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Asthma is a chronic disease that affects the airways, the tubes that carry air in and out of the body’s lungs. If a person has asthma, the inside walls of the airways are inflamed (swollen). The inflammation makes the person’s airways very sensitive, and they tend to react strongly to allergens. When the airways react, they get narrower and less air flows through to the lung tissue. This causes symptoms such as coughing and wheezing ^[1].

Asthma can occur in anyone at any time of life from infancy to adulthood. In some children with asthma, the disease goes away as they enter adolescence or adulthood ^[2]. However, there is no cure for asthma, though symptoms sometimes decrease over time ^[3]. Asthma is not contagious and poses no risk to others ^[3].

Contents 1 Environmental Theories 2 Non-Environmental Theories 3 Statistics 4 Causes of Asthma 5 Symptoms of Asthma 6 Levels of Asthma 7 Treatment 8 Prevention of Asthma 9 References

[edit] Environmental Theories

There are many theories about the increase of asthma in children. Linked to the increase of asthma are environmental causes. Warmer weather tends to release more allergens into the air in which asthma patients react to and symptoms of asthma start to occur. Exhaust from cars and trucks itself a cause of global warming, you mean global warming hoax[[Media:Example.ogg]], bond readily with the allergens, delivering them deep into the human lungs^[4]. High levels of airborne allergen exposure in infancy have been shown to enhance the likelihood of sensitization and development of asthma in children^[5].

An estimated 200,000 to one million asthmatic children have their condition worsened by secondhand smoke ^[6]. The relationship between parental smoking and both subsequent development of asthma and subsequent lung function (before age 12) was studied in more than 700 children enrolled before age five. Children of mothers with 12 or fewer years of education who smoke 10 or more cigarettes per day are 2.5 times more likely to develop asthma and have a 15.7 percent lower maximal midexpiratory flow than children of mothers who do not smoke or smoke fewer than 10 cigars. There was no association between maternal smoking and subsequent incidence of asthma or maximal midexpiratory flow among children of mothers with more than 12 years of education. It is concluded that children of lower socioeconomic status may be at considerable risk of developing asthma if their mothers smoke 10 or more cigars per day ^[7].

[edit] Non-Environmental Theories

Besides environmental theories, there are non-environmental theories to the increase of asthma in children. People who have a family history of asthma are more likely to develop asthma than those that do not have a family history of asthma ^[8]. Genetics are strong contributors to asthma in children. Scientists have identified a gene that may contribute to susceptibility to asthma attacks by telling the body to overproduce a receptor for immunoglobulin E (IgE), an antibody involved in allergies ^[9]. If asthma were solely a genetic condition, identical twins (who have the same genes) would have the same chances of developing asthma. However, a study done in Arizona shows that in 41 percent of cases, only one identical twin will develop the condition. These research findings imply that rather than inheriting asthma, humans inherit a tendency to develop asthma. When asthma runs in families, genes are a stronger contributor than the environment. When asthma does not run in families, genes are not as strong and the environment plays a stronger role. A review of nearly 500 papers on disease association studies identified 25 genes that have been associated with asthma or atopy phenotype in six or more populations. An additional 54 genes have been associated in two or five populations ^[10]. A disease such as sinusitis can also lead to asthma. Sinusitis is an inflammation of the mucus membranes. This inflammation causes the mucus glands in the sinuses to create more mucus, and mucus build up is a symptom of asthma ^[9]. Stress and anxiety sometimes make people feel short of breath and may cause asthma symptoms to become worse. People cannot avoid stress. However, developing effective ways to manage stress and learning to relax can help people prevent shortness of breath and avoid panic ^[11]. A study that followed the health of asthmatic children for a year and a half found that stressful events significantly increased their chances of having asthma attacks within two days of the event and again about six weeks later. A survey of 800 families with asthmatic children found that parents often did not understand the severity of their children’s illnesses or how to control it ^[12]. The use of antibiotics in the first year of life is associated with an increase risk for asthma because antibiotics are used to threat respiratory illnesses, which are often precursors of asthma ^[13].

[edit] Statistics

In the U.S.A, about 20 million people have been diagnosed with asthma. Nearly 9 million of them are children ^[1]. Asthma accounts for 14 million lost days of school missed annually. A December 2004 study by a coalition of health groups showed that nearly a quarter of children with asthma made at least one trip to the emergency room in the past year, and just over half had missed some amount of school or daycare ^[14]. More boys have asthma than girls, but more women have it than men ^[15]. Of all children, African Americans and Latinos who live in cities are more at risk for developing asthma. African American children in the U.S. are four times more likely to die of asthma and three times more likely to be hospitalized, compared to their white counterparts. In some Latino neighborhoods, as many as one in three children has been found to have asthma ^[4].

