Cockroaches and Asthma in Kids

David L. Rosenstreich, Peyton Eggleston, Meyer Kattan, Dean Baker,
Raymond G. Slavin, Peter Gergen, Herman Mitchell, Kathleen McNiff-Mortimer,
Henry Lynn, Dennis Ownby, and Floyd Malveaux
for the
National Cooperative Inner-City Asthma Study
New England Journal of Medicine 1997;336:1356-1363
Thomas A.E. Platts-Mills and Melody C. Carter
New England Journal of Medicine 1997;336:1382-1384

Reducing asthma could be as simple as using a little Raid.

Of course there is EPA's alternative: compel American society to waste billions of dollars annually reducing air pollution despite the lack of scientific evidence that current levels of air pollution cause or exacerbate asthma.

Researchers from the National Cooperative Inner-City Asthma Study studied 476 inner city children from the Bronx, NY; East Harlem, NY; St. Louis; Washington, D.C.; Baltimore, Chicago, Cleveland and Detroit.

The researchers reported: skin-testing showed more than one-third of the children were allergic to cockroach allergen; and home visits showed more than 50 percent of the children had high levels of cockroach allergen in their bedrooms. Children that were both sensitive to cockroach allergen and exposed to high levels had 200 percent more hospitalization per year; more unscheduled medical visits for asthma, more days of wheezing, more missed school days and more nights with lost sleep than other children.

The authors concluded:

...our findings provide evidence that exposure to cockroach allergen has an important role in causing morbidity due to asthma among inner-city children. These results suggest that reducing exposure to cockroach allergen should be an important component of plans for the management of asthma. The implementation of intensive, multicomponent cockroach reduction strategies, including education of patients and the use of safe insecticides and nontoxic traps, should be evaluated as a method of reducing morbidity due to asthma in this population.

The accompanying editorial stated:

The increase in the prevalence and severity of asthma over the past 35 years has been observed in perennial rather than seasonal disease and in many different countries. Asthma is now the most common chronic disease of childhood. our view, asthma is a disease of Western society. The developments in the past three decades that could be relevant include changes in homes and diet, the increased frequency of indoor entertainment, and the introduction of broad- spectrum antibiotics. The tendency for children to stay indoors, with an inevitable decrease in exercise combined with an increased exposure to allergens, is greater in the inner city because of concern about safety.

The editorial supports a study published in Science earlier this year which suggested [ironically] that the clean living conditions of Western society are associated with the increase in asthma observed over the last several decades. [Science 1997;275:41-42, 77-79]. Simply put, the Science study suggested children's immune systems that are not challenged - e.g., by tuberculosis infection - predisposed them to asthma later in life.

I wonder if there's a Roach Motel for EPA's air pollution proposals? The proposals could "check in, but not check out!"

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