Parents Efforts to Control Asthma in the Home Often Not Effective
Normally, air flows in and out of the bronchial tubes (airways to the lungs) unobstructed. In asthma, the airways become inflamed and air cannot pass easily into and out of the lungs. This inflammation is usually caused by an allergic reaction, which leads to swelling and tightening of the airways. Common substances present in a person’s surroundings can cause this inflammatory response. These substances are known as triggers, and a trigger in one person with asthma may not affect another person with asthma at all. Common examples of triggers include tobacco smoke, dust, or animal dander.
If a trigger can be identified, it stands to reason that it can be controlled. The National Heart, Lung, and Blood Institute (NHLBI) Guidelines for the Diagnosis and Management of Asthma urges physicians to educate patients about triggers and possible ways to control them. A study published in the August 2004 issue of the Journal of Allergy and Clinical Immunology looked at how well parents were doing when it came to addressing and controlling their children’s asthma triggers.
About the study
The study looked at 896 children between the ages of 2 and 12 with asthma, but with no other lung conditions. Trained interviews called the household of each child and spoke with the person who was usually responsible for health-related care of the child.
The interviewers asked different questions related to the child’s asthma and his or her household including:
- What are triggers to your child’s asthma?
- What specific action have you taken to rid your home of these triggers?
- Does anyone at home smoke?
- Have you received any education regarding asthma management from your child’s doctor?
On average, the respondents reported slightly more than two self-identified triggers per child. Of the triggers reported, 80% were specific environmental triggers (environmental triggers include things such as plants, animals, dust, mold, and air quality). The majority of respondents (81%) did make an attempt to control asthma triggers.
The most common types of actions taken to control asthma triggers reported in the study were:
- Purchasing special air filters
- Reducing a child’s exposure to dust
- Using a specialized vacuum for cleaning
- Purchasing special bedding
- Increasing cleaning of the house in general
- Reducing exposure to animals
The researchers found that of the actions taken to control asthma triggers, 51% of these actions were not likely to be useful for the specific trigger the parent reported. For example, 224 respondents reported buying an air filter, but only 157 reported an asthma trigger that the filter could possibly control.
Of the 1,788 actions taken to address environmental triggers, the researchers reported:
- 744 (42%) were recommended actions: considered consistent with the NHLBI guidelines
- 123 (7%) were reasonable actions: might be thought by some clinicians to be helpful, but did not have supporting evidence
- 916 (51%) were neutral actions: no known positive or negative effects
- 5 (1%) were not recommended: specifically identified as harmful and discouraged in the NHLBI guidelines
The five actions taken that were not recommended were the same: the purchase of a humidifier when the child’s trigger included house dust mites, which thrive in humid environments.
The NHLBI has described tobacco smoke as the most important environmental indoor irritant. The researchers found that 24% or 216 children in this study lived in a home with a smoker. Additionally, only 16 of these 216 families reported any attempt to reduce or eliminate smoke exposure.
Overall, receiving asthma education and more frequent doctor’s office visits increased the likelihood of attempting any action to control asthma triggers.
How does this affect you?
Asthma is a serious condition that can profoundly affect a child’s life. It is major cause of absenteeism from school and can severely restrict a child’s participation in sports and other recreational activities. And, in severe cases, it can be life threatening.
With the incidence of asthma rapidly rising in children, parents need to be educated on how they can help their children. The study’s authors feel that because so many parents are trying some type of action, they must be looking for more information and support to better help their child. But, they also suggest that the information is coming from the wrong places—television and magazines advertisements, rather than their child’s doctor.
If your child has asthma, ask your doctor what the possible triggers could be and the appropriate steps you can take to help control them. Also, ask for reliable sources of information based scientific evidence. And, most importantly, if there are any smokers in the house, make sure they keep to their own lungs and take it outside.
American Academy of Allergy, Asthma and Immunology
American Academy of Pediatrics
Asthma and Allergy Foundation of America
National Institute of Allergy and Infectious Diseases
Asthma basics. National…website. Available at: http://www2.niaid.nih.gov/newsroom/focuson/asthma01/basics.htm . Accessed August 17, 2004.
Cabana MD, et al. Parental management of asthma triggers within a child’s environment. Journal of Allergy and Clinical Immunology . 2004;article in press.
Nine million US children diagnosed with Asthma, new report finds. Centers for Disease Control and Prevention website. March 31, 2004. Available at: http://www.cdc.gov/od/oc/media/pressrel/r040331.htm . Accessed August 16, 2004.
What is asthma? National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/dci/Diseases/Asthma/Asthma_WhatIs.html . Accessed August 17, 2004.
Last reviewed Aug 19, 2004 by
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