The Science Journal of the American Association for Respiratory Care

2001 OPEN FORUM Abstracts

PILOT SURVEYTO DETERMINE POTENTIAL INDOOR TRIGGERS OF INNER-CITY CHILDREN WITH ASTHMA.

Marsha A. Rogers CRT, RobertChatburn RRT, FAARC, Timothy R. Myers BS, RRT. Rainbow Babies and Children'sHospital, Cleveland, OH.

Introduction: Asthma is achronic inflammatory airway disease that affects approximately 5 million childrenin the United States. While asthma is the most common discharge diagnosis inpediatric hospitals, it also accounts for significant daily morbidity. Childrenwith asthma tend to have increased airway sensitivity to a variety of stimuli,such as allergens, irritants, and viruses. Often, an offending environmentaltrigger can in large part be located within the patient's own home. While asthmaticfamilies appeared to have a solid foundation of knowledge in relation to thedisease and medications prescribed, this knowledge base appears inadequate inidentifying causative triggers (Resp Care 1998; 43(10) 844). Asthma triggereducation could potentially be streamlined to specific, common indoor inner-cityallergens if they could be identified. The purpose of this study was to identifyspecific indoor asthma triggers or trigger categories present in inner-cityhomes.

Methods: Over a 3-month period(May-August), all family caregivers of patients admitted to our Asthma CareUnit (ACU) were asked to complete a questionnaire to identify indoor asthmatriggers that were present in their place of residence. The questionnaire wasdesigned to identify allergens by category; Second-hand Smoke, Dust Mites, Fumes,Pets, Pests and Mold. Each main trigger category had specific allergens andsome potential preventative or causative behaviors.

Results: A total of 113 childrenand their families participated in this descriptive pilot study on Inner-cityindoor asthma triggers. Presence of indoor triggers identified by families rangedfrom 0-11 triggers (out of a possible 22 listed). The average number of identifiedindoor triggers per home was 5.2. The five most prevalent sources of potentialtriggers in this cohort of patients were: carpeting in child?s bedroom (76.1%),presence of gas stove (72.6%), carpeting in "television" room (63.7%), presenceof stuffed animals in the child's bedroom (60.2%) and exposure to second-handsmoke (32.7%). On a preventative note, the following percentages of familiesreported potential positive trigger remediation behaviors: washing of bed linens>1 time/week (87%), vacuuming of carpets >2 times/week (78.8%), householdsreporting no smokers (76.6%) and presence of dust proof casings on pillows andmattresses (25.7%). In the tables below are results reported for presence oftriggers by category (averages) and identified triggers per household (percentages). 

IdentifiedTriggers by Category

Dust Mites2.28 Pets1.18
Fumes1.65 Pests1.09
Second-handsmoke1.36 Molds0.50
IndoorTriggers Present per Household
None2 (1.8%) Six22 (19.5%)
One2 (1.8%) Seven15(13.3%)
Two4 (3.5%) Eight7 (6.2%)
Three 10 (8.6%) Nine 2 (1.8%)
Four 24 (21.2% Ten 1 (0.9%)
Five 22 (19.5%) Eleven2 (1.8%

Conclusion:Most inner-city asthmatic families that participated in this study had exposureto significant amounts of indoor allergens in their own homes.

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