Asthma Alarm

By Jeffrey Kluger

There aren't many parents who would let their children suffer needlessly. But if the results of a new survey are correct, suffering is just what many of the 6 million U.S. youngsters with asthma are doing.

Asthma, for all the problems it causes, is an eminently controllable condition, provided children take their medications, limit exposure to allergens and visit their doctor regularly. Nonetheless, Asthma Action America--a national education organization composed of 21 health groups, including the American Lung Association and the American College of Emergency Physicians--reported last week that 54% of asthmatic American children had a severe attack in the past year, and 27% had at least one attack so severe they feared they were going to die.

The study, which was the result of a survey of 41,000 households, came up with other troubling numbers: 23% of asthmatic kids made at least one trip to the emergency room in the past year; 54% missed some school or day care; 62% had to limit their activities as a result of their condition. "With today's treatments," says Dr. William Sears, professor of pediatrics at the University of California at Irvine and a consultant in the study, "these kids should be symptom free most of the time."

One of the reasons they're not is a failure of communication. Fully 71% of youngsters between ages 10 and 15 did not agree with their parents about the severity of their condition. More often than not, it was the parents who didn't realize how bad the problem was. "Kids don't want to worry their parents or miss sports, so they downplay things," says Sears.

Keeping a closer eye on kids is one way to solve the problem. The other solutions are equally straightforward. First, children must take their medicines, and parents must understand how all of them work. Fast-acting inhalers--the so-called rescue drugs--are intended for acute attacks. If your child needs the inhaler more than twice a week, you may be doing something wrong. Daily medications like corticosteroids to reduce inflammation and bronchodilators to control constriction help prevent attacks. Those are the drugs that parents tend to neglect since they don't act immediately and it's therefore tougher to appreciate their benefits.

Limiting irritants is important too. Certainly, no one in an asthmatic's household should smoke. Allergies to mites can be controlled with a mattress cover. Sensitivity to air pollution can be treated with filters. But it's important to pinpoint exactly what problem a child has. Getting rid of the family pet may be a solution, unless it turns out the child wasn't allergic to the animal in the first place.

Finally, know your child's limits. Exercise is great--until it's not. If strenuous activity leads to attacks, your child may have to learn to live with some restrictions. The more the asthma is controlled, the fewer the limitations will be--and the more both children and parents can relax.