Asthma Health Article

Asthma

A lung disease characterized by spasms and inflammation of the airways, causing wheezing, coughing, and shortness of breath.

Asthma is a lung disease characterized by recurring and sometimes persistent spasms and inflammation of the airways, causing episodic symptoms of wheezing, coughing, and shortness of breath.

Prevalence

A significant medical problem in children of all ages, asthma is the leading cause of school absenteeism and the most common reason for hospitalization of children. In 1993, asthma accounted for an estimated 198,000 hospitalization and 342 deaths among persons under age 25. Approximately 2-10% of children in the United States suffer from asthma; the most recent estimate is 4.3%. Childhood asthma is more common among boys, African Americans, residents of inner cities, and children from low-income families.

Asthma can arise at any age. Approximately 20% of cases begin in the first year of life. Wheezing due to viral or other infections in the early preschool age group is very common, however, and not all children who wheeze with infection will turn out to have asthma. Less than half of children who have a wheezing episode before age three will be asthmatic at age six. Among children aged 5-14 years of age, the asthma death rate doubled from 1980-93.

The risk factors for asthma are both genetic and environmental. Most children who develop asthma have a family history of allergies. Early damage to the lungs caused by cystic fibrosis, premature birth, artificial ventilation in an intensive care unit, and certain viral illnesses (especially respiratory syncytial virus [RSV]) can also cause a predisposition to asthma.

Severity and causes

The severity of asthma varies greatly from child to child. Mild cases may involve only a cough associated with exercise or at night. The milder forms of the disease are the most common, but asthma in its most severe form can result in a catastrophic shortness of breath that leads to death. The severity of asthma can also vary from day to day for the same person. For example, a child with asthma might be entirely well one day and then have a flare-up (attack) several days later.

In addition, asthma has marked diurnal variation in severity, which means that an asthmatic child who is symptom-free in the daytime may experience significant coughing or wheezing at night.

Preventive measures

Many simple steps can be taken to reduce asthma triggers in a child's home. Because children spend many hours asleep in their bedrooms, a number of control measures can be directed toward that room. Mattress and box springs, blankets, books, stuffed toys, clothing, carpeting, and other items in a child's room can gather dust mites. Enclosing mattresses, box springs, and pillows in plastic covers is often helpful, as is washing all bedding (and curtains) in hot water once a week. Eliminating or reducing the number of stuffed toys in a child's room (or at the very least washing them weekly) is a good idea. Removing carpeting from a child's room is very often helpful, because hard floors will gather far less dust than carpets. Vaporizers and humidifiers foster the growth of molds and dust mites and should be used sparingly in an asthmatic child's bedroom.

Other ways of controlling asthma triggers include prohibiting smoking anywhere in the house, avoiding smoke-filled areas, and avoiding the use of fireplaces or wood-burning stoves. Heating and air conditioning filters should be changed regularly. High-efficiency particulate air (HEPA) filters are available, which are very effective for removing allergens from household air.

Although there is no way to completely prevent the common cold, children with moderate or severe asthma should receive an annual influenza vaccination. Research is currently underway for an immunization to prevent RSV disease.