Linking asthma, air quality

Researchers examining relationship to help explain rising rates of disease

As a respiratory therapist, John Salka knows all about the physical impact of asthma. As a father, he knows all about the emotional toll as well.

Salka’s 11-year-old son Aleksander has asthma. He knows what it’s like to rush to the emergency room at 3 a.m. with a child who’s huffing and puffing, said Salka, who is the director of the cardiopulmonary department at Community Memorial Hospital in Hamilton.

Linking asthma, air quality
Linking asthma, air quality

“It’s a scary thing,” he said. “We’ve done it more than once unfortunately.”
As a professional and a parent, he’s concerned about air quality, its effect on people with asthma and its possible link to rising asthma rates.

“I think because of the increased pollutants in the air, we’re having much more prevalence of asthma, especially in young people,” said Salka, who also is chairman of the Mid-York Asthma Coalition, which serves Oneida, Madison and Herkimer counties.

The factsSymptoms
• Coughing during or after exercise• Shortness of breath• Wheezing sound while breathing• Tightness in the chest
What happens during |an asthma attack• Cells in your air tubes make more mucus than normal. This mucus is very thick and sticky and tends to clog up the tubes.

• The air tubes tend to swell, just as skin swells when you get a scrape.

• These changes cause the air tubes to narrow. This makes it hard to breathe.

How to cope

• Moderate and mild attacks, Take your asthma medicine.
If your medicine doesn’t work in the time it’s supposed to, call your doctor.

• Severe attacks
Take your asthma medicine and get emergency medical help right away.
You can die if you wait too long to get help.

• During any attack
Do not take cough medicine. Take only the asthma medication prescribed by your doctor.
Asthma medications

• Bronchodilators. These medicines provide relief during an asthma attack by relaxing the muscles in your air tubes.

• Anti-inflammatories. These medicines help to prevent asthma attacks by keeping your air tubes open all the time. They reduce the swelling of and mucus in your air tubes.

Is he right? Better diagnosis definitely explains some of the increase in the number of people with asthma, but experts are a bit stumped when it comes to explaining the rest of the increase scientifically, said Peter Iwanowicz, vice president and chief policy officer for the American Lung Association of New York State.

Early research does seem to show a cause and effect between exposure to polluted air and kids being diagnosed with asthma, Iwanowicz said.

Air pollution is definitely a trigger for asthma attacks. And environmental and health experts say the air in New York is none too clean.

In fact, Environmental Protection Agency data released in February shows that New York has the nation’s dirtiest air. State residents face a risk of developing cancer from air toxins of 68.1 per 1 million residents, compared with the national average of 41.5 per 1 million, according to the EPA data.

And all that smog does not hover over New York City. Last year the American Lung Association graded Oneida County an F, Madison County a D and Herkimer County a C for the number of high ozone days in each county. Ozone is the chief component of smog.

Oneida County fared better for high-particle-pollution days, scoring a B. Data was not available for the other counties.

Ozone is formed when emissions from smokestacks and tailpipes cook in warm, sunny air, producing a harmful form of oxygen, which is a corrosive gas. “So you can only imagine what it does to your lung tissue or a child’s lung tissue,” Iwanowicz said.

Particle matter comes from the burning of fossil fuels – commonly in wood stoves or diesel engines – and from sulphur and nitrogen emissions from power plants and factories. The emissions are transformed in the atmosphere.

“Both (ozone and particle matter) are known to trigger asthma attacks in people who have the disease, and ozone has been linked in some early studies to being a causal factor in the onset of asthma,” Iwanowicz said.

That’s not to say that asthma attacks wouldn’t occur in crystal-clear air. A myriad triggers can provoke asthma attacks, including allergens such as pollen, mold and pet dander; cigarette smoke; exercise; dust, perfume and other household irritants; certain medications; weather, particularly wind and cold air; and emotions.

Every day, 30,000 people in the United States have an asthma attack, 5,000 of them go to the emergency room and 14 people die from asthma, according to the Asthma and Allergy Foundation of America.

“I would say around 99.9 percent of those (deaths) should never have happened,” Salka said. “Asthma is one of the most treatable conditions known to man right now. We have medicines that are so sophisticated that none of these deaths should happen.”

Asthma easily can be managed with appropriate health care, Iwanowicz concurred. But air pollution is inescapable and makes it more difficult to manage asthma, he said.

“It can set you up for managing your asthma with a hand or two tied behind your back,” he said.

Blow the Whistle on Asthma Walk and Health Fair