Environmental Interventions for Asthma

Abstract

Exposure and sensitization to environmental factors play a fundamental role in asthma development and is strongly associated with asthma morbidity. While hereditary factors are critical determinants of asthma, exposures to environmental factors are implicated in the phenotypic expression of asthma and have been strongly associated in the risk of its development. Significant interest has thus been geared toward potentially modifiable environmental exposures which may lead to the development of asthma. Allergen exposure, in particular indoor allergens, plays a significant role in the pathogenesis of asthma, and remediation is a primary component of asthma management. In the home, multifaceted and multitargeted environmental control strategies have been shown to reduce home exposures and improve asthma outcomes. In addition to the home environment, assessment of the school, daycare, and workplace environments of patients with asthma is necessary to ensure appropriate environmental control measures in conjunction with medical care. This article will discuss the role of the environment on asthma, review targeted environmental therapy, and examine environmental control measures to suppress environmental exposures in the home and school setting.

Environment and the development of severe asthma in inner city population

“…Tobacco smoke is one of the most potent exposures for asthma morbidity. Approximately 14% of children in the United States are exposed to second hand smoke at home; the incidence is higher in inner-city low-income households [6]. In cross-sectional reviews of subjects enrolled in the National Institutes of Health (NIH)/National Institutes of Allergy and Infectious Diseases-funded School Inner-City Asthma Study (SICAS), Ruran et al [7] observed higher urinary cotinine levels in children of lower income homes as well as non-White race and Hispanic or Latinx groups.…”

Socioeconomic determinants of asthma health

“…Second-hand tobacco smoke exposure is higher in inner-city low-income households [16]. Data from the school inner-city asthma study recently found children of lower income households, nonwhite race, and Hispanic ethnicity had higher urinary cotinine levels that were associated with worse asthma symptoms and increased exacerbations [17].…”