The three-year project is funded by the Centers for Disease Control and is one of six national asthma intervention projects organized through hospital emergency departments.
"The cumulative impression of emergency room doctors is that most asthma attack visits are the result of fright or of individuals not knowing how to administer medicines effectively," said Tim Aldrich, a faculty member in the Department of Family and Preventive Medicine. Gene Feigley, environmental health sciences, and Robert McKeown, epidemiology and biostatistics, are co-principal investigators.
"Many of these emergency room visits would be unnecessary if parents knew better how to manage the disease," Aldrich said, "and so we want to evaluate the effectiveness of distributing educational materials in the ERs. We also want to determine if there are environmental contributors to these respiratory bouts, which make some of the ER visits unavoidable."
Residents of seven S.C. counties along I-77 and Mecklenburg County in North Carolina who visit four hospital emergency rooms in that region are the focus of the study. As part of the project, videos, posters, and pamphlets are made available in the ERs to better educate asthmatics or their caregivers on managing the symptoms of the disease. A Web site also is promoted that features similar information. Active intervention is directed to children 7 to 12 years old, with in-home counseling and home environmental studies for those families who choose to participate. Monitors will measure ozone levels in their homes, and periodic sampling will measure other environmental triggers such as roach dander.
"We'll use geographic information system mapping to determine where the individuals live who make the most asthma-related ER visits and what the environmental factors are in their homes," said Deborah Hurley, a public health graduate student assisting with the project. "We'll also talk with the parents and children about social or emotional triggers that can cause asthma flareups."
Worldwide, the diagnosis of asthma cases has risen dramatically, with some studies suggesting that 25 percent of children in Australia have the respiratory disorder. In the United States, asthma diagnoses are distributed among rural, urban, and suburban settings, although most federal studies have focused on large urban areas. In some cases, asthma might not be the proper diagnosis for a respiratory disorder, Aldrich said.
"One of the dilemmas of accurately diagnosing asthma is determining what the airways are responding to that causes the attack," he said. "In classic asthma, the same thing--perhaps cat dander--is triggering the reaction every time. But there is a wide spectrum of biological phenomena that can trigger respiratory distress, and that's one of things we'll be looking for in this project."
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