World Asthma Day 2026: Asthma matters in custody and SARC

Today marks World Asthma Day 2026, and this year’s theme from the Global Initiative for Asthma (GINA) is: “Access to anti-inflammatory inhalers for everyone with asthma – still an urgent need.” GINA says the focus is on improving access to inhaled corticosteroid treatment, which is essential for controlling asthma and preventing severe or fatal attacks. 

For nurses, paramedics and midwives working in police custody suites and sexual assault referral centres (SARCs), asthma can quickly become a significant clinical issue. Stress, infection, exertion, missed medication, smoking, vaping, substance use, anxiety, and poor access to regular treatment can all affect asthma control. In forensic settings, where people may be frightened, distressed, intoxicated, withdrawing, exhausted, or away from their usual medication, the need for careful assessment is clear.

Asthma is common, but attacks can be life-threatening

Asthma causes inflammation and narrowing of the airways, leading to symptoms such as wheezing, coughing, shortness of breath, and chest tightness. Symptoms can vary from mild to severe and may worsen at night or early in the morning. The NHS is clear that an asthma attack can be life-threatening. 

That matters in custody and SARC environments because deterioration may initially be mistaken for anxiety, panic or distress. A person who is struggling to breathe may not always look dramatically unwell at first. Early recognition matters.

Red flag signs and symptoms of an asthma attack

Healthcare professionals should think urgently about an asthma attack when there is:

• Severe breathlessness
• Worsening wheeze or chest tightness
• Persistent cough
• Difficulty speaking in full sentences
• Little or no response to a reliever inhaler
• Visible increased work of breathing
• Drowsiness, exhaustion, confusion, or reduced consciousness
• Blue lips or features of hypoxia
• Silent chest, poor air entry, or signs of exhaustion

The NHS notes that an asthma attack means symptoms become severe and breathing becomes difficult. Asthma + Lung UK advises seeking emergency help if someone is getting worse, or if they do not improve after using their reliever inhaler as directed. 

In practice, any person with asthma who appears unable to speak normally, is tiring, hypoxic, confused, or not responding to treatment should be treated as potentially seriously unwell and escalated urgently.

Why the 2026 theme matters clinically

The World Asthma Day message is especially relevant to forensic healthcare. GINA continues to emphasise that people with asthma need access to anti-inflammatory inhalers, especially inhaled corticosteroids (ICS), because these treat the underlying airway inflammation rather than just providing temporary symptom relief. GINA’s guidance states that, for adults and adolescents, ICS-formoterol reliever treatment reduces the risk of severe exacerbations compared with using a SABA reliever alone. NHS Scotland similarly states that SABA-only prescribing is no longer recommended without concomitant ICS. 

This is an important point for clinicians in SARCs and custody. You may not be initiating long-term asthma management during a short episode of care, but you may identify someone who:

• has asthma symptoms but no preventer inhaler
• is relying heavily on a blue reliever inhaler
• has a poor understanding of their treatment
• has had recent worsening symptoms or attacks
• has barriers to accessing GP or primary care support

That creates an opportunity to advise, signpost and refer. A brief clinical intervention may help someone reconnect with routine asthma care and access appropriate anti-inflammatory treatment.

What this means in custody and SARC settings

Forensic healthcare professionals are well placed to:

• Ask whether the person has asthma and what inhalers they use
• Check whether they have their usual medication with them
• clarify whether they use a preventer inhaler as well as a reliever
• Identify recent deterioration, recent steroid use, or recent hospital attendance
• Assess for acute red flags and escalate urgently where needed
• Advise follow-up with GP, urgent care, or respiratory services where asthma appears poorly controlled
• Document clearly, especially where symptoms may affect fitness, vulnerability, or immediate risk

A reminder for all clinicians

World Asthma Day is a timely reminder that asthma should never be dismissed as “just wheeze” or “just inhalers”. Good control saves lives, and poor control can deteriorate quickly. The 2026 theme highlights a very practical message: access to anti-inflammatory inhalers remains a priority because they reduce risk, not just symptoms. 



In police custody suites and SARCs, where people may already be vulnerable, overlooked, or disconnected from routine healthcare, recognising asthma, spotting red flags, and signposting to the right treatment can make a real difference.