Study finds asthma and pollution exposure in children
At the start of each school year, Pennsylvania children are required to undergo a school physical exam for hearing, vision, growth and scoliosis. Should asthma be added to that list?
Pittsburgh pediatrician and asthma researcher Deborah Gentile reported Friday on a three-year study that found many of the 1,200 elementary school children who live near industrial sources of pollution were exposed to levels of outdoor air pollution above thresholds set by the U.S. Environmental Protection Agency and the World Health Organization. These children were found to have high levels of asthma.
The participants in the study came from eight schools near areas of air pollution including the U.S. Steel Clairton Coke Works, NRG’s Cheswick power plant and Braddock’s Edgar Thomson Steel Works. Among the schools, 68 percent of the eligible children elected to participate.
Dr. Gentile said mandated asthma screening could result in a more comprehensive understanding of the rate of childhood asthma in Pittsburgh. The study only counted students who have received a physician diagnosis of asthma. A mandated school screening could detect students who are undiagnosed or have a high risk for asthma. In the United States, California and Connecticut are the only states that monitor asthma rates through schools.
Todd Wolynn, president of Kids Plus Pediatrics, said asthma usually is diagnosed based on two or more episodes of distressed breathing because there are various causes of respiratory distress. He cautioned that sometimes screening can
result in unnecessary tests and expenditures.
Dr. Gentile said she was inspired to conduct her research after she saw schoolchildren with undiagnosed asthma and heard from school nurses who said that up to half of the students carried inhalers.
The findings indicated that children exposed to the highest levels of fine particles from industrial sources had 1.6 times the risk of an asthma diagnosis and nearly five times the rate of uncontrolled or severe asthma.
The asthma prevalence was 22.5 percent, more than double the U.S. Centers for Disease Control and Prevention’s national estimate of 8.6 percent for children and the State Department of Health’s rate of 10.2 percent.
“I wouldn’t say I’m surprised. I’m more sad that this is going on,” Dr. Gentile said.
Among the participants, 39 percent were exposed to levels of outdoor air pollution above EPA thresholds and 71 percent were above the WHO limit.
Lisa Smith, whose daughter participated in the study, said she tries to keep their home free from factors that trigger asthma such as smoke or pet dander.
Although her daughter’s asthma is controlled by medication, it still is a “day-to-day struggle.” Ms. Smith added that she found the study to be educational and would support a mandated asthma screen at Woodland Hills Intermediate School, where her daughter is enrolled.
Asthma Capitals, a 2015 report from the Asthma and Allergy Foundation of America on the most challenging places to live with asthma, rated Pittsburgh as the 27th out of the 100 largest U.S. metro areas, with the city having worsethan-average air quality and public smoke-free laws.
Allegheny County historically has had among the worst small-particle pollution levels in the nation.
Based on the report, Dr. Wolynn expressed concern about political discussions involving rolling back environmental protection policies. If that occurs, it could lead to more severe disease, she said.
“If you’re believing in data and evidence-based medicine … then you have to say, there’s a clear link between air pollutants and particulate matter and disease that could be mitigated by doing the appropriate measures.”
While eliminating air pollution would decrease asthma rates, Dr. Gentile said asthma occurs because of a variety of factors including genetics, nutrition and medical history. According to the Allegheny County health survey, asthma is more common among individuals with lower levels of education and income.
The neighborhoods in Dr. Gentile’s findings are lower-income and closer to point sources of pollution, perhaps, she said, because families with more money can afford to live elsewhere.
Dr. Gentile, who did her research in 2014-16 in her former position with the Allegheny Health Network, is now a member of the Division of Allergy, Asthma and Immunology for the Pediatric Alliance. She presented her findings Friday during a conference at the Renaissance Hotel, Downtown.