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Summer 2007 Traveling with Asthma and Allergies AARC Diagnosis and Treatment of Asthma in Elderly Patients Smoking and the Asthma Patient News Bits
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 Read the latest news bits featured in the AARC Times, the professional publication for respiratory therapists. Asthma Patients Often Rely on Quick-Relief Meds
When It Comes to Asthma, “A” is for Atlanta Atlanta topped the list of 10 worst cities for asthma in the latest poll from the Asthma and Allergy Foundation of America (AAFA). Up from No. 4 last year, the city was cited for its high asthma death rate, high pollen levels, severe air pollution, and sub-par laws prohibiting smoking in public places. Who else made the list? Here are the other nine worst cities:
What about the best cities for asthma? You could argue there weren’t any. Even Seattle, WA, which came in as the least offensive city, flunked some of the AAFA tests, receiving “worse than average” scores on asthma prevalence and only “average” scores on other measures. Child Asthma Deaths Down, Incidence Up
Asthma Patients Should Watch Out for Red Tide Just one hour on a beach where “red tide” is in bloom may be enough to cause serious problems for asthma patients, report investigators from the University of Miami who published their findings in the January issue of CHEST. The study was conducted among 97 people with asthma who were assessed both before and after spending at least an hour on the beach during a period of active red tide and then again before and after spending a similar period of time on the beach when there was no red tide. Results showed significant differences between pre- and post-beach symptoms and spirometry during the exposure part of the study. No significant differences were observed between pre- and post-beach symptoms or spirometry during the nonexposure part. Red tide, which occurs naturally along the beaches of the Gulf Coast, is caused by blooms of the ocean organism Karenia brevis, which produces aerosolized toxins known as brevetoxins. These toxins have been shown to adversely affect the respiratory system. Is It Asthma—or Is that the Obesity Talking? They tested their theory by having eight volunteers with healthy lungs and a body mass index (BMI) of 25 undergo methacholine challenges under normal conditions and then again under three different conditions: while wearing vests filled with birdshot to mimic the chest loading common in obese people, while wearing anti-gravity suits to simulate increased lung blood volume, and while wearing both devices. The devices all simulated a BMI of 30, which is considered borderline obese. Methacholine had no effect on the volunteers when tested under normal conditions, but asthma-like symptoms resulted when they were wearing the vests and/or anti-gravity suits. Four of the volunteers were also tested with a simulated BMI of 42 and had stronger asthma-like symptoms than they did when their BMIs were simulated to 30. The authors conclude asthma symptoms in obese people might benefit more from weight loss than treatment with asthma medications. “We’ve shown that asthma symptoms seen in people who are overweight may be caused by the obesity-related increased pressure on the chest wall that reduces lung volume and alters the airways—by mechanics, in other words, rather than inflammation,” says study author Frank J. Cerny, PhD. “This may account for the high incidence of asthma in developed nations where the incidence of obesity is epidemic.” The investigators published their findings in a recent issue of CHEST. • 
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Respiratory therapists know controller medications are the way to go for people with persistent asthma. But the message doesn’t appear to be filtering down to patients. A new study supported by the federal Agency for Healthcare Research and Quality finds 31% of asthma patients rely on quick-relief medications for their asthma, compared to 14% who use controller medications. Another 31% use both, and about a quarter of patients use neither.
According to the latest data from the Centers for Disease Control and Prevention, asthma deaths in children are down, but incidence is up. Among the statistics:
Research has linked asthma with obesity, but now University of Buffalo investigators suggest asthma in the obese might not be “true” asthma at all. Rather than being caused by chronic inflammation of the airways, asthma occurring in obese people might instead be a result of obesity-related pressure on the chest wall that reduces lung volume and alters the airways.