Asthma – Statistics That May Take Your Breath Away
By Laura Kiesel
As autumn winds down and winter approaches, many people welcome the relief from allergies the season brings. But even the cold and snow don't lessen breathing problems for a significant portion of the population -- asthmatics.
Asthma is a chronic inflammation of the lungs characterized by narrowed airways. During an asthma attack, a person experiences a potentially dangerous shortness of breath. About seven percent of the world population is affected by the disease, which is responsible for approximately 4,000 deaths a year in the U.S. According to asthma data reported by the Vermont Department of Health in 2007, nearly 10 percent of Vermonters have asthma.
“There are things that families and individuals can do to keep people with asthma healthy, like using pillow and mattress covers to control for dust mites, keeping pets outside of the bedroom, and other housecleaning measures,” says Sheri Lynn, a representative from the Vermont Department of Health.
Avoiding allergens such as pollen, dust, and animal dander is critical in managing asthma and minimizing attacks. It's also important to minimize exposure to environmental pollutants, something that's not as easily controlled.
The four major air pollutants regulated by the U.S. Environmental Protection Agency that have been highlighted as contributing and exacerbating factors to asthma are: smog, particulate matter, sulfur dioxide, and nitrogen oxide. According to the Natural Resources Defense Council, multiple studies have shown that hospitalizations for asthma increase on days when high levels of particulate matter and other ambient air pollutants are recorded for the area. Second-hand tobacco smoke is also is considered a significant factor in causing asthma. Formally known as environmental tobacco smoke, it affects millions.
Both in the nation and in Vermont, asthma rates are generally higher among blacks and Hispanics than Caucasians, and in lower-income and less-educated populations. Though some medical studies have indicated a possible genetic link between ethnicity and susceptibility to developing asthma, these studies are not conclusive. However, urban living has been cited by the Mayo Clinic as a risk factor of the disease.
Additionally, the National Institute of Health has noted that people who are exposed to chemical irritants and “industrial dusts” at work are also at risk for developing what is known as “occupational asthma,” another phenomenon that seems to disproportionately affect poorer people and people of color.
The large discrepancy of asthma rates among different races and classes has long caused debate as to whether, and to what extent, environmental pollution contributes to development of the disease. This debate is part of a larger dialogue that began in earnest in 1987, when the United Church of Christ’s Commission for Racial Justice released a report that concluded that minorities are two to three times more likely than whites to live in communities sited near hazardous waste landfills. The study on which the report was based analyzed zip codes of minority communities and compared them to landfill zoning sites. The University of Massachusetts conducted a follow-up study in the mid-1990s that analyzed census tract data instead, but reached a similar conclusion. This study found hazardous waste facilities were usually located near working class communities, especially rural African American ones.
Gender also plays a role, though the reasons are not understood. Asthma rates are slightly higher in boys during childhood and adolescence than in girls. This trend reverses considerably in adulthood. In Vermont, adult women are five percent more likely than men to have the disease, with this trend being particularly pronounced in women of child-bearing and middle age. This disparity is a bit higher in the state than on the national level, though both are high.
“It is unclear as to why hospitalization rates are higher for adult women,” remarks Lynn. “The switch happens during teenage years when teenage girls have higher rates of hospital and emergency room visits than teenage boys with asthma.”
In recent years asthma rates have been noticeably higher in New England than in the nation, with the region experiencing a notable increase between 2001 and 2004. However, that trend was not evident in Vermont. Nevertheless, Vermont still has statistically higher asthma rates among whites than the national average. In particular, the prevalence of asthma rates recorded in the state in 2005 was significantly higher than the rest of the U.S. Currently, there seems to be no accepted explanation to account for these increases in either New England or Vermont.
The good news is that there are organizations working on ways to help reduce exposure to the risk factors that induce or aggravate asthma. Some groups also offer management techniques to patients who have been diagnosed with the disease. For instance, the American Lung Association (ALA) was instrumental in passing the historic Clean Air Act, which implemented National Ambient Air Quality Standards for air emissions associated with respiratory disorders. More recently in the state of Vermont, the ALA has been behind successful efforts to place smoking bans in work places, bars, clubs, and many other public spaces.
“We would like to see affordable housing [and] public housing adopt one hundred percent smoke-free policies,” says Rebecca Ryan, the director of health promotion and public policy at Vermont's ALA chapter. “A smoke-free housing policy would go a long way to protecting children from secondhand smoke exposure.”
ALA Vermont also worked on passing ordinances to restrict unnecessary idling, particularly of school buses, and in pressuring the state to set up new legal requirements for cleaner wood-fired boilers. ALA Vermont also helped establish an Asthma Clinical Research Center at the University of Vermont, which investigates the link between air pollution and asthma.
For those children who already have asthma, ALA Vermont offers a subsidized trip to 40 young adolescents each summer with moderate to severe strains of the disease. Known as “Champ Camp” and held in the town of Derby, the camp offers a comprehensive crash course in asthma management.
In terms of air pollution and personal management, Heidi Hales, who is a planning chief at the Air Pollution Control Division of the State of Vermont suggests using EnviroFlash. EnviroFlash is an EPA-designed email alert system that sends its subscribers daily air quality forecasts and related details.
According to Hales, EnviroFlash is "a really valuable tool for those with an interest in personal monitoring of air quality, such as asthmatics or other lung disease patients, who might want to know when it is best to stay indoors.”
Laura Kiesel is a freelance writer who is currently completing her Master’s thesis in natural resources at UVM. Her articles have been published in E Magazine, Z Magazine, and Agriview.
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