Local investigators plan to recruit more than 200 Baltimore families whose children have asthma to figure out what is making so many of them sick.
Baltimore's school-age children's asthma rate is estimated at 8 percent to 17 percent, higher than the national average of 7 percent. Asthma is the most commonly diagnosed pediatric illness in Maryland. It's also the No. 1 reason students miss school.
The study, announced yesterday, is funded by the Environmental Protection Agency and the National Institute of Environmental Health Sciences. The agencies awarded a five-year, $6.5 million grant to Johns Hopkins Children's Center and Johns Hopkins School of Public Health. The goal is to find out how, why, when and where school-age children are exposed to environmental factors that worsen their asthma.
First, researchers will offer an educational program to more than 1,000 families, and from that group, they will recruit more than 250 city families to participate in long-term studies of their homes and neighborhoods, said Dr. Peyton Eggleston, professor of pediatrics at the Johns Hopkins Children's Center.
He will be co-director of the new center -- the Center of Excellence in Children's Environmental Health Research --along with Dr. Jouni Jaakkola, an associate professor of epidemiology at Johns Hopkins School of Public Health.
In the coming years, researchers will monitor air quality, calculate children's allergic responses and determine how those responses affect asthma rates. Others will work at the basic science level, examining the role of heredity and other factors.
Even though diagnosis and management of the illness has improved over the past 20 years, the prevalence and severity of asthma has increased. From 1980 to 1994, asthma has risen by 75 percent among all ages, and by 160 percent among infants to 4-year-olds, according to national figures. Considered a minor problem in the suburbs, asthma is "out of control" in cities like Baltimore.
Among African-American children, the rate of the illness is estimated to be 40 percent to 50 percent higher than among whites. Hospitalization rates among African-Americans are about three to five times higher, and death rates are three times higher.
Past studies have blamed airborne pollutants such as ozone, dust and smoke, and indoor allergens such as mold, dust mites, cockroaches and cat dander. Poor access to high-quality medical care and inappropriate medication use are also factors.
Dr. Peter L. Beilenson, the city health commissioner, said he believes the project will help families in the study, particularly by giving them practical solutions. His department is working on a collaborative project with the city housing department and Hopkins to follow children with asthma from housing project high rises to new homes -- and compare the severity of their asthma.
Pub Date: 12/04/98