Asthma & Children Fact Sheet

Source: American Lung Association

December 2007

Asthma is a chronic inflammation of the airways with reversible episodes of obstruction, caused by an increased reaction of the airways to various stimuli. Asthma breathing problems usually happen in "episodes” or attacks but the inflammation underlying asthma is continuous.

* Asthma is the most common chronic disorder in childhood, currently affecting an estimated 6.8 million children under 18 years; of which 4.1 million suffered from an asthma attack or episode in 2006.

* An asthma episode is a series of events that results in narrowed airways. These include: swelling of the lining, tightening of the muscle, and increased secretion of mucus in the airway. The narrowed airway is responsible for the difficulty in breathing with the familiar "wheeze".

* Asthma is characterized by excessive sensitivity of the lungs to various stimuli. Triggers range from viral infections to allergies, to irritating gases and particles in the air. Each child reacts differently to the factors that may trigger asthma, including:

• respiratory infections, colds
• allergic reactions to allergens such as pollen, mold, animal dander, feathers, dust, food, and cockroaches
• exposure to cold air or sudden temperature change
• cigarette smoke
• excitement/stress
• exercise

* Secondhand smoke can cause serious harm to children. An estimated 400,000 to one million asthmatic children have their condition worsened by exposure to secondhand smoke.

* Asthma can be a life-threatening disease if not properly managed. In 2004, 3,816 deaths were attributed to asthma. However, deaths due to asthma are rare among children. The number of deaths increases with age. In 2004, 141 children under 15 died from asthma compared to 684 adults over 85.3

* Asthma is the third leading cause of hospitalization among children under the age of 15. Approximately 32.6 percent of all asthma hospital discharges in 2005 were in those under 15, however only 27.8% of the U.S. population was less than 15 years old.

* In 2005, there were approximately 679,000 emergency room visits were due to asthma in those under 15.

* Current asthma prevalence in children under 18 ranges from 5.7% in South Dakota and Idaho to 11.9% in Delaware.

* Within the last few years, mortality and hospitalizations due to asthma have decreased and asthma prevalence has stabilized, possibly indicating a better level of disease management, such as increased use of inhaled steroids.

* Asthma medications help reduce underlying inflammation in the airways and relieve or prevent airway narrowing. Control of inflammation should lead to reduction in airway sensitivity and help prevent airway obstruction.

* Two classes of medications have been used to treat asthma -- anti-inflammatory agents and bronchodilators. Anti-inflammatory drugs interrupt the development of bronchial inflammation and have a preventive action. They may also modify or terminate ongoing inflammatory reactions in the airways. These agents include inhaled corticosteroids, cromolyn sodium, and other anti-inflammatory compounds. A new class of anti-inflammatory medications known as leukotriene modifiers, which work in a different way by blocking the activity of chemicals called leukotrienes that are involved in airway inflammation have recently come on the market.

* Bronchodilators act principally to dilate the airways by relaxing bronchial smooth muscle. They include beta-adrenergic agonists, methylxanthines, and anticholinergics.

* In July of 2003, The Food and Drug Administration approved a new drug for patients with serious asthma. Xolair, is the first in a new class of therapies that are bioengineered to target IgE (the antibody behind allergic asthma) in the treatment of allergic disease.

* The annual direct health care cost of asthma is approximately $14.7 billion; indirect costs (e.g. lost productivity) add another $5 billion, for a total of $19.7 billion dollars. Prescription drugs represented the largest single direct cost, at $6.2 billion.

* Asthma is one of the leading causes of school absenteeism; in 2003, asthma accounted for an estimated 12.8 million lost school days in children with an asthma attack in the previous year.

* The American Lung Association funds a wide variety of asthma research. The American Lung Association-Asthma Clinical Research Centers (ACRC) network is an American Lung Association-sponsored research program seeking to develop large clinical trials that will provide useful information important to the direct care of people who have asthma. The network, with 20 clinical centers and a data coordinating center, is the largest of its kind. This work involves large numbers of subjects, making the focus of the network different from current federally funded and commercial research. Thus, the ACRC is playing a unique and important role in asthma research.

* Currently the ACRC is conducting the Study of Acid Reflux and Childhood Asthma (SARCA) which will determine if poorly controlled asthma improves when acid reflux is treated with a certain class of drug, proton pump inhibitors. Acid reflux is frequent in people with poorly controlled asthma and can lead to asthma attacks. To find out if you qualify for participation, visit the ACRC section on the American Lung Association website, www.lungusa.org.