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Home environmental risk factors in urban minority asthmatic children
1Johns Hopkins University Center for Nursing Research, Baltimore, MD 21205-2100.
Insights
Asthma in urban minority children is worsened by home exposures like smoke and dust. Interventions targeting these triggers and improving medication use are crucial for reducing asthma severity.
Area of Science:
- Pediatric Allergy and Immunology
- Environmental Health
- Public Health
Background:
- Urban minority children with asthma face significant home environmental exposures.
- These exposures, including smoke, dust, and pet dander, exacerbate asthma symptoms.
Purpose of the Study:
- To assess the effectiveness of school-based and community-based asthma education interventions.
- To identify key home environmental risk factors contributing to asthma severity in urban African-American children.
Main Methods:
- Enrolled 392 African-American children (ages 5-12) with asthma.
- Conducted baseline telephone interviews with caregivers regarding demographics and home exposures.
- Collected data on asthma symptoms, activity limitations, and medication use.
Main Results:
- High prevalence of triggers: 72% cigarette smoke, 53% dust, 34% cats, 27% dogs, 15% roaches.
- Significant symptom burden: 44% restricted activity, 62% night symptoms weekly.
- Mattress covers linked to fewer emergency visits; underuse of anti-inflammatory medications noted.
Conclusions:
- Reducing asthma severity requires controlling home environmental risk factors like smoke, dust, and allergens.
- Emphasis on smoking cessation, mattress covers, and allergen control is vital.
- Educating primary care physicians on anti-inflammatory medication use is necessary.
Abstract:
Urban minority families with children with asthma often live in homes with allergen and irritant exposures harmful to these children. We enrolled 392 African-American asthmatic children, male and female, aged 5 to 12, from 42 schools in Washington, DC and Baltimore, MD. The project is designed to test the effectiveness of school-based asthma education interventions, community-based asthma health workers' programs, and the combination on these children. Baseline telephone interviews were carried out with the primary home care-givers for demographic data and for environmental home exposures that exacerbated asthma. Exposures stated to cause wheezing in the children were cigarette smoke in 72%, dust in 53%, cats in 34%, dogs in 27%, and roach exposure in 15%. Fifty-six percent of children live with cigarette smoke exposure, 73% of which is from mothers. This was a highly symptomatic group with 44% reporting two or more days per week of restricted activity and 62% reporting two or more episodes of night symptoms per week. Those with mattress covers on beds had significantly fewer emergency department visits in the past 6 months than those without covers. Over one-third of parents reported children taking two bronchodilators without anti-inflammatory agents. Less than 20% were reported using anti-inflammatory medications. Decreasing asthma severity in this population entails the prevention and control of known risk factors in the home environment. Emphasis must be placed on cigarette smoking cessation programs, covering mattresses, and dust and animal dander control. Primary care physicians require education on the role of anti-inflammatory medications.