Concerned that five city children have died from asthma-related causes since May, Baltimore Health Commissioner Dr. Peter L. Beilenson made an appeal yesterday to parents to reduce disease risks, particularly mold, which may be thriving because of the wet weather.
Health Department officials said that asthma seems to be worse this year, afflicting more children, and with more severe symptoms, than in recent years. "In the last six months it's gotten worse," said Mary Jo Harris, who runs the city's childhood asthma program, which tracks hospital visits by vulnerable children.
More than 11,000 Baltimore children have asthma, a chronic disease that inflames the lungs and impedes breathing. Before May, only one city child had died of asthma-related causes since the beginning of 2001.
Health officials don't know what caused the rise in deaths this year - it may simply be a tragic coincidence, Beilenson said. But the spike concerns officials, and they are reviewing the cases to see if there are any common factors. "It's significant that [these cases] are happening all of a sudden," Harris said.
So far, they have not found any shared causes. The children who died were of different ages and lived in different neighborhoods, Harris said.
Speaking at an afternoon news conference, Beilenson warned that mold, which can grow in wet basements, under damp carpets or near dripping pipes, can trigger asthma. "The key to mold control is moisture control," he said.
To get rid of mold, the Environmental Protection Agency recommends scrubbing mold off hard surfaces, fixing leaky plumbing, cleaning dehumidifiers, and ventilating rooms while cooking, showering, and using the dishwasher. If mold is growing on ceiling tiles or carpets, those items might have to be replaced.
Although they have no proof so far that increased mold is causing more asthma cases, city health officials suspect that it might play a role.
Asthma is caused by many different factors: In addition to mold, other suspected triggers include smog, pollen, poor ventilation, infestations of mice and roaches, exposure to cigarette smoke and dust mites.
"Mold definitely plays a big role," said Dr. Sudhir Sekhsaria, medical director of the Asthma, Allergy & Sinus Center at Union Memorial Hospital.
The mold problem could get worse, Sekhsaria said: August and September are the peak months for outdoor mold. (Because indoor temperatures remain fairly constant, indoor mold tends to thrive year-round.)
Sekhsaria added that he has not seen any increase in asthma cases during the past six months.
Beilenson emphasized that serious asthma attacks often are preventable.
Each of the recent deaths had "some preventable aspects," he said. In one case, the child didn't use the inhaler correctly; in another, caregivers didn't recognize what factors were most likely to set off an attack.
He advised parents of children with asthma to see a doctor regularly.
Last year, 28 Baltimore adults died from asthma-related causes. So far this year, seven have succumbed. On average, Beilenson said, about 20 to 30 city adults die every year of causes linked to the disease.
While experts generally agree that incidence of asthma is growing nationally - asthma cases and asthma-related deaths have both almost doubled over the past two decades - no one is sure why.
One recent theory - the "hygiene hypothesis" - argues that because modern and suburban residents are exposed to fewer allergens than in past generations, they are more likely to suffer from allergies and asthma.