JenniferSpartzAnnotation7BuffaloCrossSectionalStudy

Annotation 7 Self-Reported Home Environmental Risk Factors for Childhood Asthma: A Cross-Sectional Study of Children in Buffalo, New York This study was done by Shao Lin, Marta Gomez, Syni-an Hwang, Jean Pierre Munsie, and Edward Fitzgerald. The first four are from the New York State Department of Health, Bureau of Environmental and Occupational Epidemiology based in Troy, NY. Fitzgerald is from the University at Albany School of Public Health, Epidemiology and Biostatistics. By the fact they define asthma to be common and chronic, their studies in epidemics would validate them in this study. This article discusses a study conducted in Buffalo on the prevalence of indoor and outdoor triggers of asthma. Based on past studies, they were able to compile a list of possible asthma triggers to include in a survey distributed to families with children from 1-17 that lived in the city of Buffalo from 1998-2001. Some problems with some of the past studies, however, were that they conducted the tests in small samples, only used “insensitive indicators” of asthma (death or hospitalization), or only focused on outdoor or indoor risks instead of both (Lin 325). This test was run in two components. The first was a cross-sectional study (through a survey) to see the prevalence of triggers among kids in Buffalo. The two part survey consisted of household demographics, habits, and potential exposures inside and outside and a parent’s survey to describe their child’s activities, smoking habits, family history of asthma, current asthma diagnosis, and family access to medical care. The second was a nested case-control study of the levels of indoor home exposures and how that relates to asthma. This was done by sampling indoor metals, VOC’s, and molds. Of the 8,250 families mailed the survey, 3,008 returned the survey with answers sufficient enough to be included in the compilation. Of those 3,008 families, only 770 had a child with asthma. Within the asthma cases, the average age at which children tended to start coughing was 3 years old. 83% of them received treatments or medicine to try to control their asthma. Only 72% of the parents were able to receive information about asthma from a health professional. It was seen that asthma occurred most commonly in males older than 5. Other factors that contributed to higher asthma rates were a history of asthma within a family, being African American or Hispanic, living with an unmarried mom, the parents having less than a high school education, or living below the poverty level. The indoor triggers seen to be the most prevalent were smoking, dampness, use of a humidifier, chemical odors from formaldehyde and VOC’s, and cockroaches. The outdoor triggers seen to be the most prevalent were living on a main, truck travelled road and chemical odors due to VOC’s, industrial facilities, hazardous waste facilities, or heavy traffic. The study also strongly focused on the ethnicity differences and how they related to education, poverty and health care. Besides health care, race appeared to be strongly related. By comparing the number of times these factors appear positive on the surveys, probabilities were formed for the likelihood of a child getting asthma in certain conditions. “The predicted probability of asthma for a child without any risk factors was 5%...A child with a family history of asthma and with no other risk factors has a predicted probability of 15%, but in combination with one environmental risk factor the probability increases to about 20%, with two environmental risk factors to about 30%, and with four environmental risk factors to 46%” (328). Some triggers not seen to be as important were household proximity to gas stations, time available for medical care, and rats/mice in the house. The results of this survey show that the causes of childhood asthma are truly unknown. The number of risks in a given environment may allow for the chances of getting asthma to increase, however, they do not guarantee that a child will get asthma. It is also not possible to apply the results to the general population as the demographics of Buffalo are very different than those of the world. Some trends that the people conducting the survey followed were that mortality and morbidity rates of childhood asthma were rising and many past studies were showing a developing relationship between air pollution and asthma. Working off these ideas, they were able to come up with a survey that could possibly show them the development and possible causes of asthma within a city. The article mentions being reviewed by the Institutional Review Boards of the New York State Department of Health and SUNY Buffalo. This gives the impression that prominent groups went over this study and still thought it was legitimate. At the end of the article they also discuss the problems seen in past studies (how similar surveys have stated it was about asthma, therefore families without asthma did not respond) and how they attempted to rectify those problems (said the study was a general health-environment survey), so a standard could be created that families with asthma could be compared to. This article relates to the group’s shared questions as it talks about the region of Buffalo studying the prevalence of triggers in the area. The study was conducted of families with kids to find how often certain triggers showed up in the home and had a possible effect on the health of the family. The study also concluded that indoor air triggers were easier to control, but even through that control, the causes of asthma still are not known.

Citation: Lin, Shao et. al. “Self-Reported Home Environmental Risk Factors for Childhood Asthma: A Cross-Sectional Study of Children in Buffalo, New York.” Journal of Asthma 45:4, 325-332. 2008