Asthma: An Environmental Epidemic

by Nicholas Medeiros on February 16, 2014

The sound of the metal canister clicking into its plastic holder echoes as the child presses his lips to the rubber mouthpiece.  The site of an inhaler has become an all too common one in today’s society as millions look for relief from the chronic condition known as asthma.  26 million people suffer from the disease every year – myself included.  Chest tightness, coughing, wheezing, and shortness of breath plague its victims as restless nights develop into a seemingly endless cycle with limited relief in sight.  A chronic disease blindsided millions in all age, sex and racial groups.  In 1980, asthma affected only about 30.7 per 1000 population. Fast forward to 1993 – just thirteen years later – and the rate is 53.8 per 1000; a 75% increase.  Among children under 4 years, the rate rose from 22.2 per 1000 in 1980 to 57.8 per 1000 in 1993; a 160% increase.  What factors contribute to these substantially increasing numbers in such a short timeframe?  Environmental factors including air pollution, an increase in ground level ozone, and the existence of toxic chemicals in our environment all contribute to the rising rates of asthma throughout the world.

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Asthma can be provoked by a variety of “triggers.”  Think cigarette smoke, dust, outdoor air pollution, mold, and cockroaches – the list goes on and on.  Which one of these triggers has changed (or is changing) for the rate of asthma to have increased so much in the past 30 years?  Household dust does not seem to be anymore of a problem now than it was in 1980 (especially considering the abundance of infomercials selling some sort of state of the art de-duster.)  With cigarettes at nearly $10 a pack, and CVS announcing they will no longer sell them, fewer people seem to be smoking today than ever before; so we can remove dust and cigarette smoke from the equation.  What else could it be?  If you guessed air pollution and an increase in ground level ozone, you were right.  It appears the government recognizes these increases as “going green” seems to be the trend of the new millennium.  Public policy is changing to offer incentives for sustainability, as schools and universities are emphasizing the importance of recycling and safe air practices.  We may grow tired of hearing the nonstop chatter concerning the environment, but if these efforts can result in reduction of a chronic disease (along with many other benefits) maybe its time we start listening.

To reduce this pollution we would first need to know what is causing it.  A variety of factors are at play, but let’s start with nitrogen oxide, a gas emitted from tailpipes and power plants.  When combined with oxygen and sunlight, it can contribute to ground level ozone and smog.  High levels of ozone can be found it cities such as New York City and Los Angeles where there is an abundance of traffic.  Another factor contributing to this pollution is particulate matter – referring to dust, soot, ash, diesel exhaust particles, smoke, and sulfate aerosols.  These small particles can be lodged in the lungs and result in increased rates of asthma in children.  Recent studies show that the highest rates of asthma hospitalization are in places with high levels of particulate matter.

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When examining asthma morbidity and mortality rates in America, a striking direct correlation between the disease and cities where poverty is prevalent emerges.  Approximately 5,000 Americans die of asthma each year.  African-Americans are three times as likely to die of asthma compared to Caucasian Americans.  Why?  Certainly there may be a genetic factor at play, but beneath the surface, all evidence leads to poverty as the undercurrent of disease severity.  Sure, poorer people may not be able to afford expensive medication and doctor’s visits, but more than this, poor environmental conditions due to poverty is hugely responsible for high rates of asthma.  Poor people live in the areas where air pollution and particulate matter are highest.  Another huge concern for children growing up in New York City’s housing projects is cockroaches and mold – not because of their pesky presence, but simply because these two environmental factors can trigger asthma.  It is very difficult to have these removed as Dateline NBC explored in their documentary, “Mold, Mice and Zip Codes: Inside the Childhood Asthma Epidemic.”  In the special, six-year-old Amanda had chronic asthma as a result from the mold in her bathroom.  The mold had accumulated from a leak in the pipes from the floor above.  Amanda’s mother, Rosanna, fought her landlord and city representatives for many years.  The landlord was reluctant to remove the mold because this is a costly procedure.  Finally, Rosanna drew enough attention to the matter that the landlord had no other choice but to remove the mold.  Not surprisingly, Amanda’s asthma disappeared.  These poor urban living conditions as well as polluted city air contribute to the increasing asthma rates in minority children who live in cities.

In conclusion, it is no secret that air pollution and environmental mismanagement leads to increasing rates of asthma but how can we reduce the rates of air pollution?  Simple.  Recycle paper, plastic, glass bottles cardboard and aluminum cans.As annoying as your university’s incessant emails may be reminding you to do so, they may be on to something.  Recycling conserves energy and reduces production emissions. Strategically plant trees around your home to provide shade in the summer but enough sun in the winter.  Buy green electricity produced by low or zero pollution facilities.  Clean up mold in living quarters (especially if children are present).  And when it comes to driving, join a carpool to get to school or work.  Let’s reduce air pollution so in the future; our biggest worry will be bad hair days, not bad air days.

Clean-Park

References –http://www.epa.gov/asthma/molds.htmlhttp://inplainsight.nbcnews.com/_news/2014/01/03/22149240-mold-mice-and-zip-codes-inside-the-childhood-asthma-epidemic?lite http://www.nhlbi.nih.gov/health/health-topics/topics/asthma/http://www.cdc.gov/asthma/


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