Asthma is challenge for city children

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More than 80 percent of a group of inner-city Pittsburgh children with known asthma had poor care in controlling the disease, a study by local researchers has found. The study also found that in a group of children who had never been told they had asthma, nearly half failed a screening test, indicating they could have the disease.

Concluding that more effort in the community needs to be done to help these children and others like them, researchers from Allegheny General Hospital and the Duquesne University School of Pharmacy presented their results Sunday at the annual meeting of the American Academy of Allergy, Asthma and Immunology in New Orleans.

"There may not be one single reason" for the high numbers, said lead researcher David Skoner, director of Allegheny General's Division of Allergy and Immunology. The study screened 69 youngsters in an afterschool program at a Hill District church.

"You can draw no conclusions from this population," Dr. Skoner said. "We weren't in the homes to test parents' knowledge of anything." More research is planned.

"But in general terms, children in the inner city have significantly more problems," the allergist added. Urban children are exposed to allergens such as heavy tobacco smoke, cockroaches, and/or pollution emanating from traffic on nearby highways.

"One other thing to keep in mind [is] a main caregiver for these kids is at school," Dr. Skoner said. "They may have parents who don't listen to advice or don't have the ability to get to a doctor or maybe it's just the lowest priority that day when other things are going on. ... Sometimes parents don't trust the medical system to be able to help."

The asthma control study measured the children's height, weight and lung function and then evaluated them for the presence of asthma and how well its symptoms of inflammation were under control. Uncontrolled asthma can lead to more serious asthma attacks, often requiring emergency trips to the hospital.

Seventeen, or 24 percent, of the children were known to have asthma, and 14 of those children, or 82 percent, had poor control over the symptoms, the researchers found. Among the group with no prior asthma diagnosis, 25 children failed the asthma screening test, indicating those children needed further evaluation and possible treatment.

About half of the 69 children were either overweight or obese, still another significant problem for the at-risk group.

"A lot of kids there probably can't run because of asthma," Dr. Skoner said. "They can't run, they put on weight. Weight can contribute to asthma, and asthma can contribute to weight. It's a little bit of a vicious cycle."

Allegheny General also presented a second study suggesting that low levels of vitamin D among asthmatic children between the ages of 6 and 12 may result in worse symptoms.

An Allegheny General team led by allergist and chief department researcher Deborah Gentile looked at the levels of vitamin D in 60 children: 20 with what's commonly known as hay fever and asthma; 20 with hay fever; and 20 with neither disease.

Low levels of the vitamin already have been seen as possible contributing factors to children developing asthma.

The researchers found that the children with both hay fever and asthma had the lowest vitamin D levels, while the children with hay fever only also had lower vitamin D levels compared to the children with neither ailment.

But studies so far are preliminary, and more research is needed, Dr. Skoner said.

The abstracts will be printed in a supplement to the Journal of Allergy and Clinical Immunology.

Pohla Smith: or 412-263-1228.


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