Doctors lack data to prevent asthma

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http://www.tennessean.com/sii/00/05/31/asthma31.shtml

5/31/2000

Doctors lack data to prevent asthma

By Bill Snyder / Staff Writer

Asthma is on the rise in Tennessee but because of a lack of information,

health officials admit they do not know the best way to prevent the chronic

lung disease.

" We don't have a comprehensive picture of asthma in Tennessee, " said Dr.

Dennis C. Stokes, a pediatric lung specialist at Vanderbilt Children's

Hospital. " Given the amount of money spent on asthma and the impact on

schools and families, it's sad we don't track it. "

Stokes was attending a luncheon yesterday, the purpose of which was to

introduce Health-Track, a new public health initiative that is calling for

better monitoring of chronic diseases and the environmental factors that may

contribute to them.

" We are blindfolding our public health professionals, our own communities,

by not collecting these data, " said Jim O'Hara, executive director of

Health-Track, which is based at town University in Washington, D.C.,

and supported by the Pew Charitable Trusts.

" As a nation, we have not made the investment we need to provide our

communities, our public health professionals, our researchers with the kind

of information that will allow them to make progress in stopping the rise of

many of these diseases, " O'Hara said during the luncheon at the Vanderbilt

University Club.

Asthma is a chronic inflammation of the airways in the lungs that causes

coughing, wheezing and shortness of breath.

An estimated 290,000 Tennesseans, including nearly 82,000 children younger

than 18, suffer from the disease, according to a 1996 survey, the latest

data available.

Nationwide, the prevalence of asthma more than doubled from 1980-95, to 14.6

million people. Without effective prevention, that figure will nearly double

again by the year 2020, said O'Hara, a former federal health official and a

former Tennessean reporter.

Asthma attacks can be triggered by allergic reactions to pollen, dust mites,

tobacco smoke, pollution and other airborne irritants.

The American Lung Association recently gave Nashville, Knoxville and 118

other major metropolitan areas across the country an " F " for high levels of

ozone, a prime ingredient of smog.

Last fall, the Tennessee Clean Air Task Force estimated that ozone triggers

19,000 asthma attacks each summer in Nashville alone. But the link between

ozone levels and asthma has not been well studied, health officials said.

Experts are even less certain about the alarming increase in the prevalence

of the disease, but theories include:

.. People spend more time indoors, increasing exposure to mold and dust

allergies.

.. Vaccinations, by preventing many infections, somehow throw the immune

system out of balance, making children more prone to allergies.

.. Asthma may be linked to lack of exercise and the rise in obesity among

children.

Because of the lack of data, however, " we don't know which of these is

correct, " Stokes said.

Officials also are at a loss to explain why African-Americans are more

likely to suffer from asthma. Is it lack of access to health services, or

are predominantly African-American neighborhoods more likely to be in highly

polluted areas?

" We need health data, environmental hazard data and exposure data, " O'Hara

said.

The U.S. Centers for Disease Control and Prevention spends $10 million

annually on tracking asthma and supporting treatment efforts in the states.

Researchers have estimated that a comprehensive national tracking program

would cost $25 million annually.

Stokes said the CDC should take the lead on developing such a program. State

" health departments don't have the resources without the help of the CDC, "

he said.

Bill Snyder covers health care for The Tennessean. He can be reached at

(615) 259-8226 or bsnyder@... .