Asthma prevalence and morbidity among urban children is increasing.
Pest allergens, such as cockroach and mouse, are present in high concentrations in US urban housing and have both repeatedly been linked to asthma morbidity in sensitized children. Mouse allergen levels are higher in schools than in homes.
In addition, concentrations of many pollutants are higher indoors than outdoors in urban communities. Exposures to indoor pollutants such as particulate matter (PM) and nitrogen dioxide (NO2) are associated with asthma in children.
Environmental interventions are challenging to implement. However, when they reduce relevant indoor allergen and pollutant exposures, they are associated with clear improvements in asthma.
Other modifiable risk factors in urban childhood asthma include dietary and nutritional factors. Overweight and obese children, may be more susceptible to the pulmonary effects of pollutant exposure. Insufficiency of vitamin D and folate has also emerged as modifiable risk factors for asthma morbidity in children.
The identification of these modifiable risk factors for urban childhood asthma morbidity offers a ripe opportunity for intervention.
Environmental exposures and asthma morbidity in children living in urban neighborhoods - Matsui - 2014 - Allergy - Wiley Online Library http://buff.ly/1iCX2Lt
Image source: House Mouse, Mus musculus. Wikipedia, George Shuklin, Creative Commons Attribution ShareAlike 1.0 License.
Image source: Interstate 80, seen here in Berkeley, California, is a freeway with many lanes and heavy traffic, Wikipedia, GNU Free Documentation License.