Asthma - the Increase is Breathtaking
Asthma Rates in Cleveland - Greater Cleveland Asthma Coalition Report (May 2004)
Helping Families Manage Asthma
Asthma Triggers
Pests and Asthma
Excess Moisture and Asthma
The Link with Lead Poisoning
Asthma in Ohio
Links to More Information on Asthma

• Asthma is the leading serious chronic illness of children.
• Prevalence rates increased 70% from 1982 to 1994 (4% to 7%) and asthma related deaths of children increased 50% to 1500 per year.
• Asthma is the leading cause for childhood hospitalization at two major Cleveland hospitals and third nationally.
• Asthma is in the Air

Asthma Rates in Cleveland - Greater Cleveland Asthma Coalition Report (May 2004)

• A study in two Cleveland elementary schools found 22% to 26% of children reported they have diagnosed asthma.
• Between 16% and 32% of children in these schools with no known asthma diagnosis reported symptoms consistent with asthma.
• Cuyahoga County Asthma Data Report (pdf, 13pgs)

Helping Families Manage Asthma

5 tasks that families must master to sucessfully manage asthma:

1. Complying with medication regimens
2. Identifying and reducing environmental triggers
3. Anticipating and coping with attacks
4. Navigating the health care system
5. Communicating with childcare and school

See the details of Helping Families Manage Asthma.

Asthma Triggers 

• Asthma triggers are things that make breathing problems worse for people with asthma.
• There are many different kinds of asthma triggers. They include air pollution, pollen, cold weather, colds and emotional stress.
• Some of the strongest triggers are found in the home - dust mites, cockroaches, mold and tobacco smoke.
• Indoor Asthma Triggers factsheet
• Indoor Asthma Triggers 1/21/10 Youngstown, Ohio presentation - PDF
• Indoor Asthma Triggers 1/21/10 Youngstown, Ohio presentation - slides (ppt)

• This Institute of Medicine online report, Clearing the Air: Asthma and Indoor Air Exposures, examines how indoor pollutants contribute to asthma - its causation, prevalence, triggering, and severity.
• Opponents of stricter regulations for air pollution often try to wrongly minimize the adverse health effects of outdoor air by pointing to the role of indoor pollution in illnesses like asthma. Indoor vs. Outdoor

Pests and Asthma

Roaches and Rodents - Potent Asthma Triggers

• Multiple factors contribute to the severity of asthma. Allergens associated with cockroaches and rodents are potent and pervasive asthma triggers. They are especially prevalent in substandard housing. For example, in the National Cooperative Inner-City Asthma Study 37% of the children were allergic to cockroach allergen. High levels of cockroach allergen was found in the dust of 50% of the children's bedrooms. Sensitivity and exposure were significantly associated with increased likelihood of asthma symptoms.

IPM - Safer and More Effective Pest Control

• The old methods of pest control - still too commonly used - rely on monthly spraying of volatile and toxic insecticides for roaches and use of strong poisons for rodents. These methods are costly, ineffective in the long run, and potentially dangerous. Even when done properly, spraying can leave persistent pesticide residue. Irritant chemicals in some insecticide sprays can actually trigger asthma attacks (see Asthma, Children and Pesticides: What you need to know, Beyond Pesticides - National Coalition Against the Misuse of Pesticides). Poisons used for rodents are one of the most common sources of poisoning of young children.
• The state-of-the-art in the pest control industry is Integrated Pest Management (IPM), which is safer, more effective, and cheaper in the long run than the old methods. IPM utilizes pest monitoring, environmental controls, mechanical capture, and targeted applications of small amounts of low-volatility, least-toxic pesticides.

Getting Rid of Roaches

• Cockroach Control Guide -web
• Cockroach Control Guide (PDF)- English- Black and White or Color; Spanish- Black and White or Color
• Get Rid of Roaches- Breather Easier (PDF)- English- Black and White or Color; Spanish- Black and White or Color
• Roach Baits Work! - EHW's graphic guide
  

EHW Roach Allergen Reduction Project

• EHW conducted a study in public housing units, testing new methods for 1) assessment of cockroach allergen contamination, 2) safer elimination of cockroach infestation, and 3) effective cleanup of roach allergens.
• Project materials include summary, final report, model specs, public housing recommendations and related slide shows.
• EPA and the National Center for Healthy Housing case study write-ups of the the Roach Allergen Reducation Project

IPM in Schools

• IPM - How do you spell it? EHW Overview of IPM in Schools (pdf, 7 pgs of power point slides)
• EPA IPM in Schools - protecting children in schools from pests and pesticides

IPM in Multi-Family Buildings

• EHW Model IPM Contractor Program (pdf, 6 pgs)
• EHW Roach Control in Public Housing (pdf, 4 pg)
• Integrated Pest Management in Affordable Housing, National Center for Healthy Housing
• A Practical Guide to Cockroach Control in Multi-family Housing Units, Purdue University

• Other Pest Control Links

Excess Moisture and Asthma

A number of asthma triggers are associated with excess moisture, including house dust mites, mold and cockroaches. 

Home Moisture Audit

• Jim LaRue, EHW's Building Science Consultant, provides a step-by-step guide for diagnosing moisture problems in the home.

Moisure Reduction Projects

• The Cuyahoga County Urban Mold & Moisture Program explored the relationship between mold, moisture, asthma triggers and the respiratory health of children living in inner city neighborhoods throughout Greater Cleveland. Homes received environmental interventions focused on the reduction of water infiltration, removal of water damaged building materials, HVAC alterations, lead hazard control, and environmental cleaning.
  • Reduction in Asthma Morbidity in Children as a Result of Home Remediation Aimed at Moisture Sources, Environmental Health Perspectives (pdf - 7 pgs.)
  • Urban Mold & Moisture Control Interventions (2005)

• The Cleveland - Cuyahoga County Healthy House Initiative (CCHHI) integrated weatherization and healthy house interventions and further refined the moisture interventions developed in the Urban Mold and Moisture Project.
  • CCHHI Moisture Control Interventions (2007) including new, illustrated summary

Moisture Resources

• Damp Indoor Spaces and Health (2004), by the Institute of Medicine, examines the relationship between damp or moldy indoor environments and adverse health outcomes, discusses how and where buildings get wet, how dampness influences microbial growth and chemical emissions, the ways to prevent and remediate dampness, and the elements of a public health response to the issues.
• SOEH Report: "Mold-Related Health Effects: Clinical, Remediation Worker Protection, and Biomedical Research Issue
• The New England Asthma Regional Council has a useful document entitled Healthy and Affordable Housing: Practical Recommendations for Building, Renovating, and Maintaining Housing to help homeowners reduce the impact of home pollutants such as moisture on persons with asthma.

The Link with Lead Poisoning

Asthma in Ohio

• The Burden of Asthma in Ohio, Ohio Department of Health
• Ohio Statewide Asthma Plan

More Information on Asthma

New Links

• ClevelandHealth.info - Asthma - Local Health Indicators
• National Prevalence and Exposure Risk for Cockroach Allergen in US Households a study in Environmental Health Perspectives

Recommended Books and Periodicals

More Asthma Links

Links to EHW's Activities Related to Asthma