Asthma, it’s a common illness that’s not always so well managed.

Part of the problem is that people don’t take advantage of all the knowledge on hand, believes paediatrician Richard Fulton.

He and other experts will observe World Asthma Day on the steps of City Hall on Tuesday.

They’re hoping that residents affected by the disease join them between 11.30am and 2.30pm at the Open Airways event.

Asthma education will be on offer and free spacers, microfibre cloths and pillows will be given out, all with the aim of getting people to “celebrate the joy of breathing freely”.

“Bermuda, for the size of the Island we have, has a wealth of knowledge,” Dr Fulton said. “As part of World Asthma Day we’re just encouraging people who suffer from asthma to take advantage of all the good knowledge we have. My hope is to raise awareness of what asthma is and to enable those who have it to live as full a life as possible. For me that’s always the most important thing.

“I recently met a young boy whose mother was not taking him swimming because it was making his asthma flare up. Once his asthma was better controlled he was able to swim as often as he liked. Asthma should not limit what people are able to do.

“Part of the problem is everybody thinks they know a lot about asthma but actually we can all learn — even the world’s experts.

About 9,000 people on the Island are affected by asthma. A total of 2029 sought treatment at the Emergency Department at King Edward VII Memorial Hospital for asthma-related illness last year.

According to Dr Fulton, about half were kids.

It’s a statistic that was raised by Professor Martyn Partridge at a public forum at the Bermuda Underwater Exploration Institute last month.

“He thinks one of the main reasons why asthma is not well treated is because it’s so common that a lot of people become quite nonchalant,” said Dr Fulton.

The irony is that people are still dying as a result of asthma — in the same numbers as they were 30 years ago.

“I think it’s because the public and doctors are perhaps not [as concerned about it as they are other diseases]. There’s the danger of saying, ‘It’s just asthma’.”

Dr Partridge also highlighted that in the future it may be possible to classify asthma, Dr Fulton said.

“Traditionally everybody gets labelled as being an asthmatic whereas if someone has heart disease they want to know what it’s caused by. At the moment they just get told, ‘You have asthma’.”

Academics are now looking at how to classify asthma into different subtypes. People who suffer as a result of exercise or people who produce more mucous may receive different treatments in the future, Dr Fulton added.

“With reference to children it’s probably even more important to classify the type of asthma, although in the early years it’s more difficult to do this,” he said. “Asthma can be really severe but because it’s so common and usually a mild disease, doctors’ traditional understanding of asthma has perhaps been oversimplified. Our current belief is that the truth is more complicated. In the future, patients will want to know what type of asthma they have and we hope that we will be able to tailor their treatment accordingly.”

Asthma is one of several allergy-related diseases, or atopic conditions, that have been on the rise in the last 100 years or so, he said. It’s grouped along with eczema and nasal and food allergies.

Said Dr Fulton: “At the current rate of increase, pretty much everybody will have some kind of allergy in the next 50 years or so. It’s recognised globally that allergies are on the rise and have been for some time.”

The difficulty is in understanding the possible reasons for the increase and the “significance to us as a population”.

“We don’t really know [the cause] but one hypothesis is that prior to the 1930s we all carried many types of parasites that infected the gut. It is thought that these may have been useful in presenting allergens to us in a way to have a controlled response as opposed to presenting them to us in a way that caused an allergy.

“Another theory is that today everything’s too sterile. The trouble is it’s very difficult to prove the theories and at any rate, allergies were on the rise before the parasites were eradicated or we started to wipe down every surface with antibacterial wipes.”

With the guidelines for asthma now fairly universal, preventer treatment is the key.

“In the various international guidelines, asthma is most commonly treated according to a stepwise approach. When you start seeing symptoms worsen, you step up to the next level of treatment. As a patient, you should be aware what level you’re on and when you should be stepping up a level and recognising when it’s controlled, that you can step down.

“My hope is to see asthma that’s properly controlled. Better asthma control would mean that sufferers would be able to take part in all activities and hopefully have less frequent and less severe asthma attacks.”