For some, it's like being a fish out of water, or having an elephant sit on your chest. For others, it's feeling like a boa constrictor is wrapped around your chest, making breathing impossible.

For the 9 percent of Utahns who have asthma, it's a disease that requires attention, maintenance and constant vigilance. But for the parents, teachers and coaches of young athletes with the disease, understanding how to deal with it just became a little easier.

Utah is below the national average for asthma prevalence, said Libbey Chuy, a health program specialist for the state Department of Health's asthma program. The numbers have gone up though, almost doubling since 2002, when about 5 percent of Utah residents suffered from the disease, she said.

"That's a combination of things," Chuy said, including better testing, which leads to higher numbers but better treatment.

Many young people are affected, which is the gist of the health department's newest asthma initiative, launched Wednesday. "Winning with Asthma" is a 30-minute online presentation for coaches, teachers, parents and anyone involved with youth sports, "because on any given team, one or two athletes will have the disease," Chuy said.

The presentation, at winningwithasthma.org, gives the viewer facts about the disease, how to maintain it and signs to watch for.

But it's not just young people who are affected. Asthma is found in people of all ages, ethnicities and genders, although it's more common in females. According to a behavioral risk factor surveillance system, 8.4 percent of Utah females have asthma, compared to 9.1 percent of females nationwide, while 6.4 percent of Utah males have the disease compared to 5.4 percent of males nationwide.

"Right around puberty, it seems to be a switch," she said.

For children under the age of 14, males are hospitalized more for asthma symptoms or attacks. In the adult population, females have a higher rate of prevalence. Mortality rates from asthma are low, about 5,000 people nationwide.

But the costs can be high. According to a hospitalization report, there were 1,577 hospitalizations for asthma in 2003, with charges of almost $10.5 million, more than half of which was paid for by Medicare or Medicaid. Jacque Brown, spokeswoman for Timpanogos Regional Hospital, said almost 600 people were treated for asthma in 2005. Utah Valley Regional Medical Center saw almost 1,000 people for respiratory problems, many of which were asthma-related, in the final quarter of 2005, said hospital spokeswoman Janet Frank.

Costs add up elsewhere as well; Chuy said adults with asthma reported 1.9 more days per month staying home sick from work.

The key is asthmatics have to understand the disease and their triggers, she said. The health department is taking an active role in helping people who have asthma, but they have to know their own cases.

Most asthmatics have medication; either a short-term inhaler to take care of symptoms or daily medication to reduce mucus and swelling that cause the bronchial tubes to contract, cutting off air flow. There's some common sense involved too.

"Another way to maintain asthma is just to avoid the things that trigger your asthma," Chuy said, adding this could be mold, irritants or chemicals in the air, pollen, pet dander or exercise.

For some, this means getting rid of a pet or ensuring the air at home or work is properly purified. It's a little harder to avoid going outside, so the inversions common to a Utah winter or pollutants in the air from manufacturing can trigger symptoms.

Chuy said studies show that on days after air pollution has been abnormally high there is an increased incidence of symptoms, including coughing, wheezing and chest tightness, more attacks and more children absent from school.

The health department has taken a number of actions to educate the public, including sending out fact sheets, meeting with teachers to discuss the disease and holding informational meetings with elderly people. The Legislature has also taken up the fight; state Sen. Patrice Arent, D-Holladay, introduced a bill that passed in the 2004 session that would allow students to use inhalers at school if the student's parents and health care provider signed off on it.

This story appeared in The Daily Herald on page D1.