Allercy and Asthma Health


Fall 2007

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The Official Publication of AAN - MA

News Bits

Read the latest news bits featured in the AARC Times, the professional publication for respiratory therapists.

PhotoSmoking Blamed for Childhood Asthma Increase

Could cigarette smoking be the main factor behind the rise in childhood asthma seen over the past few decades? Researchers from Columbia University’s Mailman School of Public Health think it might. They point to several factors to back up their thesis:

  • Environmental tobacco smoke has a higher concentration of toxic substances such as carbon monoxide and carbon dioxide than the smoke inhaled by smokers.
  • Children breathe more air than adults and have narrower airways, so environmental tobacco smoke is a greater causal risk factor of asthma in children.
  • Globally, six studies have shown environmental tobacco smoke to be a risk factor of incident asthma, with a 2.5 times greater risk seen in young children with mothers who smoke more than 10 cigarettes per day indoors compared with mothers who smoke fewer cigarettes or not at all.
  • U.S. Department of Health and Human Services statistics indicate exposure to environmental tobacco smoke, especially in the home, increases a child’s likelihood of developing asthma by 63%.

“We have identified parallel increases in childhood asthma and cigarette use among adults during the past century in the United States. These parallel trends suggest that the increase in cigarette use may be a contributing factor to the rise in asthma among children during the same period through increased exposure to environmental tobacco smoke,” says study author Renee D. Goodwin, PhD, MPH.

Add Asthma to the List of Obesity-related Problems

A new study in the first April issue of the American Journal of Respiratory and Critical Care Medicine suggests a new approach for dealing with asthma: lose weight. Researchers from the National Jewish Medical and Research Center in Denver, CO, who reviewed the medical literature on obesity and asthma find the incidence of asthma is increased by about 50 percent in people who are overweight or obese.

 “If significant weight loss could be achieved in the population of overweight and obese individuals, it could be estimated that the number of new asthma cases in United States adults might fall by as much as 250,000 per year,” says lead author E. Rand Sutherland, MD, MPH. “If that decrease can be extrapolated to the pediatric population, where the annual incidence of asthma is as much as five times higher, the effect of even small changes in mean population body mass index may translate into significant decreases in asthma incidence in children and adults.”

Sputum Monitoring for Asthma Control?

Could sputum monitoring have a role to play in controlling asthma? Queensland, Australia, researchers who reviewed three studies involving 221 adult patients suggest it could.

The studies all compared asthma exacerbations among patients who were monitored via inflammatory markers in their sputum with those who received traditional monitoring alone. Those in the sputum analysis group had fewer exacerbations and longer periods of time between exacerbations than those who were monitored with lung function testing and symptom tracking. These results were seen despite no significant differences in asthma symptoms, quality of life scores, or corticosteroid use between the two groups.

So, is sputum analysis coming soon to a facility near you? Probably not, says Miles Weinberger, MD, director of the division of allergy and pulmonary diseases at the University of Iowa/Children’s Hospital of Iowa, who commented on the Australian findings. “It’s uncomfortable, it’s time-consuming, and it requires special lab facilities to examine the sputum. I can’t imagine it being done in routine clinical care.” He notes sputum induction can also lead to bronchospasm. “I think careful clinical monitoring and pulmonary function testing at the time of assessment is just as practical and just as good if done well.”

The report appeared in the April issue of The Cochrane Library.

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