Trying to make breathing easier

Asthma: As childhood cases increase, studies search for answers about what triggers the disease

May 30, 1999|By Bob Condor | Bob Condor,Chicago Tribune

If allergies weren't disruptive enough in a child's life, they can also lead to the more serious consequence of asthma.

"Childhood asthma is still on the upswing," said Dr. Richard Evans, chief of the allergy and immunology division at Children's Memorial Hospital in Chicago. "The hospitalization and emergency-room visit rates are up too."

Evans is one of the primary researchers for a National Institutes of Health study about how to prevent asthma attacks in children. An asthma attack occurs when the bronchial tubes are obstructed because of inflammation or spasms and air cannot travel from the nose and mouth to the lungs.

The NIH is looking at such asthma attack triggers as dust mites, molds, pollens, grasses and pets. Extra attention is being placed on cockroaches, which have been linked to the rise of asthma in poor neighborhoods. The Environmental Protection Agency is running concurrent air-quality tests to determine whether pollution plays a role in the rising incidence of asthma.

Viral infections are another major cause of asthma attacks. Scientists at the University of Wisconsin are following 200 couples with newborns to determine whether the combination of parents with asthma (one or both) and a viral respiratory infection before age 3 significantly increases risk.

A recent British study indicated infancy and early childhood might be a critical time to take precautions. Children exposed to dust mites at age 1 were more likely to have developed allergy symptoms by age 12.

Nearly 5 million U.S. children have asthma, along with 10 million adults.

Evans said parents being alert to symptoms is important in early diagnosis. Research shows that the longer children aren't treated, the greater the chances of decreased lung function, some of which may not be fully regained.

"Family history of parents or siblings is a key indicator," Evans said. "With younger children, we ask parents to be aware of any coughing during exercise, which is an asthma trigger, or [at] nighttime. Another possible symptom might be coughing while crying or laughing. Not in isolation, but if the coughing is consistent."

In older children, shortness of breath is easier to spot, though it is not always a common symptom. Besides asking parents to use mattress and pillow covers and to wash bedsheets frequently, Evans says it is vital to make sure asthmatic children are not exposed to secondhand cigarette smoke.

"The trigger is directly related to how close the child gets to the smoke," Evans said. "We are looking at exposure in the same room or even the child who walks into a room where an adult had been smoking. Parents should do all they can to reduce allergen load."

Asthma doesn't necessarily translate to a limited lifestyle or serious illness. There are Olympic champions with asthma. There are many convenient medications, such as bronchodilators and nonsteroidal anti-inflammatory drugs (asthma patients should avoid using aspirin), that help patients address attacks or symptoms on the spot.

Many hospitals have support groups for children and parents. The American College of Allergy, Asthma and Immunology has an Internet site at http://allergy. mcg.edu, or call 800-842-7777.

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