May 4, 2005
NEW ORLEANS - Asthma kills about 5,000 Americans every year. About a third of the children who die from asthma were considered to have mild asthma and had no previous hospital admissions for the lung disease.
"The number of deaths annually is absolutely appalling," says Jane El-Dahr, professor of pediatrics in allergy and clinical immunology at Tulane University Health Sciences Center. "With the current medications and understanding we have today about asthma, there is no reason for anyone to die. These are unnecessary deaths," says El-Dahr, who is incoming president of the Louisiana Society of Asthma, Allergy and Immunology.
More than 70 percent of people with asthma suffer from allergies. While most believe spring allergy season provokes the worst asthma symptoms, medical textbooks say September is the peak time for children to experience asthma attacks. In Louisiana residents are exposed year-round to pollinating grasses and mold.
Recent research conducted by El-Dahr and colleagues charted the number of emergency department visits of more than 3,000 children with asthma in three cities - New Orleans, Tucson and Charlottesville, Va. In Charlottesville, the number of emergencies peaked in September, just as the medical textbooks predict. But there was no spike in ER visits in New Orleans or Tucson at any time during the year.
In addition, other common allergens such as dust mites and cockroaches that thrive in the humid Louisiana climate can wreak havoc all year long on the respiratory systems of people with asthma.
"We would like to see people with asthma staying vigilant all year long, to maximize asthma control,' El-Dahr says. "Even a person with mild asthma can have a severe attack."
El-Dahr and her colleagues are working to implement using asthma action plans statewide. These customized, written guidelines for the asthmatic and the patient's family to follow clearly spell out the proper medications and when to use them; when to call the doctor; and when to go to the emergency department.
The asthma action plan outlines symptoms in three zones - green, yellow and red, with clear instructions. One plan is being piloted in the New Orleans area through a grant funded by the Centers for Disease Control and Prevention to the "Step Together New Orleans" program. In addition, the Louisiana Society of Asthma, Allergy and Immunology will be promoting to doctors a simple, one-page questionnaire to ask patients about their asthma.
Questions on the questionnaire include if the child woke up at night wheezing or coughing more than twice in the past month; if the child avoided exercise because of asthma symptoms; and if the child needed albuterol (a rescue medicine) more than twice a week in the past month.
Most asthma patients over-estimate the level of control they have over their disease, El- Dahr says, and parents over-estimate their child's level of control, despite the fact that nearly 50 percent of their children had to miss days of school.
"Parents need to know that asthma is a year-round problem, so good asthma control and monitoring should be year-round," El-Dahr says. For more information about asthma control, go to Better Control for Better Living at: www.sleepworkplay.com
Tulane University, New Orleans, LA 70118 504-865-5000 firstname.lastname@example.org