed to high levels of grass pollen, enabling sufferers to take preventative measures in danger periods.
Thunderstorm Asthma is a topic on the Centres Asthma Educators Course - the last presentation of this well respected course for 2020, commencing Thursday the 12th November.
13/10/2020
In light of the improved COVID 19 situation in both Victoria and New South Wales, The TSANZ and ANZSRS provide the following updated recommendations regarding the performance of lung function tests across Australia and New Zealand.
• All Pulmonary Function Testing including cardiopulmonary exercise testing and bronchoprovocation testing can now be performed in patients who are afebrile, and who have no symptoms of a viral illness.
• Level one PPE or greater, in line with local guidelines, and physical distancing in public areas is still required.
• It is recommended that Body Temperature is measured on all patients prior to testing to ensure they are afebrile.
• Pulmonary Function Testing is NOT recommended in patients who are febrile, or who have an escalating acute respiratory condition.
• We also recommend that testing only be performed using lung function equipment that utilise inline filters. Level 2 PPE (droplet and contact precautions, including the use of N95 masks) may be considered where inline filters are not available OR where high levels of ventilation (CPET) or coughing (e.g. BPT, airway clearance initiation assessments - Bronchitol, 6%NaCl) are expected.
The TSANZ and ANZSRS suggest that members should check for guidance from their state and federal health departments. The link to the Australian Department of Health is: www.health.gov.au and the link to the Ministry of Health in NZ is https://www.health.govt.nz/our-work/diseases-and-conditions/covid-19-novel-coronavirus.
This approach is consistent with recent recommendations by national and international agencies and are subject to ongoing review.
Prof. Bruce Thompson Mr Jarrod Warner
TSANZ President ANZSRS President
Using e-cigarettes triples the chance of a non-smoker taking up cigarettes and there is "insufficient" evidence that they help smokers quit, according to a new report submitted to the Government and reported in the ANU Portal, Medical Express and mainstream press (AFR) et al.
Research led by The Australian National University (ANU) reviewed the worldwide evidence on e-cigarettes and smoking behaviour, relevant to the Australian context.
The report has been widely reported in the press with perhaps more rigorous discussion given recent TGA Interim decision to allow E-Cigarettes prescription in 2021.
The state's Deputy Chief Health Officer, Professor Allen Cheng, used Thursday's (1/10) daily coronavirus press conference to warn Victorians about the impending threat of an epidemic of thunderstorm asthma.
As reported in THE AGE - "The period from October to December is a time that epidemic thunderstorm asthma can occur and this is a result of high levels of grass pollen, particularly rye grass in the air," Professor Cheng said.
"When that is combined with certain thunderstorm conditions, particularly high winds, that can lead to thunderstorm asthma."
The TGA published on the 23rd September an interim decision under which the Poisons Standard would be amended to re-classify nicotine for human use as a prescription-only medication, rather than a dangerous poison.
The interim decision is open to public consultation and a final decision will be made by the end of the year.
Australians could be able to buy e-cigarettes with nicotine at chemists by mid-next year if they have a prescription from their doctor.
Reported in The Age - Australian Medical Association President Omar Khorshid said nicotine was a "highly addictive poison" and that doctors should be focused on getting people "off cigarettes completely and off nicotine completely", not replacing one form of the drug with another.
"The actual evidence for the effectiveness of e-cigarettes to get off nicotine altogether is not yet proven. It may not work at all," Dr Khorshid said.
Click here for TGA Interim Decision
Simon Chapman (23/6) examines the proposed changes and investigates positions
Megan Haggan reported in the AJP (26/6) anxiety of the change amongst medical professionals.
Emily Mcpherson discusses the published decision on 9News - September 23rd 2020
Dana McCauley reports in THE AGE (24/9) the position of concerned health professionals
For theLimbic members, Michael Woodhead (24/9) reports “E-cigarettes decision “will protect Australia’s lungs” respiratory groups say”
The team at the Lung Health Promotion Centre are pleased to announce the first of their Spring education offerings.
The well respected Asthma Educators Course (Online Webinair) kicks of on the 12th and 13th of November. For those whom have previously attended an appropriate course and are currently practicising - we are pleased to present the Smoking Cessation and Asthma Educators Development days on Thursday 15th and Friday 16th of October respectively.
Stay tuned for additional offerings (online and self directed)
Hopefully we will see soon
A recent study has been published in the MJA regarding potential long term impacts of Asthma prescriptions.
The study, led by University of Queensland Professor John Upham, found that while there is significant benefit in the short term from the treatment, the long-term effects may outweigh any benefit gained.
Reported in the The AGE - "Doctors used to think that if you just have a short course of these tablets for a few days it didn’t really matter and you would only suffer side-effects if you took them day after day for a long period," Professor Upham said.
The latest edition of the Asthma Australia Handbook 2.1 has been released.
First published in 1990, initially as the Asthma Management Plan and then as the Asthma Management Handbook, the Handbook was one of the first Australian guidelines addressing the diagnosis and management of a chronic condition. Throughout its eight editions, the Handbook has set the standard for best-practice asthma management in Australia by being comprehensive and user-friendly, and emphasising a team approach to asthma care.
This edition continues the new name – the Australian Asthma Handbook – and the same commitment to practical advice for primary care health professionals. Current version 2.1 was published in September 2020. Version 2.0 was published in March 2019. Version 1.0 was published in March 2014, with minor updates published as version 1.1 (April 2015), version 1.2 (October 2016), and version 1.3 (December 2017).
A recent study has been published in the MDPI discussion of prescription efficiay of asthma drugs to preschoolers.
The UNSW study assessed patterns of asthma FDC controller medicines dispensed to Australian children and adolescents, aged one to 18 years, between January 2013 and December 2018. A representative 10% sample of PBS dispensing data was used.
However, 88% of the FDC inhalers dispensed to children and adolescents were prescribed as first-line therapy, which is not recommended.
Clare Watson in the Medical Republic quotes “Clearly, there’s work to be done in addressing the inappropriate prescribing that is still occurring in children under five,” said Professor Adam Jaffe, a respiratory paediatrician at UNSW Medicine, member of the National Asthma Council Australia Guidelines Committee and co-author on the study.
A 2 day online presentation course covering the latest advances in asthma management and care for Health Professionals.
Taking an holistic approach, the course is presented by active experts and helps skill participants to be able to work effectively one on one with clients for effective management and health outcomes.
Presented by a panel of practicing health professionals including the team of the Lung Health Promotion Centre at the Alfred.
On the 10th August 2020, the TSANZ in conjunction with the ANZSRS updated recommendations regarding the performance of lung function tests.
Our recommendations from the 8th August 2020 are being changed for those practicing in Victoria or the Greater Sydney Region in response to the increase in COVID-19 in these areas.
Following lobbying from 20+ backbenchers - legislation to prevent unregulated import of Nicotine based vaping products was delayed from proposed July 2020 to 2021
The Guardian’s Paul Karp discusses the lobbying that led to the decision - Click here for more details