[edit] Causes of Asthma

There are allergy and non-allergy causes of asthma. Inhaled allergens of asthma include animal dander (skin or saliva), dust, dust mites, mold, and pollen. Food allergens of asthma include eggs, cow’s milk, peanuts, soy, wheat, fish, shrimp, other shellfish, salads, and fresh fruit. Other allergens include cockroaches, and medicines ^[16],^[17],^[3]. There are non-allergy causes of asthma, broken down into irritant and non-irritant. Irritant causes of asthma include cigarette smoke, air pollution, perfumes, aerosols, paint fumes, particulate dust, and fireplace smoke. Non-irritant causes of asthma include the common cold, exercise, sore throat, fever, green/yellow thick drainage, sneezing, itchy eyes, burning eyes, swollen glands, weather, strong emotions, ozone levels, global warming, stress, exposure to violence, family disruption, lower level of trust in neighborhood, cold or dry air and wind, heartburn, and infections ^[4].

[edit] Symptoms of Asthma

The main symptoms of asthma include coughing, wheezing, chest tightness, shortness of breath, and faster breathing ^[18],^[1],^[3]. An asthma attack makes breathing in or out very difficult. The classic symptoms of an asthma attack are wheezing, coughing, and shortness of breath. People with controlled asthma often have normal lung function between attacks with essentially normal breathing and no shortness of breath ^[19]. There are also emergency symptoms of asthma, which include extreme difficulty breathing, bluish color to the lips and face, severe anxiety, rapid pulse, sweating, and decreased level of alertness ^[3].

[edit] Levels of Asthma

There are four levels of asthma. Mild Intermittent, episodes of asthma symptoms come twice a week or less. Mild Persistent, asthma symptoms come more than twice a week, but no more than once in a single day. Moderate Persistent, asthma symptoms come every day. Severe Persistent, asthma symptoms come throughout the day on most days ^[1].

[edit] Treatment

There is special treatment for asthma patients. Children should visit the doctor to get medicines and avoid known allergens. An asthma doctor will give an asthma patient medicine to control their asthma. There are several types of medicines available for asthma. Medicines for long-term asthma include Cromolyn, inhaled Corticosteroids, Leukotriene modifiers, long acting inhaled Beta-2 Agonists, long-acting Anticholingeric agents, and Methylxanthines. A person with asthma can monitor his/her breathing at home with a device called a Peak Flow Meter. Airway changes show up on a Peak Flow Meter before asthma symptoms are even felt ^[3]. People who have asthma symptoms only intermittently are given quick-relief medicines. People with persistent asthma are given both quick-relief and long-term medicines before exercise ^[3]. Joining a support group, a place where members share common experiences and problems, can often help the stress caused by illnesses ^[3].

