Indoor air pollution and childhood asthma

Asthma is responsible for one-third of all hospital stays and over a half-million emergency-room visits a year in kids under age 15. (AP Photo/Carlos Osorio)

One out of every seven children I see in my pediatrics practice has asthma. An even bigger number - one out of three - have wheezed at least once in his/her lifetime, a potential warning signal for asthma. 

This common breathing problem is responsible for one-third of all hospital stays and over a half-million emergency-room visits a year in kids under age 15. Asthma can be life-threatening, and its everyday downsides can make kids’ lives difficult 24/7: I see children who cough so much at night that they are always tired from the loss of sleep and others who cannot run without having a coughing fit and so do not play sports. 

Two weeks ago I helped organize the 7th Philadelphia Asthma Disparities Conference program, which originates with Tyra Bryant-Stephens, M.D., of Children’s Hospital of Philadelphia and director of Philadelphia’s wonderful Community Asthma Prevention Program (CAPP). Bryant-Stephens is a leader locally and nationally in novel and effective programs to prevent childhood asthma and to close the gap on “asthma disparities.”

What are asthma disparities? Truth is, they’re huge. According to the National Institutes of Health, children who are of Puerto Rican descent are 2.4 times more likely than white children to have asthma; African-American children are 1.6 times more likely. Overall, African-Americans are three times more likely to be hospitalized with severe asthma – and to die from it – compared to whites.

These disparities have many roots, but one is inside air pollution. A primary part of CAPP’s success is related to its work inside the homes of people with asthma to eliminate surprising, yet often simple-to-fix sources of indoor air pollution.  (If you live in West, Southwest, South or North Philadelphia and your child - ages 2 to 16 - uses a controller medication for persistent asthma, you may be eligible for CAPP’s Home Visiting Program. CAPP also offers asthma classes for parents and kids age 5 and up, asthma workshops for schools, educational programs for doctors and has a wealth of information for families at its Web site.)

Keeping the air clean inside your home helps everyone breathe easier and lowers the risk for asthma attacks in children – and adults - with this serious breathing problem. Here are some things you can do around the house to minimize asthma triggers in your indoor air:

  • Ban smoking. An estimated 400,000 to one million asthmatic children have asthma worsened by exposure to secondhand smoke, according to the American Lung Association.
  • Ask smokers to change clothes before coming inside. Even exposure to ‘third-hand smoke – the particles that cling to the hair, clothing and skin of a smoker, can make asthma worse for kids.
  • Put plastic covers on the mattress and pillow of the beds in the asthmatic child’s bedroom.
  • Wet dust the child’s room daily with disposable wipes or paper towels.
  • Keep surfaces clear (“like a Marine’s barracks”) for easy cleaning. Put all the objects you cannot wash frequently into the closet - such as stuffed animals, throw pillows and fabric decorations.
  • Don’t let pets – dogs, cats, guinea pigs, ferrets, the mouse your kid brought home for the weekend from the school science class - into the bedroom of the person with asthma,  ever. Pet dander can be a potent asthma trigger.
  • Avoid perfumes or other strong smells such as strongly-scented cleaning products.

Over the next week or two I’ll be blogging about other aspects of childhood asthma, a health issue that is a huge threat to our children's health and near and dear to my heart.

Gary Emmett, M.D., is director of hospital pediatrics at Thomas Jefferson University Hospital.