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A Look at Some Key Asthma Irritants…

A Look at Some Key Asthma Irritants…. Drew Evans, Leah Moore, James Waldron EVE 486 October 21, 2009. Presentation Overview. What to expect… Asthma: General Overview Cockroaches Mold Environmental Tobacco Smoke. What is asthma?.

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A Look at Some Key Asthma Irritants…

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  1. A Look at Some Key Asthma Irritants… Drew Evans, Leah Moore, James Waldron EVE 486 October 21, 2009

  2. Presentation Overview What to expect… • Asthma: General Overview • Cockroaches • Mold • Environmental Tobacco Smoke

  3. What is asthma? • Asthma is a lung condition that makes breathing more difficult for asthmatics than for others • Airways are inflamed (they swell and produce excess amounts of thick mucus) • Oversensitivity to certain triggers (muscle around the airways tighten up when exposed) • The exact cause of asthma is unknown • Hereditary • Environment

  4. Common Triggers • Exercise • Allergens • Pollen • Mold • Animal Dander • Cockroaches • Weather • Airborne Irritants/Pollutants

  5. Presentation Overview What to expect… • Asthma: General Overview • Cockroaches • Mold • Environmental Tobacco Smoke

  6. Trigger: Cockroaches • Most common: • Blatella germania (German) • Periploneta americana (American) • Blatella orientalis (Oriental) • Proteins, referred to as allergens, that can affect asthma are primarily found in a cockroach’s digestive enzymes, feces, and body parts • These allergens are easily kicked up into the air while vacuuming, making the bed, or walking across the carpet

  7. Cockroach Case Study #1 Role of Cockroach Allergy and Exposure to High Levels of Cockroach Allergen in Causing Morbidity Among Inner-City Children with Asthma (Nov. 1992 – Oct. 1993) - 476 asthmatic children (aged 4-9) from eight U.S. inner-city areas - 36.8% allergic to cockroach allergen - 50.2% of bedrooms contained HIGH levels of cockroach allergen in the dust - The allergic children exposed to high levels experienced: 0.37 hospitalizations/year (versus 0.11 for other children) 2.56 unscheduled medical visits/year (versus 1.43 for other children) Overall, more days of wheezing, missed school, and nights with lost sleep

  8. Cockroach Case Study #2 Early-Life Environmental Risk Factors for Asthma: Findings from the Children’s Health Study - Case-Control Study nested in the CHS - 691 Subjects: 279 cases (with asthma) 412 controls (asthma-free) - Children exposed in 1st year and after to get ‘any’ asthma – OR = 2.03 - Children exposed in 1st year and after to get ‘early persistent’ asthma – OR = 2.13 - Children exposed in 1st year and after to get ‘late-onset’ asthma – OR = 1.85 - Any exposure resulted in early transient wheezing – OR = 3.05

  9. Cockroach Preventions • Keep food and garbage stored in sealed containers • Clean up food and liquid spills immediately • Clean dishes as soon as you are done using them • Fix leaks and other moisture problems quickly • Keep counters and the floor free of clutter • Remove boxes, piles of papers, and other hiding places • Seal cracks in and around cabinets

  10. Presentation Overview What to expect… • Asthma: General Overview • Cockroaches • Mold • Environmental Tobacco Smoke

  11. Trigger: Mold • Common Types: • Cladosporium • Penicillium • Molds can produce spores which, when disturbed migrate through the air and can grow on almost any type of substance as long as moisture is present. • Even if the spores are dead, the allergens associated with them can be problematic for years.

  12. Mold Case Study #1 Levels of Household Mold Associated with Respiratory Symptoms in the First Year of Life in a Cohort at Risk for Asthma - 880 infants were examined - Respiratory symptoms increase by 20% for each increase in mold level found in home.

  13. Mold Case Study #2 Moisture Damage and Childhood Asthma: A Population-Based Incident Case Control Study - 363 new cases of asthma (12-84 months) - Presence of visible mold in the home shown not only to strike up asthma, but also plays into the development of persistent asthma.

  14. Mold Preventions • Fix leaks quickly • Dry damp areas • Lower the level of humidity (dehumidifier or cracking a window to allow proper ventilation • Keep drip pans clean (heat pumps, dehumidifier) • Vent clothes dryers to the outside

  15. Presentation Overview What to expect… • Asthma: General Overview • Cockroaches • Mold • Environmental Tobacco Smoke

  16. Trigger: Environmental Tobacco Smoke • Sources: • Exhaled smoke • Side Stream Smoke • Second hand smoke has 4,000 substances, including about 60 carcinogens. • Tobacco smoke irritates the bronchial passageways of people with asthma.

