Most of us spend the vast majority of each day indoors, where air quality can be 2-5 times worse than outside. Indoor air quality issues revolve around environmental contaminants such as allergens and airborne chemicals.

• Chemicals that release fumes, called volatile organic compounds (VOCs), are in solvents, cleaning products, air fresheners, polishes, adhesives, paints, new carpeting and furniture. One study found that young kids in homes with high VOC levels were four times as likely to develop asthma.
• Dust mites and other indoor allergens love pillows and mattresses, and we often hear the statistic that up to 10 percent of the weight of a two-year-old pillow is made up of dust mites, living and dead, and their droppings. Enclosing mattresses and pillows in allergen-proof covers can keep the mites at bay, as can washing sheets and blankets in hot water weekly. Dust mite populations can also be controlled by reducing indoor humidity to below 60 percent and removing carpets from the bedroom.
• Stoves or heaters that burn gas, propane, kerosene, wood or charcoal produce carbon monoxide, and the gas can accumulate in poorly ventilated areas. Another dangerous source is from gasoline motors (such as cars or lawn mowers) that are running in enclosed spaces. Carbon monoxide is second only to heroin as a cause of death by poisoning in the US. A carbon monoxide detector is a simple tool that will give you peace of mind.
• One six-inch houseplant per 100 square feet of living area can filter VOCs and vastly improve your indoor air quality. Bamboo palms, Chinese evergreens and English ivies are the three best in removing formaldehyde, benzene and carbon monoxide from indoor air.
• Opening your windows to let polluted air out and fresh air in can noticeably improve indoor air quality.
• Household chores can help with air quality: dust often, keep your ducts clean and forego chemical cleaning products and air fresheners. Also, use a HEPA-filtered vacuum at least twice a week (plus a HEPA air purifier in a the bedroom of a child with asthma), and keep your plumbing in good repair to avoid mold growth.
• Keep the chemicals outside by taking your shoes off at the door to avoid tracking of contaminants, hanging dry-cleaned clothes outside before they make it to the closet and never smoking inside (better yet – take the pledge to never smoke!).

Many parents assume that our current government regulations do a pretty good job of protecting our children from exposures to unhealthy chemicals – not realizing that the current law from the 1970’s is now as ridiculous and out-of-date as a polyester leisure suit. Of the more than 80,000 synthetic chemicals now on the market in the US, the EPA has only been able to require safety testing on about 200. This needs to change, and leaders across the political spectrum are calling for action.

On January 21, 2010 a broad coalition called Safer Chemicals, Healthy Families has released a powerful, readable report called The Health Case for Reforming the Toxic Substances Control Act (TSCA). Yes, they make a strong health case (at least one percent of all disease comes from environmental exposures, and 10 percent of diabetes, and up to 30 percent of now-epidemic conditions like asthma). But beyond this they (Or I guess “we”. both DrGreene.com and Healthy Child Healthy World are part of this coalition) make a powerful economic case. Chemical policy reform should save us at least $5 billion in health care costs each and every year.

Whether you care about preventing cancer, learning disabilities, ADHD, autism, Alzheimer’s, Parkinson’s, reproductive and fertility problems, or asthma — or just saving our society billions of dollars – read the report, share the report, join the movement.

“In simplest terms, real reform will lead to more healthy babies, fewer women with breast cancer, a return to normal fertility patterns, and a lower number of people with Alzheimer’s disease. This is the promise of TSCA reform.”

From 1973 to 1999, childhood cancers increased by 26 percent, making cancer the greatest health threat to children. Currently, one in a 100 8-year-old children in the U.S. have been diagnosed with autism spectrum disorder, according to U.S. Centers for Disease Control and Prevention researchers, and the number might be as high as 1 in 58 for boys, according to a phone survey in the journal, Pediatrics. According to Robyn O’Brien, author of The Unhealthy Truth, one out of every three U.S. kids currently suffers from allergies, asthma, ADHD, or autism—our children’s bodies are clearly under assault. But why?

In yesterday’s article I mentioned how, as one concerned father, I set out to try to find out the dangers that are children are facing and how I learned about something called endocrine disruption, or the disruption of the hormones that control everything from mood to gene expression.

As I was researching my fact-based novel, one of the things I discovered was that since World War Two, approximately 80,000 chemicals have been invented, and thousands of these have been produced in excess of millions of pounds per year. Only a small percentage of these chemicals have ever been tested to discover their effects on animals and humans. (If you want to discover how the chemical industry undermined government regulation, watch Bill Moyers brave and brilliant documentary, Trade Secrets.)

