Kids with asthma breathe easier away from air pollution

Better air quality is associated with a significant reduction of airway inflammation in kids with asthma, according to a new study.

Researchers report that just 1 week after a group of school-age kids left an urban area for a rural one, airway inflammation went down and "virtually every single child more or less increased pulmonary [lung] function."

The study recruited 37 children with mild but persistent untreated asthma who lived in a highly polluted urban environment and moved them to a less polluted rural area.

After 7 days, researchers noted that most of the kids had a rapid and highly significant improvement in lung function. While other studies have shown that pollution exposure increases airway inflammation, this is the first to suggest that this effect might be reversible.

The study concludes that some kids with asthma may need much less or even no asthma medications if they breathe cleaner air. But, of course, that’s not possible for many kids with asthma, so the researchers urge officials to work to "clean the air in cities. Our situation in the US has improved, but there’s much more to do."

Although ozone has received a great deal of press, it’s not the only pollutant that causes poor air quality. In 2004, the American Lung Association also included particle pollution levels in its annual "State of the Air" report for the United States.

Particle pollution refers to tiny particles of acids (such as nitrates and sulphates), dust, dirt, smoke, soot, and droplets from aerosols that are suspended in the air we breathe. The smaller the particles, the deeper they can get into the lungs, where they cause problems.

Twenty-three percent of the population of the United States, including 1,500,000 kids with asthma, live in areas with levels of particle pollution that are unhealthy year-round.

If you live in an area with poor air quality, it might not be possible to completely eliminate your child’s exposure, but you can minimise it by monitoring pollution levels and planning accordingly when they’re going to be high.

The Air Quality Index (AQI), created by the Environmental Protection Agency (EPA), monitors outdoor air quality by measuring levels of five major air pollutants in 700 US counties. The AQI uses a colour-coded system to indicate when air quality is dangerous. Green or yellow are acceptable colours, and orange, purple, or maroon mean kids should limit their time outdoors.

The AQI varies from season to season, day to day, and even from morning to evening. In cities of more than 350,000 people, state and local agencies are required to publicly report the index daily, but many smaller communities also do so. Your area also might report the next day’s index, allowing you to plan ahead.

On days when air quality is poor, run the air conditioning and limit your child’s time outside. Plan any outdoor activities for early in the day – when air quality tends to be better – and avoid spending time in areas where there’s a lot of traffic.

If your child participates in a sport that practices outside during hot weather, you should talk to the coach about alternate arrangements, such as working out in an air-conditioned gym. Also, make sure your child always has his or her rescue medication on hand.

Improving the air quality in your home is also a good idea. You can do this by using an air cleaner, venting all gas appliances to the outside, and avoiding wood fires in your house.

You should also talk to your child’s doctor about increasing medication during times when air pollution is high. This can be included as part of your child’s asthma action plan.

(Source: Nemours Foundation: Pediatrics: April 2009)