No breath of fresh air

Indoors no better for children with asthma

Baltimore Sun

BALTIMORE — Parents have long known that the polluted, pollinated air outdoors can bring on asthma attacks in their children. Now it turns out that many asthmatic inner-city kids are under assault inside their homes — where cigarette smoke, dust mites, mold and cooking smells can make them sicker than car exhaust or ragweed.

Researchers are finding a direct link between the air children breathe at home and the asthma attacks that are the source of hundreds of thousands of emergency-room visits in the United States every year. The latest study, published recently by Johns Hopkins researchers, quantified the increase in asthma symptoms for every increase in air pollution particles inside Baltimore homes.

Such findings have begun a movement of health professionals going door to door to educate families about the potential dangers of indoor air and helping them clean up their homes. The goal is to reduce childhood asthma 50 percent by 2012.

“We tend to think of outside as being the polluted place and indoors being the sanctuary,” said Dr. Gregory B. Diette, a director of the Johns Hopkins Center for Childhood Asthma in the Urban Environment. In many of the Baltimore homes he surveyed, Diette found that inside air was a problem.

As many as 1 in 5 Baltimore children are believed to suffer from asthma, the most common chronic childhood disease but one that disproportionately affects inner-city black children.

Scientists don’t yet know exactly what causes asthma, a lung condition that temporarily narrows the airways and causes wheezing, coughing and difficulty breathing. The number of children with asthma has risen significantly over the past two decades.

“What is then responsible for this dramatic increase in asthma over the past 20 years? That’s the million-dollar question,” said Dr. Elizabeth Matsui, a pediatric allergist at the Johns Hopkins Children’s Center and, along with Diette, an author of the study.

Matsui said allergists have known for years that the home — where children spend most of their time — holds hidden dangers for those with asthma. But only recently, she said, have pollution scientists started to research the relationship between indoor air and asthma.

The problem of poor indoor air quality appears to be most serious in low-income city households. Reasons for that aren’t fully understood, but researchers say city homes tend to be smaller than those in the suburbs, so bad air has less chance to be diffused. And in older houses, there is more likely to be dust from old plaster and wood.