We feed these chemicals to our children through the chemicals on the food they eat, in the water they drink, in the lotions we put on their skin, in the products that they touch, and even in the air they breath. A recent study of fetal cord blood—the blood a child is born with before they take their first breath—found 413 chemicals and on average more than 200 different chemicals per child.

Many endocrine disrupting chemicals are plastics. You may have heard of the chemical Bisphenol A, or BPA, which is a plasticizer that has been used to make plastic bottles (including baby bottles), to coat children’s teeth so they don’t get cavities, and to line canned food. In lab animals (we can not do controlled studies on people for obvious reasons), BPA has been shown to impair brain development, cause down syndrome, cause breast cancer, prostate cancer, low sperm count, and even obesity.

Obesity? Have a look at this picture. The mouse on the left is a normal mouse; the one on the right was exposed to tiny amounts of BPA during its gestation. Could exposure to this chemical, seven billion pounds of which is produced and put into our environment every year, play a role in the epidemic in adult and childhood obesity that is spreading around the world?

Why don’t you know about this? Well, let’s just say there are lots of people who don’t want you to know about this and have worked hard to obscure the facts. On Sunday, May 31, 2009, the Washington Post broke the story that manufacturers of packaging for beverages and foods, including some of their customers, like Coca-Cola, were trying to defend the use of BPA and use “scare tactics” to make sure that the chemical was not banned. I couldn’t believe it. It was as if some of the villains from my novel had come to life. But if I had my characters try to recruit a pregnant woman to discuss the benefits of BPA—as they industry execs apparently did—no one would have believed it.

Out of shortsighted economic interests, also known as greed, we are conducting an unprecedented experiment on the health of our children.

Tomorrow, we will look at how what’s happening to our children is happening to the whole planet, and the next day why some children get sick and other’s don’t. Then we’ll discover the silver lining and what can turn this around. Finally, on Friday, we look at what you can do to try to keep your family safe.

For more information about endocrine disruption, the research mentioned in this blog post, and about Doug’s fact-based eco-thriller, Eye of the Whale, please visit www.DouglasCarltonAbrams.com.

I love it when I hear television interior designers talk about “bringing the outdoors in” and greening up a home with houseplants. Decorating your house with lush green plants does so much more than spruce up your living room. Houseplants are magnificent air purifiers, and they’re a great, inexpensive resource for reducing indoor pollutants.

I’m amazed at how effective plants are at filtering toxins from the air. The plant filters the chemicals, absorbing them through the leaves then breaking the contaminants down with the bacteria associated with their roots. As adults, we spend about 80 percent of each day indoors, and our kids might even spend more! The air in our homes can contain many volatile organic compounds (VOCs), chemicals that release fumes. VOCs are found in many solvents, cleaning products, air fresheners, polishes, adhesives, paints and carpets. Studies have shown that young children exposed to high levels of airborne VOCs were four times more likely to develop asthma, so I’m strongly in favor of anything we can do to reduce these toxins in our homes.

One study revealed that one six-inch plant per 100 square feet of living area is a good rule of thumb for greening your home. The healthier the plant, the more air it can filter.

Other Resources:
Parent Picks: How to Grow Fresh Air: 50 House Plants that Purify Your Home or Office
DrGreene Top Ten: The Top Ten Air-Filtering Plants

Updated guidelines for the diagnosis and management of asthma from The National Asthma Education and Prevention Program emphasize objective measurements, tailored treatment plans, and environmental awareness. Objective measurements are the cornerstone of diagnosing and monitoring asthma.

Get to know your child’s FEV1 (forced expiratory volume in 1 sec – how much he or she can blow in one second – something you should be able to measure at home by the time they are in school ). It’s also important to keep track of key information, such as frequency of symptoms, inhaler use, nighttime awakenings, and anytime symptoms interfere with activities. This information is then used to create a stepwise treatment plan – working up to find the amount of medicine needed to control symptoms now and reduce the risks of future problems.

The stepwise approach also includes a step-down plan, in order to achieve success with the least amount of medicine possible. Algorithms for plans are included in the guidelines for kids age 0 to 4 years, 5 to 11 years, and 12 years and up.

