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What are my exacerbation triggers? Actichlor Bleach???

I started work in the operating theatres of an NHS hospital just over a year ago. I take Seritide 250 2 times a day 2 puffs, Salbutamol PRN and Montelukast at night. I have noticed in July last year I was starting to take my Salbutamol more often. Since then had a few exacerbations and prescribed Prednisolone 40mg/day for 7days & antibiotics. Each time pulled round after steroid treatment. But was really puzzled as to why it kept happening. Went to the doctors on Thursday when I felt another episode coming on and got the usual steroids of the nurse practitioner (who to be fair is awesome and knows my history very well) anyhoo Wednesday came and by tea time I could hardly breathe so took emergency dose of steroids (as per my action plan) and 10 lots of Salbutamol with no effect. Just got out of hospital today (Sunday) after a trip to A&E and subsequent admission. Nebulisers, Magnesium & Steroids have slowly back to 75%ish peak flow.

In my time in hospital I have been trying to determine a trigger for these exacerbations. I do honestly think it is Actichlor we use at work. Some people ignore instructions and put 10 tabs in half a bucket of HOT water sometimes you can see the vapour coming from the bucket.

Also now I am thinking down the cleaning product type route bleach also makes me wheezy. But Actichlor seems to be nasty stuff.

As I say I only came out of hospital today and going to put all my thoughts to the asthma team that are coming out to see me this week as a follow up.

Just thought you may be interested or if you had any thoughts/suggestions (stay away from Actichlor) or similar stories.

Cheers James

BTW - Used Actichlor whilst on night shift Tuesday...Hospital Wednesday???

5 Replies


Sorry its been a rough few days for you, I too am trying to work out the triggers, but so far I have only identified fluctuations in temperature and oven cleaner. So if anyone has any suggestions as to how to get my oven clean again without resorting to that, I would be grateful, and would be even more grateful if you came and cleaned it for me... lol

We all seem to be having a bad start to the year this year, I do hope it gets better. xx


James- have you searched the forum, as cleaners used in hospital have certainly come up a few times before. Not sure which particular ones though. I guess this is one of the reasons why asthma can be worse in nurses.

It might be worth speaking to occupational health about, or filling in an incident form because if the nasty chemicals were responsible your hospital admission then the incident should be reported to the HSE under the RIDDOR regulations. Also if it has to be reported people might take it more seriously.

I would try and make sure that people at least make the Actichlor up properly and if possible not near to you.

Hope you continue to feel better.

There are quite a few nurses on the forums who will hopefully come along with something more helpful!

Cubi- Oven cleaner is awful stuff! I just clean the oven my leaving a dish of boiling water in there (with the oven on low) to loosen the stuff and then wipe! Or I get the boyfriend to do it, shall I send him round?



james im still learning my triggers and bleach and kitchen cleaners set my asthma off. I have found lots of things that set me off. But thinking back i was reacting to somethings before i knew i had my asthma back again.

I am keeping a list of my triggers so i have them for when i see the asthma nurse and also for my reference as i can add to it if needs be.

If you talk to your workplace manager then they should help you out.

Hope you are better soon




Thanks for your replies and messages everyone, good to know there are others out there.

Been to see my asthma nurse today and she has referred me to a respiratory consultant as an urgent case, which is good news.

Also spoke to my theatre matron today and said I suspected Actichlor was a possible trigger. She is a great manager and said they would do anything to ensue I didn’t get exposed, which I believe they will. I will get stick for not cleaning but in a good banter type way and my colleagues will send me away if Actichlor is going to be used, they are a good bunch.

As for now I will see the consultant and take it from there I suppose. I am feeling positive that I will get sorted. I know there are a lot of people with worse Asthma it just annoys me that I am very active cycle/hiking and play hockey and felt awesome since Christmas and then WHAMMM, have an exacerbation for your birthday. Would love a year of control.

Thanks for listening and I will keep you posted, once again thanks for your messages


PS Check this out I’m doing it in June hope to be fit enough again



hi jimbo,

i used to work on general paeds/hdu area of DGH trust. they used actichlor obviously and always triggered me, so felt really guilty bout it, but i could never do any cleaning that involved actichlor :)

i did get banter but just ignored it. got hell of a lot more aggro bout the sick time instead, but thats another long story!!

work in paeds itu in another trust, they use some other stuff, and are aware of the actichlor situation. other things gotta watch with are sanicloth, am okay when wiping ends of cannulas for iv access etc... weird ??



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