Transcript Asthma and Environment - Harvard School of Public Health

Asthma and Environment
Doug Brugge, PhD, MS
Tufts University School of Medicine
Asthma is Increasing
Asthma Hospitalizations, Boston
Primary Prevention of Asthma
environment
genetics
exacerbation environment
medication improvement
asthma
Environmental Factors
Biological
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Chemical
Bacteria/Viruses 
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Cockroaches
Dust mites
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Mold
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Pets
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Pollen
Rodents
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Structural
Tobacco smoke Water/moisture
Building
Heating ventilation
materials
& air conditioning
Carpet/furniture
Combustion from Deteriorated
stove/heater/etc… buildings
Appliance disrepair
Household
chemicals
Old carpet/upholstery
Pesticides
A Chemical Affects Breathing
Franklin Hill Survey I
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62 %
43%
70%
40%
38%
66%
73%
35%
57%
reported moisture and leaks
smelled or saw mold growth
had cockroaches in apartment
had mice or rats in apartment
used oven to heat apartment
reported stuffy air
experienced overheating in apartment
of respondents smoked
of households had at least one smoker
Mold
Franklin Hill Survey II
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Respondent asthma rate = 40% (n=53)
Child asthma rate = 56% (n=61)
40% of respondents reported wheezing in
the last month (n=53)
48% of respondents reported cough (n=53)
48% of respondents reported sneeze (n=53)
Franklin Hill Survey III
Significant associations between:
 Moisture & Wheeze
 Sewage & Wheeze
 Odor & Wheeze
 Cracks & Wheeze
 Renovations & Wheeze
Franklin Hill Participants
Industrial Cleaning
Effect of Industrial Cleaning
3500
Apartment 1
Cockroach antige n
(U/g)
3000
Apartment 5
2500
2000
1500
1000
500
0
November
February
April
Month of Sample
June
Summary
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Sources of asthma exacerbation are numerous and
widespread.
There is likely no single “smoking gun”
Solutions will need to be multifactoral.
Lots of people in public housing have asthma.
The environmental factors in public of greatest
concern appear to be overheating, fungi,
cockroaches, mice, smoking and NO2