Children with asthma living in the inner city, are exposed to multiple indoor allergens and tobacco smoke in their homes, states a recent issue of the New England Journal of Medicine. A study was performed to determine the role of environmental intervention, tailored to each child’s allergic sensitization and risk factors in improving asthma-related outcomes.
The family was provided with knowledge, skills, motivation, equipment and supplies necessary to perform the intervention. This included remediation of exposure to dust mites, passive smoking, cockroaches, pets, rodents, and mould. A safe sleeping zone was also created.
Allergen-impermeable covers were placed on the mattress, box spring, and pillows of the child’s bed. A vacuum cleaner equipped with a high-efficiency particulate air filter and a power brush was provided for cleaning the floor. An air purifier was set up in the bedroom if exposure to passive smoking, cat, dog or mould allergens were present. For children sensitized and exposed to cockroach allergen, professional pest control was arranged.
Significantly fewer symptoms of asthma during both the intervention year and the follow-up year were reported. A greater reduction in asthma-related symptoms occurred within two months and were sustained for two years. There were also significant reductions in the disruption of the family’s routine, parent’s and children’s lost sleep, and missed school days. Unscheduled asthma-related visits to the emergency department or clinic, decreased during the intervention year.
Allergen levels, especially of cockroaches, can be successfully reduced in the homes of inner-city children with allergic asthma by appropriate intervention. — Dr Fatema Jawad
Pollutants and diseases
The numbers of sufferers of brain diseases, including Alzheimer’s, Parkinson’s and motor neurone disease, have soared across the West in less than 20 years, scientists have discovered.
The alarming rise, which includes figures showing rates of dementia and have trebled in men, has been linked to rises in levels of pesticides, industrial effluents, domestic waste, car exhausts and other pollutants, says a report in the journal Public Health.
In the late 1970s, there were around 3,000 deaths a year from these conditions in England and Wales. By the late 1990s, there were 10,000.
“These are nasty diseases: people are getting more of them and they are starting earlier,” said Professor Colin Pritchard of Bournemouth University, one of the report’s authors. “We have to look at the environment and ask ourselves what we are doing.”
The report, which Pritchard wrote with colleagues at Southampton University, covered the incidence of brain diseases in the UK, US, Japan, Australia, Canada, France, Germany, Italy, Netherlands and Spain in 1979-1997. The researchers then compared death rates for the first three years of the study period with the last three, and discovered that dementias — mainly Alzheimer’s, but including other forms of senility — more than trebled for men and rose nearly 90 per cent among women in England and Wales. All the other countries were also affected.
For other ailments, such as Parkinson’s and motor neurone disease, the group found there had been a rise of about 50 per cent in cases for both men and women in every country except Japan. The increases in neurological deaths mirror rises in cancer rates in the West.
The team stresses that its figures take account of the fact that people are living longer and it has also made allowances for the fact that diagnoses of such ailments have improved. It is comparing death rates, not numbers of cases, it says.
As to the cause of this disturbing rise, Pritchard said genetic causes could be ruled out because any changes to DNA would take hundreds of years to take effect. “It must be the environment,” he said.
He added that the causes were most likely to be chemicals, from car pollution to pesticides on crops and industrial chemicals used in almost every aspect of modern life, from processed food to packaging, from electrical goods to sofa covers.
Food is also a major concern because it provides the most obvious explanation for the exclusion of Japan from many of these trends. Only when Japanese people move to the other countries do their disease rates increase.
There are an estimated 80,000 industrial chemicals in use and “for the vast majority of chemicals we have so little safety data that the regulatory authorities have no idea what a safe level is,” says Matthew Wilkinson of the World Wildlife Fund.
“There’s no one single cause ... and most of the time we have no studies on all the multiple interactions of the combinations on the environment. I can only say there have been these major changes (in deaths): it is suggested it’s multiple pollution,” says Pritchard. — Samina Iqbal
