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Kid’s Asthma: Test For Pollutants Inside the Home

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If your child suffers from asthma, he or she should be tested to see if they are allergic to indoor pollutants such as dust mites, insects, pet dander, molds, secondhand cigarette smoke and certain household cleaning supplies says a new clinical report released by the American Academy of Pediatrics (AAP).

Controlling the triggers of asthma in the home may work as well as or reduce the need for medications wrote Elizabeth C. Matsui, MD, MHS, FAAP,  of Johns Hopkins Hospital in Baltimore and colleagues, authors of the new guidance in the November issue of Pediatrics.

"We know that targeting all exposures that can trigger a child's asthma is more likely to be successful and to result in significant improvement than targeting only one or two of them, and can help reduce asthma attacks and the need for medication," Matsui said.

According to the report, an assessment of a child's individual environmental history should be an integral part of asthma management. The authors urged pediatricians to ask families about exposure to the following common triggers:

·      Dust mites and mold: An estimated 30-62% of children with persistent asthma are allergic to dust mites, and about half are sensitive and exposed to mold.

·      Furry pets: Cats and dogs are common furry pets found in homes, yet up to 65% of children with persistent asthma report being allergic.

·      Presence or evidence of pests such as cockroaches and rodents: Cockroach allergen exposure was first linked to asthma morbidity in children in 1997, and the link has been replicated ever since. Nearly 75-80% of U.S. homes contain detectable amounts of mouse allergen. Concentrations in homes in neighborhoods with high poverty rates are up to 1,000-fold higher than those found in suburban homes.

·      Indoor air pollution: Cigarette smoke is a major indoor trigger, with nearly 30% of all U.S. children and 40-60% of U.S. children in low-income households exposed to second-hand smoke in their homes. Additionally, the use of older wood-burning stoves, unvented space heaters, and other sources of combustion can produce nitrogen dioxide and other pollutants that are known to exacerbate asthma symptoms.

·      Household chemicals: Common household items such as air fresheners and cleaning agents include chemicals that can be respiratory irritants and trigger asthma symptoms.

The report recommended seeing an allergist to identify which allergens may be triggering your child’s asthma.

By asking specific questions, Matsui noted that pediatricians can play an important role in helping parents recognize something in the house may be making their child’s asthma worse.

"Which exposures to focus on will be informed by questions the pediatrician asks of the family," Matsui said. "Asking about pets will identify children who may have pet allergen exposure contributing to their asthma. Similarly, asking about signs of mouse or cockroach infestation will indicate which children might be at risk from these exposures."

Additionally, pediatricians should routinely ask about second-hand smoke exposure as this will guide further discussion about ways to eliminate or reduce a child's exposure to smoke, she said.

Dust mites are the most common indoor pollutant, however, you won’t see these pests crawling around your house. They are so tiny - a microscope is needed to actually see them. They feed mainly on the tiny flakes of human skin that people shed each day. These flakes work their way deep into the inner layers of furniture, carpets, bedding and even stuffed toys. These are the places where mites thrive. An average adult person may shed up to 1.5 grams of skin in a day. This is enough to feed one million dust mites!

Having dust mites doesn’t mean your house isn’t clean. Even the cleanest of houses can harbor these unwelcomed creatures. You can find out more about dust mites at http://www.aafa.org/page/dust-mite-allergy.aspx.

Indoor allergens can definitely make your child’s asthma worse and although many insurers do not currently cover environmental assessments and control measures, there are both public and private resources available to aid pediatricians, specialists, and patients with environmental remediation efforts.

Story source: Alexandria Bachert, http://www.medpagetoday.com/pediatrics/asthma/61125

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