Childhood Asthma on the Rise

"There's something going on in the world around us," reports Swartz. "There are a lot of competing theories, but no one can account for the rise." Swartz explains that it's probably a complicated mixture of genetic and environmental changes. The good news is more and more controlled experiments are being done to find out why asthma is on the rise. "We understand more about how a particular asthma attack starts then why some kids get sick," adds Swartz.

Studies have shown such things as ozone, sulfur oxides, and chlorine in pools can affect asthma attacks. Indoor triggers include cockroaches, dust mites, furry pets, mold, tobacco smoke, and some chemicals. Swartz adds that pesticides and herbicides can also trigger asthma attacks. (When the chemicals are brought into the home—tracked in on the bottom of shoes or on clothes—they can get on rugs and furniture.) "If you get these substances inside the home, they don't break down as quickly," he explains.

Carbon monoxide exhaust, diesel fumes, and soot also impact asthma. "Atlanta is a notoriously congested city," Swartz says. "But during the 1996 Olympics there was a large reduction in traffic. There was also a reduction in hospitalizations [from asthma]." The study concluded that the reduction in traffic created a reduction in ozone pollution, which in turn reduced the number of acute asthma attacks.

Additionally, a British study published June 2003 in the journal The Lancet says children may be at increased risk of severe asthma attacks if exposed to nitrogen dioxide air pollution (such as that found in vehicle exhaust and gas grills) before they suffer a viral infection from a cold of flu.

Asthma rates vary across the country. Studies have shown that people of low-income, minorities, and children living in inner cities have higher rates of asthma. Besides urban areas, asthma is higher in areas that have large farming operations. "Major farming operations have a lot of truck and equipment traffic going on. These vehicles put out tremendous amounts of diesel," Swartz says. "The higher levels of pesticides, higher levels of diesel—we see some startlingly high asthma rates."

There are some simple things parents can do to decrease the chances of their child having an asthma attack:

• Choose bare wood or tile floors over carpeting in your home.
• Wash bedding in hot water once a week and limit or remove stuffed animals from your child's bed.
• Cut back on the time your child spends outdoors.

"I hate to tell people who have kids not to let them outside and exercise," Swartz says. But parents should be aware of air-quality conditions. When the air-quality index gets into the unhealthy stage—the orange or red levels—children should remain indoors.