All kids with asthma deserve an environmentally aware approach to their asthma, looking seriously for the triggers of their asthma that may be reduced. This includes allergy testing, or at least an allergy assessment, as well as efforts to minimize exposure to tobacco smoke and air pollution (from my perspective, both indoor and outdoor air pollution are important). In addition, conditions such as obesity, acid reflux, sinus infections, and excess stress or anxiety – all of which can make asthma worse – should be identified and treated if possible.

Childhood asthma doubled between 1985 and 2000¹, qualifying as a real epidemic. Kids who have it deserve at least this level of care, to help them thrive with their chronic condition.

¹U.S. Department of Health and Human Services. Action Against Asthma, May 2000.
The guidelines are available at www.nhlbi.nih.gov/guidelines/asthma/asthgdln.htm.

Changes in the home environment can be as powerful as medications in treating asthma, according to an exciting study in the September 9, 2004 New England Journal of Medicine. Researchers in the Inner-City Asthma Study Group followed almost 1,000 elementary school children with allergic asthma severe enough to require at least one hospitalization or two emergency visits. The study lasted for two years.

Half of the children received routine asthma treatment. The other half had 5 to 7 home visits by environmental counselors during the first year of the study in order to identify and reduce allergens in the home. The visitors looked for dust mites, passive smoking, cockroaches, pets, rodents, and mold, and helped with home changes depending on the child.s allergy skin testing. Part of the plan included creating an environmentally safe sleep zone for the child. Allergy covers were placed on the mattress, box spring, and pillows of the child’s bed. The environmental counselors gave the families a vacuum cleaner equipped with a high-efficiency particulate air (HEPA) filter and either a power brush if the child’s bedroom or family room was carpeted or a bare-floor brush and instructed in its use. A HEPA air purifier was set up in the child’s bedroom if the child was exposed to tobacco smoke, allergic to cats or dogs, or sensitized to mold. For children sensitized and exposed to cockroach allergen, professional pest control came. The results were outstanding, both during the year of the visits, and the following year.

The benefit of the changes translates into 34 fewer days with reported wheeze during the 2 years of the study, compared with similar children who did not have the home changes. They also averaged missing almost 2 weeks less school during the two years, and four fewer urgent or emergency visits for their asthma. This effect is similar to what we see from inhaled steroid medicines for asthma.

Aren’t all these changes expensive? If you add together the all the equipment and professional services costs, the environmental changes cost about $1,500 to $2,000 per child. This is about the same as the cost of two years of an inhaled corticosteroid and albuterol for a child with moderately severe asthma. The benefit of the environmental changes lasted for at least a year after the visits. If the benefits continue longer, the cost per year of benefit would be even lower. And these same changes could be implemented by many families at much less expense. Keep in mind, though, that the effort to address multiple possible triggers in this study was much more effective than previous studies where only a single change was made.

For my own child, I would want to do all I could to create an environment that reduced the triggers of his asthma. I expect this would decrease the medicines needed to keep his asthma under optimal control. When possible, I prefer addressing causes to treating symptoms.

Could it be that how you clean or how you decorate your home might influence whether your child develops asthma? Could the smell of new wall-to-wall carpets be linked to asthma risk? A provocative study in the September 2004 issue of Thorax suggests there is a strong connection. Researchers from Australia analyzed air quality inside children’s homes, including temperature, humidity, and the presence of chemicals in the air.

The young children exposed to high levels of volatile organic compounds (VOCs) in the air were four times more likely to develop asthma. VOCs are chemicals that release fumes. They are found in many solvents, cleaning products, air fresheners, polishes, adhesives, paints, and new fitted carpets (as well as in tobacco smoke). VOCs are also found in some new pieces of furniture. The ‘new’ smell may be a bad smell. The three VOCs with the biggest impact in the study were benzene (with the highest risk), followed by ethylbenzene and toluene. Every 10-unit increase of toluene in the home air doubled the risk of asthma; each similar increase in benzene tripled it.

We already knew that these fumes could trigger wheezing in people with asthma. This study goes further, suggesting that the fumes can cause lung damage resulting in asthma. Getting asthma depends on a combination of inheritance and exposures. While many diseases are becoming less common, asthma continues to increase each year. It has already become the most common chronic disease in children. Reducing exposure to VOCs in your home might be one way you can lessen your child’s risk of developing asthma.

If your child has asthma, or might have asthma, you may want to learn all you can about it rather than relying on the bits and pieces you learn at office visits or in the ER. Besides giving your child better care, this may result in happier, better behaved kids, according to a study in the September 2003 Journal of Allergy and Clinical Immunology.

