American Lung’s Ongoing Battle:
For Everyone To Breathe Easily

by Darline Turner Lee, Physician Assistant, ACSM Exercise Specialist

Article Last Reviewed: Sept. 9, 2006

My daughter was seven months when she had her first asthma attack. It was subtle, just some faint wheezing at first. Then she developed this barking cough. I took her to the pediatrician and it was confirmed, she does have asthma.

It was really no surprise. Genetically my husband and I are a poor combination where allergies are concerned. My childhood history of infrequent asthma attacks has tapered to rare episodes now as an adult. My husband had severe asthma as a child and still has perhaps one major attack a year. My baby didn’t really have a chance-although I had hoped to spare her this potentially deadly nuisance.

According to the American Academy of Allergy, Asthma and Immunology and the American Lung Association, approximately twenty million Americans have asthma—of which six million are children under the age of eighteen--and four million children had asthma attacks in the past twelve months. Since some children have rare episodes or have not been formally diagnosed and treated, officials in both organizations believe the number of affected children to be slightly higher. Asthma is twenty-three percent more prevalent in African Americans than Caucasians and may be as high as fifteen percent more prevalent in Hispanics than Caucasians. It is eight to ten times more common in developed nations such as the United States and Great Britain than in developing nations.

What is Asthma?

Asthma is a chronic inflammatory condition of the airway. It is characterized by increased airway sensitivity to various stimulants resulting in airway narrowing, inflammation of the tissues that line the airway and increased mucus secretion. These covert changes lead to the overt symptoms of chest tightness, wheezing, coughing and breathlessness. In severe episodes an individual can have such difficulty breathing that they are unable to take in enough oxygen and require immediate emergency medical attention. Asthma accounts for two million emergency room visits and five hundred thousand hospital admissions annually. Approximately five thousand people die from asthma in the United States each year.

What brings on asthma attacks? The triggers are many and varied but the typical triggers are colds and viral respiratory infections, allergens (such as pollens, pet dander, dust, mold foods and perfumes), cold air, nighttime, excitement, stress, exercise, environmental pollution and cigarette smoke. It still boggles my mind when people with asthma continue smoking or parents of asthmatic children continue to smoke in their presence.

The Environmental Protection Agency (EPA) published a fact sheet on secondhand smoke in 1993 which showed that it is a significant cause of lung cancer in adults and extremely detrimental to respiratory development in children. Get a full copy of the report at www.epa.gov.

How is asthma treated? The mainstays of treatment are bronchodilators and corticosteroids. Bronchodilators such as albuterol are for acute episodes. These short acting medications immediately relax the smooth muscles of the airway allowing air in and easing breathing. They come in metered-dose inhalers for older children and adults and as liquids for use in portable breathing machines (nebulizers) for smaller children and others not able to coordinate use of inhalers.

Corticosteroids prevent the inflammation that develops following airway stimulation. They reduce the swelling of the tissues lining the airway and the mucus secretion. They come liquids, pills and as metered dosed inhalers. Corticosteroids start to act more slowly but their effects last for a longer duration and are additive. Thus, one typically has to use a steroid for a number of days to gain any benefit from it.

A newer class of drugs called leukotriene inhibitors work by blocking the inflammatory response. They slow tissue swelling, mucus secretion and white blood cell response. They are taken regularly as preventive treatments. Singulaire and Accolate tablets are leukotriene inhibitors.

The American Lung Association is dedicated to promoting healthy lungs in Americans through education and legislation. They are on the forefront of antismoking initiatives and have conducted much of the research that has yielded the information we have about lung diseases. The Austin Chapter of the American Lung Association is sponsoring its annual Blow the Whistle on Asthma Walk on Saturday, March 27, 2004 in Fiesta Gardens Park. The walk is a major fundraiser of the organization to help support research and lobbying efforts. Anyone can participate. You can walk as an individual, as a family or build a team of friends, family members or corporate employees. Participants are asked to get donations and each person who collects $100 will receive a commemorative T-shirt.

If you wish to help the American Lung Association with its mission to fund research and legislation not only for asthma but for all lung diseases, visit their website at www.texaslung.org. As a parent of a child with asthma and loved ones with lung diseases, I appreciate your support.