it is also important to examine for positive triggers of asthma symptoms, such a dust mites, cockroaches, animal dander, moulds, pollens, exercise, and exposure to tobacco smoke or cold air. Exposure to agents encountered in the work environment can also cause asthma. If work related asthma is suspected, details of work exposure and improvements in asthma symptoms during holidays should be explored. It is also important ti assess for comorbidities that can aggravate asthma symptoms, such as allergic rhinitis, sinusitis, obstructive sleep apnea and gastroesophageal reflux disease.