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SafetyAlerts
October 22, 1999

Asthma and Child Health Experts Announce First Guide for Diagnosing and Treating Asthma in Children

Endorsed by 3 Major Health and Asthma Groups, Aim is to Raise Standard of Care for Millions of U.S. Children

Washington, D.C. (SafetyAlerts) - Alarmed by the escalating rate of asthma in children, and determined that they receive the highest standard of medical care, the nation's leading pediatric and asthma experts today announced the release of a definitive guide for physicians and other health care professionals for identifying and treating asthma in children and adolescents under age 18. The most common chronic disease of childhood, asthma affects nearly 5 million children and adolescents.

Pediatric Asthma: Promoting Best Practice Guide for Managing Asthma in Children, the only set of stand-alone pediatric treatment recommendations endorsed by the National Heart, Lung, and Blood Institute's (NHLBI) National Asthma Education and Prevention Program (NAEPP), the American Academy of Pediatrics (AAP) and the American Academy of Allergy, Asthma and Immunology (AAAAI), was unveiled at a press briefing at the National Press Club. The guide is adapted from the NHLBI's 1997 Guidelines for the Diagnosis and Management of Asthma.

Featured speakers included Suzanne Hurd, Ph.D., director of the Division of Lung Diseases, NHLBI; Gary S. Rachelefsky, M.D., FAAAAI, initiative co-chair and past president of the AAAAI, Gail G. Shapiro, M.D., FAAAAI, secretary/treasurer of the AAAAI and co-chair of the initiative and Laurie Smith, M.D., AAP's chair of the Section on Allergy/Immunology.

The guide represents a unified effort that recognizes the medical and developmental issues unique to children and adolescents with asthma. In addition to NHLBI, AAP and AAAAI, representatives from six other medical/health organizations, and a governmental agency, contributed to development of the document: The Agency for Health Care Policy and Research; the American College of Allergy, Asthma and Immunology; the American Thoracic Society; the Centers for Disease Control and Prevention; the Children's Health Fund; the National Association of School Nurses; and The Robert Wood Johnson Foundation, which provided a grant to this project. A specialist in family medicine also contributed to the guide.

"Asthma in children has become one of the most critical public health issues of our time," Dr. Rachelefsky said. "The disturbing statistics on asthma in children demand a concerted initiative to ensure that our children receive the best care regardless of where they live and whether they see an asthma specialist, a family physician, pediatrician or other health provider. Asthma can and should be controlled."

Pediatric Asthma: Promoting Best Practice Guide for Managing Asthma in Children is the cornerstone of a major national initiative designed to raise the standard of care for all children with asthma. Another key piece includes convening national conferences -- the second of which will be held today through Sunday in Washington, D.C. -- encouraging connections between community programs that address issues of asthma, providing blueprints for the development of local asthma coalitions that address issues of asthma management and delivering best practice information to health care providers and managed care decision makers.

A Disease on the Rise
Asthma is a chronic inflammatory disorder of the airways. Inflammation in asthma contributes to respiratory symptoms such as coughing, wheezing, shortness of breath or rapid breathing, and chest tightness. Asthma "attacks" can occur following exposure to triggers. In children, these triggers are most often viral upper respiratory infections, tobacco smoke or allergens such as dust mites, animal dander, molds and cockroaches.

For children, uncontrolled asthma symptoms often interfere with school, sleep and extracurricular activities. The child may have less stamina or seek to limit/avoid physical activities to prevent coughing or wheezing. Asthma symptoms may also affect energy levels, concentration, peer relations and overall well being.

Although the reasons remain unclear, asthma rates have risen steadily since the 1970s -- particularly among children. Reports show that asthma prevalence increased by 75 percent from 1980 to 1994,1 with an alarming 160 percent in children under age 4. For children and adolescents age 5 to 16, the rate of asthma had jumped 72 percent during that same period.2 African-American children are particularly vulnerable to the disease. In fact, asthma is 26 percent more prevalent in black children than in white children.3

Asthma exacts an enormous economic toll, as well. The disease is responsible for 10.4 million physician office visits per year, one-third for patients under 18,4,5 and for more than 570,000 emergency room visits for wheezing in children under age 15.6 More than 10 million school days are missed each year due to asthma,7 resulting in nearly $1 billion in lost productivity costs (from parents' lost work days). Direct treatment costs of pediatric asthma approach $2 billion annually.8
"These statistics should disturb us," Dr. Shapiro said. "Uncontrolled asthma is unacceptable. When children with asthma can rely on their families and health care professionals to recognize their symptoms and provide accurate diagnoses and optimum treatment, the symptoms of asthma nearly disappear. Utilizing this comprehensive, easily referenced pediatric guide - endorsed by these three major health and asthma groups - will make it easier for health care providers to accurately diagnose and treat asthma in their young patients. And that will be a victory for children and their families who are struggling with asthma."

Pediatric Asthma: Promoting Best Practice was convened by the AAAAI and funded through an unrestricted grant from Merck US Human Health.

Source and Referances:  American Academy of Allergy, Asthma and Immunology

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