  17. Cigarette Smoke Case Study #1 Environmental Tobacco Smoke and Adult-Onset Asthma: A Population-Based Incident Case–Control Study (Sept. 1997-March 2000) - 239 Exposed Group - 487 Control Group • Asthma patients reported higher exposure to tobacco smoke at both home and work place. - 49.2% of asthma is attributable to ETS

  18. Cigarette Smoke Case Study #2 The Burden of Environmental Tobacco Smoke Exposure on the Respiratory Health of Children - Children ages 2 Months to 5 years with parents that smoke in the household 1835 children exposed 1-19 cigarettes smoked in the house 1114 children exposed 20 or more cigarettes smoked in the house -Odds Ratio : Ages 2 Months to 5 year

  19. Cigarette Smoke Preventions • Don’t smoke in homes or cars • Don’t smoke around children and people with asthma • Don’t go to places where people smoke

  20. References “Asthma.” kidshealth.org. The Nemours Foundation, n.d. Web. 9 Oct. 2009. <http://kidshealth.org/teen/diseases_conditions/respiratory/asthma.html#>. Stöppler, Melissa Conrad, and William C. Shiel Jr. “Indoor Allergens.” MedicineNet.com. MedicineNet, Inc., n.d. Web. 9 Oct. 2009. <http://www.medicinenet.com/indoor_allergens/article.htm>. “Cockroaches and Pests.” epa.gov. U.S. Environmental Protection Agency, 29 Jan. 2009. Web. 9 Oct. 2009. <http://www.epa.gov/asthma/pests.html>. Rosenstreich, David L. “The Role of Cockroach Allergy and Exposure to Cockroach Allergen in Causing Morbidity among Inner-City Children with Asthma.” The New England Journal of Medicine. Volume 336:1356-1363 (8 May 1997). Web. 9 Oct. 2009. <http://content.nejm.org/cgi/content/abstract/336/19/1356>.

  21. References Salam, Muhammad Towhid. “Early-Life Environmental Risk Factors for Asthma: Findings from the Children’s Health Study.” Environmental Health Perspectives. Volume 112:6 (May 2004). Web. 10 Oct. 2009. <http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1241973>. “Mold Remediation in Schools and Commercial Buildings.” epa.gov. U.S. Environmental Protection Agency, 18 Sept. 2008. Web. 9 Oct. 2009. <http://www.epa.gov/mold/append_b.html>. Gent, Janneane F. “Levels of Household Mold Associated with Respiratory Symptoms in the First Year of Life in a Cohort at Risk for Asthma.” Environmental Health Perspectives. Volume 10:12 (December 2002). Web. 9 Oct. 2009. <http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=1241132&blobtype=pdf>. Pekkanen, J. “Moisture Damage and Childhood Asthma: A Population-Based Incident Case-Control.” European Respiratory Journal. Volume 29:3 (2007). Web. 9 Oct. 2009. <http://www.ersj.org.uk/cgi/content/full/29/3/509>. “Facts About Mold.” nyc.gov. New York City Department of Health and Mental Hygiene, 2009. Web. 9 Oct. 2009. <http://www.nyc.gov/html/doh/html/epi/epimold.shtml>.

  22. References AAP - Journal of the American Academy of Pediatrics. Web. 19 Oct. 2009. <http://pediatrics.aappublications.org/cgi/reprint/101/2/e8>. "Environmental Tobacco Smoke and Adult-Onset Asthma: A Population-Based Incident Case-Control Study -- Jaakkola et al. 93 (12): 2055 --." American Journal of Public Health. Web. 19 Oct. 2009. <http://www.ajph.org/cgi/content/full/93/12/2055>. "Environmental Tobacco Smoke." Cancer Information | Cancer Meds | Leukemia | Colon Cancer | Lung Cancer | HIV/AIDS | Hepatitis | Mesothelioma. Web. 19 Oct. 2009. <http://www.meds.com/lung/smoking/environmental.html>. "Secondhand Smoke | Indoor Environmental Asthma Triggers | US EPA." U.S. Environmental Protection Agency. Web. 19 Oct. 2009. <http://www.epa.gov/asthma/shs.html>.

  23. Thank You!!! Questions???

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