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Asthma in Children

What's the Problem?

Asthma is a chronic inflammatory disorder of the airway passages in the lungs. Episodes or “attacks,” occur when the airways narrow after a viral infection, during exercise, or exposure to triggers such as animal dander, dust mites, cockroach particles, pollen, tobacco smoke, air pollution, or chemical irritants. Symptoms of an asthma attack or episode include coughing, wheezing, chest tightness, and difficult breathing. In worst cases, asthma results in death.

Currently, there is no way to prevent the initial onset of asthma, and there is no cure. In 2001 an estimated 31.3 million people in the United States reported that they had been diagnosed with asthma sometime in their lives. An estimated 20.3 million of these people reported being currently diagnosed with asthma and 12 million had experienced an asthma attack in the previous 12 months. In 2000, asthma accounted for 10.4 million outpatient visits, 1.8 million emergency department visits, 465,000 hospitalizations, and 4,487 deaths. People with asthma collectively experience 100 million days of restricted activity each year.

In 2001, asthma, one of the most common chronic diseases among children in the United States, affected about 6.3 million children. In 2000, there were 223 childhood deaths from asthma in the U.S., along with 728,000 emergency department visits and 214,000 hospitalizations. An estimated 14 million missed school days are attributed to asthma each year, and asthma is the third-ranking cause of hospitalization among those younger than 15 years of age.

Who's at Risk?

Although asthma rates differ only slightly by race, severe asthma hits hardest and disproportionately among poor, minority, inner-city populations. Emergency department visit rates have continued to slowly increase and large disparities persist. Compared to Caucasians, African-Americans have a rate three times higher for emergency room visits, hospitalization rates, and death rates.

Can It Be Prevented?

Currently, there is no way to prevent the initial onset of asthma, and there is no cure. However, people who have asthma can still lead quality, productive lives if they control their asthma. People can control their asthma by working with their doctors to develop and follow a personalized asthma management plan; taking asthma medication when and as prescribed by the doctor; and avoiding contact with environmental asthma triggers.

The Bottom Line

Although asthma remains a serious health problem, people with asthma can still control their disease and lead quality, productive lives. People with asthma can control their disease by: working with their doctors to develop and follow an asthma management plan; taking medications as prescribed; and avoiding asthma triggers. Children who suffer from asthma require medication quickly when an attack occurs, so careful supervision is necessary during high pollution days. Early medical management and reduced exposure to environmental triggers allows many children to live normal lives, sometimes outgrowing their asthma.

The consequences of not managing asthma are substantial: reduced quality of life, missed school and work days, illness, doctor and emergency room visits, hospitalizations, financial hardship due to medical bills that could have been avoided, and even death.

Case Example

High pollution warnings are in effect when seven-year-old David suffers a severe asthma attack on the way home from school. Mrs. Jones, the neighbor who usually watches David in the afternoon asks if he has an inhaler (asthma medication) in his backpack. He says he doesn't because his school won't permit kids to carry medication. There is an inhaler in the school nurse's office if he needs one at school, but only empty inhalers in the apartment. The boy admits his mother had no money for refills. As his breathing worsens, Mrs. Jones tries to phone his mom at work, but can't reach her. Mrs. Jones rushes David to the busy emergency room of the local trauma center. They wait for another 30 minutes before the doctor can see David. The frightened mother arrives from work and realizes the delays and lack of medication have created a life-threatening situation. After several hours of intensive treatment and an overnight stay with IV medication, David is released. The next day, a case worker from the hospital visits to work with David's mother to help her manage her son's asthma.

 

Page last modified on November 11, 2003


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