How Modular IoT Technology Will Help Manage Thunderstorm Asthma

Imagine a situation where thousands of people all of a sudden find themselves unable to breathe. Thousands of people present themselves to hospitals and doctors surgeries struggling with wheezing, coughing and a shortness of breath. Some are turning blue. 1900 people call emergency services for an ambulance over 5 hours, the demand far exceeding supply. Many people end up in hospital and 8 die. It’s not a gas leak or smoke from an industrial fire. Instead, it’s the respiratory condition asthma, triggered by nature.

In Melbourne, Australia on November 21 a thunderstorm hit after a hot day of temperatures reaching 38-degree Celsius (100.4 degrees Fahrenheit). The temperature dropped rapidly, accompanied by rain and strong winds of up to 100 kilometres per hour recorded. Emergency services and hospitals were overwhelmed. Paramedics dealt with an unprecedented 1,900 emergency calls in five hours and Melbourne hospitals treated more than 8,500 patients in two days. It is the world’s worst recorded case of thunderstorm asthma.

Thunderstorm asthma

The cause of the outbreak of asthma is a phenomenon known as thunderstorm asthma. Thunderstorm asthma is characterised by huge amounts of pollen released before or after a major storm, triggering asthma attacks. The main hypotheses explaining association between thunderstorms and asthma claim that thunderstorms can concentrate pollen grains at ground level which may then release allergenic particles of respirable size in the atmosphere after their rupture by osmotic shock. During the first 20–30 min of a thunderstorm, patients suffering from pollen allergies may inhale a high concentration of the allergenic material that is dispersed into the atmosphere, which in turn can induce asthmatic reactions, often severe. Subjects without asthma symptoms, but affected by seasonal rhinitis (hay fever) can also experience an asthma attack. A number of the effected victims in Melbourne experienced asthma symptoms for the very first time.

Thunderstorm asthma has is a rare phenomenon that was first identified and studied after three recorded events in the 1980s; in Birmingham, England, in 1983 and in Melbourne, Australia in 1987 and 1989. Further reports have been recorded in London, Naples, Atlanta and Ahvaz.

According to The Age, Dr Michael Sutherland, a respiratory physician and allergist at the Epworth Hospital, said the event was “by far the worst” in world history, and could prompt doctors to prescribe preventative medication to people with severe hay fever who are not asthmatic during spring.

How technology can help prevent and manage asthma

As well as preventative medicine and an asthma action plan there are a number of ways science and medical technology together can help prevent and mitigate the effects of thunderstorm asthma. Here at nexpaq we believe that modular technology can make an important contribution to equipping people with accurate, real-time information about their environment and health status. Here are some examples:

It is now common to receive a daily pollen count with a weather report each day. The pollen count tells us how many grains of plant pollen were in a certain amount of air (often one cubic meter) during a set period of time (usually 24 hours). To collect a sample of pollen the air, a plastic rod or similar device is covered with a greasy substance. The device spins in the air at a controlled speed for a set amount of time — usually over a 24-hour period. At the end of that time, an analyst studies the surface under a microscope. Pollen that have collected on the surface are identified by size and shape as well as other characteristics. A formula is then used to calculate that day’s particle count.

It’s notable that Australia is one of the few developed countries without a national pollen count program. Academic researchers are in the process of establishing the Australian Pollen Allergen Partnership to measure pollen at their various educational institutions. Whilst an important initiative it seems rather belated compared to other countries.

Pollen counts also have their limitations. As explains:

“Actual pollen counts and our resulting forecasts can be used to represent wide geographic expanses, sometimes up to many miles. It is extremely rare to find multiple pollen counting stations throughout an entire metro area. Pollen counting is a time-consuming and costly commitment. Typically, if there is a pollen counting station in a city, it is used to represent the entire metro area.”

Further, the counts reported are always for a past time period and may not describe what is currently in the air.

Imagine if a pollen tester as available as a module on your mobile phone with a corresponding mobile app to supply real-time readings of your local pollen count? It would be a useful device in any allergy sufferer or asthmatics tool kit. Knowing the real-time count could help you decide when to stay indoors.

A modular peak flow meter

Asthma is generally managed through a medical plan that may involve a peak flow meter to test lung health, a preventative inhaler and a treatment inhaler. Peak flow meters are gradually becoming digital such as the PiKo-1 that can store up to 96 peak flow (lung capacity) readings. Data can be reviewed via a single operating button, eliminating the errors associated with paper diaries. Prices compare to mechanical peak flow meters. PiKoNET software. All tests can be easily downloaded for tracking and trending.

The most successful digital treatment monitor is CareTRx™, a sensor device that clips onto the top of an inhaler to monitor is a small cap equipped with sensors and on-board memory that fits over the canister of most metered-dose inhalers. When a user presses down to deliver a dose, the on-board memory stores that data. Then, when the user is near a mobile device, the cap automatically connects and syncs to the cloud and to the product’s app. Lights around the cap also illuminate when it’s time for a dose.

Of course carrying multiple inhalers and peak flow meters are cumbersome and the loss of an inhaler can put a person’s life at risk. Therefore, a clip on, sensor enabled modular device could be life changing for many asthmatics.

Real time tracking asthma medication



Asthma medication traditionally includes preventative steroid based medication (such a Symbicort) and treatment medication such as Salbutamol. The design of the medication receptacles can play an important part in managing asthma. In the picture above, the Symbicort tells the user how many doses they have left in the device after each use. Significantly, the Salbutamol (used for treatment during asthma attacks) does not. The consequences are that people could believe themselves suitably equipped in the case of asthma but find themselves with an almost empty canister.

If the canisters were equipped with sensor technology a mobile app could not only keep an accurate account of dosages available but also monitor when medication is used and the dose and frequency, enabling users to track their condition over a period of time. This could be shared with family and health professionals and assist in asthma care. The sensor could also alert when it reaches below a certain threshold and automatically order another inhaler from their health professional.

As a health condition, thunderstorm asthma does not possess a single stand alone prevention tool or solution. The increase of asthma can also be attributed due to green house gas, pollution and the use of pesticides in crop management. But we can ensure that citizens are empowered with information and resources to help their successfully monitor and manage their health. Real-time data is an integral tool to achieve this.

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Originally published at

Tech journo and writer, based in Berlin, Germany.

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