Study may give asthmatic kids more breathing room

A study by the National Jewish Medical and Research Center in Denver, Colorado, shows how surges in air pollution affect asthmatic children

February 1, 2000
Web posted at: 12:04 p.m. EST (1704 GMT)

By Environmental News Network staff

Inner-city children with severe asthma may soon breathe easier as a result of a study in progress in Denver, Colorado.

Armed with a $220,000 grant from the U.S. Environmental Protection Agency, Dr. Nathan Rabinovitch hopes to learn how surges in air pollution levels impact severely asthmatic children living in urban areas. By monitoring changes in air quality, physicians may be able to predict asthma attacks hours or even days in advance.

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"We hope to determine the amount of time between a sharp rise in pollution levels and the start of the kids' asthma symptoms," said Rabinovitch, an asthma specialist at the National Jewish Medical and Research Center in Denver.

"So far, studies have not been consistent in identifying how long this takes," Rabinovitch said. "If we find, for example, the lag time is five days, in that time we can run tests to see what body mechanisms are affected. This will give us an idea where to go with further research and treatment options."

"This study has the potential of giving the strongest data ever collected about the impact of air pollution on children with asthma," he added.

The study could also have a bearing on current air-quality standards set by the EPA, said Rabinovitch. Congress is currently mulling proposals to tighten these rules.

About 5.3 million children in the United States have asthma, which accounts for 10 million absences from school each year. "The quality of asthma medications has increased, but childhood asthma continues to get worse and more children are dying," Rabinovitch said.

The asthma study, which began Nov. 15, involves 40 asthmatic children ages 6 to 12, all of whom attend the Kunsberg School at National Jewish. Twice during the school week, the researchers record the time each child takes his asthma medication. They also rate the child's asthma symptoms at the time.

This information is correlated with data from air-pollution monitoring devices placed in areas frequented by the students, including the inside of the school, the school parking lot and downtown Denver.

In another phase of the research, 10 of the students are carrying monitors that gather samples of the air continually. The mechanism is about the size of a paperback book and weighs two pounds. The children carry the device in a backpack that they will wear for the duration of a school day, five days a week, for four weeks.

The monitors measure each student's exposure to airborne matter in his day-to-day environment at school, outdoors and at home. Twice a day, the researchers change filters to analyze the amount of particulate found the air samples.

The portable monitors and stationary monitors at the school will help tell researchers whether the measurements from the downtown monitor are a good gauge of particulate exposure. It may be that day-to-day pollution levels at school and in the home are the biggest enemy of asthmatic children, said Rabinovitch.

Rabinovitch and his colleagues are in the middle of the first stage of the study, which will continue through March 15.

The next phase will take place from Nov. 15 to March 15, 2001. During this time, the researchers will conduct blood and sputum tests during spikes in air pollution, hopefully with the same group of children. In their analysis, they will be looking for eosinophils, or marker cells for asthma.

They will also try to determine whether airborne particulate causes wheezing in asthmatic children in the same way that allergens cause wheezing in allergic people. It is possible, said Rabinovitch, that asthmatic wheezing is a result of another kind of reaction to the particles.

Though the study is not focused on minority children, Rabinovitch notes that 75 percent of the youngsters being tested represent minority groups. The research might shed light on why minority children in the inner city tend to suffer more from asthma than their white counterparts, he said.

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