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Asthma poses serious risks for kids


July 30, 2012
SPRINGFIELD — School's out for the summer, and for kids with asthma, that could spell problems.

"My biggest concern for the summer is that too many kids and parents stop regularly prescribed controlled medications. Then, when kids go back to school in the fall, they end up having more severe asthma episodes. Medications should never be stopped without the advice of your child's pediatrician," Dr. Robert Kaslovsky, chief of Pediatric Pulmonology at Baystate Children's Hospital, said.

Asthma is a disease caused by inflammation of the airways, resulting in increased mucus production and swelling of the breathing tubes known as bronchi in the lungs. The swelling, along with a tightening of the muscles around the bronchi, causes air to be trapped in the lungs, which makes it difficult to exhale.

Statistics from the Massachusetts Department of Public Health note that asthma affects 10 percent of children statewide, with particularly high rates in Springfield (16 percent) — one of the most asthma aggravating cities in the United States — and Holyoke (18 percent).

"There is no clear-cut, single answer as to why asthma rates are on the rise. As physicians, we do know that certain environmental factors both inside and outside the home serve as what we refer to as 'triggers,'" Dr. Matthew Sadof said, a pediatrician at Baystate Children's Hospital, who also serves as chair of the Pioneer Valley Asthma Coalition.

The triggers — which often bring on asthma attacks — include things like dust, mold, pet dander, dust mites, pest infestations such as cockroaches and rodents, all types of pollen and other pollutants in the air, weather changes, and even smells.

Poor air quality also means serious breathing challenges for those with chronic lung diseases such as asthma. Hampden and Hampshire Counties recently received a failing grade for air quality. In April, the American Lung Association's State of the Air Report, which assigns letter grades to counties nationwide based on ozone and particle (often referred to as soot) pollution, gave the two Massachusetts counties an "F."

"Hot, humid weather often accompanied by pollution can be very dangerous for young and old asthma sufferers alike. And, there may be a few days when parents will want to consider keeping their child safe indoors in the comfort of air conditioning, especially on days that reach near 100 degrees or more like we've already seen this summer," Kaslovsky said.

Allergies are also big triggers in the summertime for those allergic to green grass, especially a freshly-mowed lawn, and weeds of all kinds culminating with troublesome late summer ragweed pollens. Additional summer culprits include campfires and charcoal grills that have smoky fumes, which can trigger an asthma attack.

According to Kaslovsky, running, as well as all kinds of seasonal sports, can bring upon asthma attacks with exertion.

"If a child has asthma with any type of exertion, parents should make sure he or she is given their albuterol inhaler beforehand," Kaslovsky said.

The American Academy of Pediatrics offers the following additional year-round tips to avoid asthma triggers:
  • Reducing exposure to dust mites by covering mattress and pillows with special allergy-proof encasings, washing bedding in hot water every one to two weeks, removing stuffed toys from the bedroom, and vacuuming and dusting regularly. Other avoidance measures include using a dehumidifier and removing carpeting in the bedroom.

  • If your child is allergic to furry pets, remove them from the home. If this is not possible, keep them out of the bedroom and put a high-efficiency particulate air (HEPA) filter in your child's bedroom. Also, wash animals regularly.

  • Reducing cockroach infestation by regularly exterminating, setting roach traps, repairing holes in walls or other entry points, and avoid leaving out exposed food or garbage.

  • Mold in homes is often due to excessive moisture indoors, which can result from water damage due to flooding, leaky roofs, leaking pipes, or excessive humidity. Repair any sources of water leakage. Control indoor humidity by using exhaust fans in the bathrooms and kitchen, and by adding a dehumidifier in areas with naturally high humidity. Clean existing mold contamination with detergent and water. Sometimes porous materials such as wallboards with mold contamination will need to be replaced.

  • Reducing indoor irritants by using unscented cleaning products and avoiding mothballs, room deodorizers, or scented candles.

  • Never let anyone smoke inside the house, even if the windows are open.
Parents should also take into consideration summer travel plans, as children with asthma may experience worsening symptoms during travel.

The American College of Allergy, Asthma, and Immunology recommends:
  • Checking pollen counts at your destination.

  • Requesting a non-smoking room where you are staying.

  • Packing medications according to air travel regulations.

  • Being aware of what access to medical care is available at your destination.

  • Speaking with your child's pediatrician before traveling about your destination and the activities you are planning.
"People with asthma can lead a healthy and normal life. We have the knowledge to make life better for them, it just takes education and time," Sadof said.

For more information, visit baystatehealth.org/bch, then click on Pediatric Specialties, and then Pediatric Pulmonology.



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