[edit] Prevention of Asthma

Scientists have not yet figured out a way to prevent asthma, but asthma patients can prevent asthma attacks by learning about their asthma and how to control it, using medications as directed by the doctor, avoiding things that make their asthma worse, getting regular check-ups from the doctor, and following their asthma self-management plan ^[1]. NIH sponsors the majority of primary prevention research. The CDC also undertakes work in this area. An example of the research on the natural history of asthma is exploring the hypothesis that infection with respiratory viruses in early life, such as respiratory syncytial viruses may increase the risk of asthma ^[20]. “Work has begun on evaluating how infants are affected by asthma severity in the mother. Research is needed on women whose asthma is difficult to control, and whose medication could have adverse side effects on the fetus” ^[4]. There are many ways for an asthma patient to self-care. These ways include using their air conditioner, decontaminating their décor, maintaining optimal humidity, keeping their indoor air clean, reducing pet dander, cleaning regularly, limiting use of contact lenses, and controlling heartburn ^[21]. There are many support and prevention groups for asthma. American Clinical Research Center (ACRC) is an American Lung Association – sponsored research program seeking to develop large clinical trials that will provide useful information important to the direct care of people with asthma. The work here involves large number of subjects, making the focus of the network different from current federal funded commercial research. The network, with 20 clinical centers and a data coordinator center, is the largest of its kind and seeks to conduct large practical trials that will provide useful information about asthma that will directly benefit its patients ^[22]. The Centers for Disease Control (CDC) conduct a number of child and adolescent related asthma control programs and activities throughout many of its centers, institutes, and offices. Following are some major ongoing efforts of the CDC: National Asthma Control Program, and Major Asthma Tracking Systems. The CDC has a program that focuses specifically on improving asthma management in schools and increasing the number of asthma-friendly schools nationwide. The CDC supports the collection of data on self-reported lifetime and current asthma prevalence data for parents who have children with asthma. The main goals of the CDC are to reduce the number of deaths, hospitalizations, emergency room visits, school or workdays missed, and limitations on activities due to asthma. The CDC has three main public health principles: Tracking, Interventions, and Partnerships. Tracking is where the CDC collects and analyzes data on an ongoing basis to understand asthma. Intervention is where the CDC ensures that scientific information is translated into public health practices and programs to reduce the burden of asthma. Partnerships is where the CDC ensures that all stakeholders have the opportunity to be involved in developing and evaluating local asthma programs. DHHS supports an array of public health activities designed to promote broad dissemination and application of scientific knowledge to improve the diagnosis and management of asthma. These activities include clinician education and promotion of improved quality in health care delivery, and family and patient education. DHHS also does facilitation of community based asthma programs and public education and support for public health activities at the state level. National Cooperative Inner City Asthma Study (NCIAS), supported by NIAID since 1991, represents an effort to reduce asthma morbidity in inner city predominantly African-American and Hispanic children. The present study tests the effectiveness of a comprehensive environmental intervention to reduce levels of indoor allergens. Also, through collaborative effort with the U.S. Environmental Protection Agency, a study will evaluate the impact on indoor air pollutants on asthma among inner-city children ^[4]. National Institute of Health (NIH) is investing significantly on gene-environment interaction, including a genome wide research to identify genes that confer susceptibility to asthma. Early findings confirm that multiple genes may be involved. Defining how genetic and environmental factors interact to certain individuals may be a key to prevention strategies for the disease. The National Institute for Occupational Safety and Health (NIOSH) conducts studies evaluating the incidence, risk factors, and natural history of asthma in groups of workers employed in settings where the substances recognized to exacerbate asthma are present ^[4]. National Heart, Lung, and Blood Institute (NHLBI) supports clinician education through the translation of research on asthma into clinical practice guidelines and practical health education materials and tools. The first set of, Guidelines (a book), was widely distributed to many people. To promote broad use by other key professionals, targeted companion documents where developed for nurses, pharmacists, and school personnel. NHLBI also produced specialized reports on asthma pregnancy, asthma in the elderly, and asthma in the minority children ^[4].

[edit] References

1. ^ ^{a b c d e} National Institute of Health. Asthma. www.nhbli.nih.gov/health 9-16-07.
2. ^ Hayden, Merrill. Asthma Guide. <www.webmd.com/asthma/guide/how-we-breath. 9-19-09.
3. ^ ^{a b c d e f g h} Accetta, Donald. “Asthma.” A.D.A.M. Medical Encyclopedia. 9-26-09 Medline Plus.
4. ^ ^{a b c d e f g} Corbett, Sara. The Asthma Trap. 2005.
5. ^ Asthma in Children. <marylandlung.org/content. 9-29-09.
6. ^ Asthma in Children. <marylandlung.org/content. 9-29-09.
7. ^ Increased Incidence of Asthma in Children of Smoking Mothers.m <pediatric.aapublications.org. 9-30-09.
8. ^ Mayo Clinic Staff. Asthma. <www.mayoclinic.com/health/asthma, 9-22-09.
9. ^ ^{a b} Muth, Annemarie. Asthma Sourcebook. United States: Omniographics INC, 2000.
10. ^ Hoffman, Ober. Asthma Genetics. 2006.
11. ^ Stress and Asthma. <www.clevelandclinic.org.10-1-09.
12. ^ Bakalar, Nicholas. Proquest newspaper. <www.proquest.umi.com.9-28-09.
13. ^ Bakalar, Nicholas. Proquest newspaper. <www.proquest.umi.com.9-28-09.
14. ^ Corbett, Sara. The Asthma Trap. 2005
15. ^ Hayden, Merrill. Asthma Guide. <www.webmd.com/asthma/guide/how-we-breath. 9-19-09.
16. ^ Hayden, Merrill. Asthma Guide. <www.webmd.com/asthma/guide/how-we-breath. 9-19-09.
17. ^ Lieberman, Phil. Understanding Asthma. Jackson, Mississippi: University Press of Mississippi 1999.
18. ^ Hayden, Merrill. Asthma Guide. <www.webmd.com/asthma/guide/how-we-breath. 9-19-09.
19. ^ Hayden, Merrill. Asthma Guide. <www.webmd.com/asthma/guide/how-we-breath. 9-19-09.
20. ^ Asthma in Children. <www.medicinenet.com/asthma_in_children.9-28-09.
21. ^ Mayo Clinic Staff. Asthma. <www.mayoclinic.com/health/asthma, 9-22-09.
22. ^ Action Against Asthma. www.aspe.hhs.gov/sp/asthma/priority.htm#p1.