Prather Pediatric and Allergy Center - Ask Doctor Brent

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Title: Environment Does Make a Difference in Asthma

Category: Asthma and Allergy


A recent study done at Boston City Hospital and published in the American Journal of Diseases of Children showed clearly that racial, social and environmental factors were important risk factors for childhood asthma. They found that among black children the rate of asthma incidence was 4.4 percent compared to only 2.5 percent for white children. They carefully studied several variables including the fact that the black children were more likely to live in poverty, to be exposed to maternal cigarette smoking, to have large family size and to have smaller home size, to have been born with low birth weight and to have a maternal age younger than 20 years. When all of these individual factors were controlled, the incidence actually was equal in rate of asthma between whites and blacks. In summary, their research showed that it was not the race that caused the higher incidence of asthma for blacks over whites, but rather the poverty status and all the other factors associated with it.

Other factors discovered in this study were that asthma was more likely to occur at a younger age (such as between one and three years of age) when all of these poverty factors were involved in the child's family and his home. This is just one of many recent studies which confirm the importance of trying our best to control environmental factors which are important precipitants of asthma and increase childhood asthma and cause it to occur at an earlier age. Things that all parents can control include smoke in the home and to a certain extent, dust in the home.

Controlling smoke at home is extremely important and many studies have showed that simply having the parents blow their smoke outdoors had a major impact in decreasing the asthma in the home. Cigarette smoke seems to be worse than any other single factor, with regard to irritating the nose, eyes and lungs of allergy patients, particularly asthmatics. It is very critical that people who smoke avoid smoking in the homes or work places of asthmatics. Next to cigarette smoke, the second worse thing in the home which is found in practically every home in the South due to our high humidity and warm climate is the dust mite. A recent study in the New England Journal of Medicine showed that the quantity of mites in the home had a direct linear correlation with the early onset of asthma in the home in susceptible individuals. This is something that has been assumed for years but the study published in the New England Journal was the first time it was ever shown in such a dramatic fashion. This study convinced all allergists that it is worth going the extra mile to control dust mites in the homes of susceptible patients.

The dust mite is found primarily indoors and particularly in pillows, mattresses, old furniture, closets and carpets. It has a very short half life and dies and becomes ground up with other particles in indoor dust. The feces of the mite is actually the most important part in regard to allergy. There are a few proteins in the feces which are very allergy producing and the size and shape of the feces is very similar to a ragweed spore. The simplest measures to take in mite control include common sense dusting, simple furnishings and covering the pillow and/or mattress with a vinyl zipper cover. More extensive measures include a very effective air filtration system such as an electrostatic precipitator which can be plugged in and electronically cleans air in the rooms or in the entire home. This should have a HEPA filter which stands for high efficiency particulate air filter. Other measures include a few new sprays which apparently work to draw the mite feces and proteins out of the carpet when vacuuming. These are called Allergy Control Solution and the other product is called Akarosan. These can be obtained directly through the companies that produce them or through your drug store. Without using these sprays, mites are very hard to rid from fixed carpet and even water trap vacuum cleaners such as Rainbow do not effectively rid the carpet of these sticky proteins.

Other factors which are very important in the environment of an allergy patient include avoiding pets indoors because of the allergy nature of their dander. The worst pet as far as allergy goes is the cat because of proteins in its saliva which it constantly spreads on its body and then rubs up against furniture. Dogs are not quite as bad although all dogs are allergenic including chihuahuas. The idea that chihuahuas will cure patients of asthma has never been proven and actually chihuahuas cause allergy in susceptible individuals just like any other dog.

In summary, anything which can be done to keep our indoor environments, particularly our bedrooms, as dust, smoke and animal free as possible will go a long way toward decreasing flare-ups in asthma, hayfever and other allergy problems.