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Tracking Down the Asthma-Air Pollution Link

Posted on: Tuesday, 28 February 2006, 18:00 CST

When it comes to the connection between asthma and air pollution, researchers know it's there, but have only begun to figure out how it works.

As the evidence mounts to prove the ill health effects of smog and other air pollution -- for example, it's known that smog and other air pollution can trigger asthma attacks -- it's suspected that bad air can cause asthma in the first place, but it's not known how.

The wheezing and coughing of an asthma attack -- when lung spasms constrict airflow and cause shortness of breath -- can be so severe that emergency medical aid is required.

A variety of factors, such as cold air, dust mites and cigarette smoke, can trigger an attack. Studies show attacks also are more prevalent among asthmatics who live in areas with a lot of air pollution.

About 9 percent of Californians -- more than 3 million people -- have asthma.

"We don't fully understand what the causes of asthma are," Dr. Rob McConnell told the hundreds of people attending a recent one- day conference on the asthma impacts of air pollution, held recently in Los Angeles by the South Coast Air Quality Management District.

McConnell, a co-investigator on the long-term Children's Health Study at USC, noted a conclusion of the study that found children in areas of high ozone-smog -- downtown Los Angeles and the Inland Empire -- who played team sports were three times as likely to have asthma as children living in clean air towns of the Central California coast.

But ozone wasn't a trigger for attacks, research has found. From research involving people who live near freeways, the trigger seems to be the traffic-related pollutants of nitrogen oxides and particles.

In hopes of getting highly specific data about the health effects of air pollution -- especially traffic-related pollution -- a new study called the Los Angeles Family and Neighborhood Survey will examine levels of air pollution in 60 Los Angeles neighborhoods and track lung function in asthma in the children living there. More than 3,000 families will be followed.

Air quality monitors will be placed on trees, libraries, schools and in shirt pockets, said UCLA researcher Dr. Beate Ritz. A very detailed map of exposures and health effects will be generated using geographic information system modeling.

That will be of interest in the Harbor Area and South Bay, where residents are concerned that port- and traffic-related air pollution is taking its toll on people's health.

With the rapid increase in traffic through the ports of Los Angeles and Long Beach, port growth is an emerging health issue, USC's McConnell said. It's another area of asthma and air pollution that needs more study.

"There is little data on what the health impacts of these exposures are," McConnell said.

Los Angeles County's rate of asthma actually is a little lower than the statewide prevalence, but there is a higher rate of hospitalization for asthma attacks, said Dr. Rick Kreutzer, chief of environmental health investigations for the state Department of Health Services.

Genetic background is a factor in having the condition, as some races tend to have more cases of asthma than others, and within races, there's wide variance among ethnicities. For example, people of Korean descent in California have low rates of asthma compared to those of Japanese and Filipino descent.

Health officials know that asthma hospitalizations are 3 1/2 times higher among blacks compared to others, but that basic asthma prevalence among blacks is only slightly higher.

"There still remains a lot in this state that is unexplained about asthma," Kreutzer said.

Speed critical with anthrax

A quick diagnosis and starting of basic antibiotic treatment -- not modern, intensive hospital care -- is what saves lives when people contract the disease anthrax.

Stanford University researchers looked at not only the U.S. anthrax attacks from 2001, but 82 total confirmed inhalational anthrax cases from 1990-2005 all over the world.

It was catching the disease in its early stages that likely was the most effective way of saving the victim. Overall, victims died in 85 percent of the cases examined by the researchers. In the 2001 attacks in the U.S., five of the 11 people who contracted the disease died.

Victims in the 2001 attacks were more likely to have started antibiotics during the initial phase of the disease, caused by bacterial spores.

But anthrax is difficult to diagnose, researchers said, so it takes a high level of vigilance on the part of physicians to catch the disease early on.

It was also found that lung drainage via chest tube was another important part of treatment, so a good supply of these tubes is a necessary part of the preparation for bioterror attack.

Source: Daily Breeze

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