10 ways to combat asthma (in honor of Asthma Awareness Month and World Asthma Day)

Asthma has been on my mind lately, because a child in my extended family was recently diagnosed with it after going to the hospital for respiratory problems. The chronic disease is one of the leading causes of hospitalization in children.

In addition, at least 20 million American adults are estimated to have asthma.

Today is World Asthma Day, in connection with Asthma Awareness Month.

Join me after the jump to read about five policies our society should implement, as well as five steps individuals can take, to reduce the incidence and severity of asthma in our households and across the country.

Five things our society could do to reduce asthma:

1. Reduce the amount of electricity generated by coal. Coal-fired power plants are major sources of sulfur dioxide and particulate matter in the air, which have both been linked to asthma attacks. That is one reason that public-health advocacy groups have joined environmental organizations to fight the construction of coal-fired power plants.

We should be doing much more to conserve energy and generate power from renewable sources, with a view toward taking old coal plants offline. At the very least, we should stop building new coal-fired power plants. Some states have already moved in this direction, but sadly, just last week the Iowa Utilities Board approved construction of a new coal-fired plant in Marshalltown. (Even more frustrating, the Democrats on the utilities board were the ones who approved the plant–but that’s a topic for another diary.)

2. Reduce smoking in public places. The Iowa legislature passed a fairly tough smoking ban this year, which covers most public places, including bars and restaurants. According to the Environmental Protection Agency,

Secondhand smoke can trigger asthma episodes and increase the severity of attacks. Secondhand smoke is also a risk factor for new cases of asthma in preschool aged children who have not already exhibited asthma symptoms. Scientists believe that secondhand smoke irritates the chronically inflamed bronchial passages of people with asthma.

Although some smokers have been whining about the new law, the smoking ban should improve public health and reduce the incidence of asthma among people who work in bars and restaurants, as well as their children. (Heavy secondhand smoke exposure for pregnant women raises the risk that their children will develop asthma.)

3. Invest in more compact development (as opposed to urban sprawl) and improve alternatives to driving, with decent public transportation and walkable or bikeable neighborhoods (“complete streets”). The Smart Growth America website notes that

People in sprawling metro areas must cope with the dispersed pollutants associated with increased automobile use. Road transportation is a major contributor to the formation of ozone, which aggravates asthma. Nine million children have asthma. Smog, created in large part by auto emissions, has been shown to be a factor in causing asthma among children playing active sports in polluted areas. An academic study commissioned by SGA, Measuring Sprawl and Its Impact, shows that people in more sprawling places breathe more polluted air. The study found that the severity of ozone pollution is strongly related to the degree of sprawl. In fact the difference in ozone levels between the most sprawling and least sprawling metro areas is 41 parts per billion: enough to shift a metro area from ‘code green’ air quality status to an unhealthy ‘code red.’

The EPA Smart Growth Office just released a new report which shows how infill development (building within older neighborhoods, as opposed to sprawl at the fringe of metro areas) improves air quality by reducing transportation emissions. Here is a link to the pdf file.

4. Move away from industrialized methods of livestock production (confined animal feeding operations or CAFOs) toward sustainable animal husbandry. A policy statement from the American Public Health Association noted in November 2003:

Numerous studies document serious respiratory problems among CAFO workers, including chronic bronchitis and non-allergic asthma in about 25 percent of confinement swine workers.35,36 Workers exposed to the potent neurotoxin hydrogen sulfide at levels only slightly higher than those at which its odor becomes detectable (5.0 ppm vs .025 ppm), have been found to have accelerated deterioration of neurobehavioral function;37 and

Scientists convened first by the Centers for Disease Control and Prevention (CDC), and more recently by the University of Iowa and Iowa State University, agree CAFO air emissions may constitute a hazard to public health, in addition to workers’ health.3

A study supported by the National Institute of Environmental Health Sciences and published in the journal of the American College of Chest Physicians showed that “Elementary school children may be at higher risk for developing asthma” if their school is near a CAFO.

5. Plant more trees and preserve existing trees in urban areas. A recent study in New York found a correlation between tree-lined streets and lower asthma rates in children. And that’s not even among the top ten benefits of trees, as described on the Trees Forever website.

Five things individuals can do to reduce asthma:

1. Don’t smoke, especially if you are pregnant or live with children:

Many of the health effects of secondhand smoke, including asthma, are most clearly seen in children because children are most vulnerable to its effects. Most likely, children’s developing bodies make them more susceptible to secondhand smoke’s effects and, due to their small size, they breathe more rapidly than adults thereby taking in more secondhand smoke. Children receiving high doses of secondhand smoke, such as those with smoking mothers, run the greatest relative risk of experiencing damaging health effects.

Smoking is also “the most significant risk factor” for developing severe adult-onset asthma.

2. Keep your home clear of other common triggers of asthma, such as dust mites, mold and cockroaches.

Not every case of asthma can be prevented; some people are simply more susceptible because of factors such as family history and allergic tendencies. However,

3. Maintain a healthy weight. Obesity appears to be correlated with asthma. Also,

there is evidence that losing weight can relieve asthma symptoms. Some evidence also suggests that people who are overweight, (body mass index greater than 25), have more difficulty getting their asthma under control. Weight loss in anyone who is obese and has asthma or shortness of breath reduces airway obstruction and improves lung function.

4. Breastfeed your babies if possible, because breastfeeding may reduce the risk of asthma, or delay the onset of asthma in children. A large Australian study found that infants who are exclusively breastfed in the early months “have a substantial reduction in the risk of developing asthma by age 6.”

You may want to use cloth diapers as well, because a study published in the Archives of Environmental Health suggests that emissions from disposable diapers may trigger asthma:

Upon exposing the mice to various brands of disposable diapers, “a decrease (was observed) in the ability of (the) animals to move air during exhalation,” Anderson said. Noting that this finding accurately describes asthma or an asthma-like reaction, she added that “if mice and humans respond in a similar manner to diaper emissions, disposable diapers could be important with respect to the worldwide asthma epidemic.”

In contrast to the results obtained with disposables, “new cloth diapers produced very little respiratory effects and appeared to be the least toxic choice for a consumer,” the researchers write.

Though the disposable effect was noted “even when the emissions of a single diaper are diluted in the air of a small room,” Anderson said, she cautions that it is too early to indict diaper chemicals. “Whether the diaper chemicals initiate clinical disease, simply trigger an asthma-like response or are not implicated (at all) in human disease will not be known until after a vast amount of human data has been accumulated,” she commented.

As the author of that article notes, more study of this issue is warranted. But as a precautionary measure, you may want to avoid disposable diapers anyway, especially since there are plenty of other reasons to use cloth.

5. Become aware of how your actions can affect large-scale asthma triggers.

Some of this involves changing your personal consumption habits. Conserve energy so there is less demand for electricity–and consequently less rationale for building new coal-fired power plants and more reason to take old plants offline. Reduce your own vehicle miles traveled–combine errands, carpool, take the bus, walk or ride your bike. Buy locally grown food from a farmer’s market rather than food from a factory farm.

In addition, you can become politically active on issues that relate to the causes of asthma and fight for more rational energy, agricultural and transportation policies. Join groups that are working to promote renewable energy, sustainable agriculture or neighborhoods that are conducive to walking and biking. Advocate for more smoke-free environments or subsidized smoking-cessation counseling.

I welcome your comments and suggestions about ways to reduce the incidence and severity of asthma.

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