The less that parents are familiar with asthma (especially from having asthma themselves or having it in the family), the more likely that the children will develop behavioral difficulties. Parents may expect too much from their kids. On the other hand, they may back off from expectations because the child has asthma or because they don’t want to provoke a wheezing episode.

Learning to understand asthma and to approach it with calm, capable confidence is a great gift to yourself as well as to your child.

Because allergies to pets are common, people long assumed that exposure to pets made allergies more likely. A number of studies have turned this assumption upside down. The August 2003 Pediatrics Synopsis Book summarizes the current understanding.

For a newborn coming into a home, or for a child who has not developed allergies, exposure to a dog or to multiple pets appears to decrease the risk of allergies, eczema, and perhaps (in one study) even asthma. In the studies summarized, as the numbers of cats and dogs went up, hay fever, eczema, and other allergies decreased.

For a child who is already allergic, but not to pets, getting pets does not appear to help or hurt. For a child who is already allergic to pets, there is no allergic benefit to keeping the pets, and exposure will make symptoms worse. If a child has asthma and is pet-allergic, then it may be wise to move the pet from the home.

There has never been a better time to be sure your asthma is under control. With a proper treatment plan, most asthma symptoms can be prevented or minimized. Uncontrolled, the linings of the airways in the lungs can remain inflamed. This is not healthy for the lungs. It can also mimic symptoms of SARS, or make actual SARS worse.

Rebecca Raleigh, an American citizen who was the first suspected SARS patient in India, turned out not to have SARS, but to have a fever from another cause during a flare-up of her asthma. The core symptoms of SARS are fever greater than 100.4 F (38.0 C) and cough (usually a dry cough), difficulty breathing, or other respiratory symptoms. The respiratory symptoms of SARS and asthma can be the same. Toss in a fever, and you either have anxiety – or a real case of SARS.

Keeping asthma inflammation under control can also make it easier for people with asthma to cope with SARS or other lung infections if they are really present.

Asthma is a lung condition where the airways are sometimes tight – a result of airway hyper-responsiveness. Our airways are designed to be responsive to harmful substances in the air. If we walk through clouds of smoke, our airways will shrink, protecting our delicate lung tissues from the noxious ingredients in the smoke. They should return to normal when we begin to breathe fresh air. People with asthma have an exaggerated tightening response.

Different people with asthma respond to different “triggers.” Viral infections are among the most common triggers, especially in young children. Other triggers include smoke, animal dander, pollens, molds, house dust mites, fumes and fragrances, or cold air.

When we exercise, we breathe rapidly and are unable to bring air temperature all the way up to 98.6 degrees — particularly if we breathe through the mouth. Thus, asthmatics who are sensitive to cold air will often wheeze with exercise. (Wheezing, the classic asthma symptom, is the noise made by air moving through these tight airways.) Because asthmatics respond differently to different triggers, their airways are tighter at some times than at others.

Hyper-responsive airways tighten in three ways in response to triggers. First and most immediately, smooth muscle surrounding the airways constricts, narrowing the caliber of the airways. Second, the airways are narrowed by inflammation and swelling of the airway lining. This leads to the third component of airway narrowing, which is the accumulation of mucus and other fluids, which can plug the airways.

The inflammation is the most important part of the disease. It perpetuates the cycle of airway narrowing. It can cause ongoing damage. It also is the slowest to respond to treatment.

Despite clear treatment guidelines, far too many people have uncontrolled asthma. Albuterol is very effective at helping people breath better for the moment, but does nothing to treat the inflammation.

People with asthma who have symptoms more than twice a week, or nighttime wheezing more than twice a month, benefit greatly from using a preventive, anti-inflammatory medicine rather than using albuterol alone.

Certainly, someone who uses albuterol daily should be on a preventive medicine instead or in addition to inhaled albuterol. Preventive and anti-inflammatory medicines are greatly underused for controlling asthma.

If you or your child has asthma, ask that the National Asthma Education and Prevention Program (NAEPP) guidelines be followed. Preventing inflammation prevents damage to the lungs and can greatly improve the long-term outcome.

More infomation on SARS:
SARS – A Worldwide Threat
SARS Update
SARS Hotel
SARS KidsS
top Respiratory Infections
SARS – School’s Out
Preventing SARS
SARS and Allergies
Disease – Severe Acute Respiratory Syndrome (SARS)
SARS Unmasked
Prepare for the Worst; Hope for the Best