Asthma rate and costs from traffic-related air pollution are much higher than once believed

A research team led by University of Massachusetts Amherst resource economist Sylvia Brandt, with colleagues in California and Switzerland, have revised the cost burden sharply upward for childhood asthma and for the first time include the number of cases attributable to air pollution, in a study released this week in the early online version of the European Respiratory Journal.

The total cost of asthma due to pollution is much higher than past traditional risk assessments have indicated and there is growing evidence that exposure to traffic-related air pollution is a cause of asthma and a trigger for attacks, so it should be included, say the authors. They conducted the study in Long Beach and Riverside, Calif., communities with high regional air pollution levels and large roads near residential neighborhoods.

Total additional asthma-specific costs there due to traffic-related pollution is about $18 million per year, almost half of which is due to new asthma cases caused by pollution, they report. Brandt worked with researchers at the University of Basel, Switzerland, Sonoma Technology, Inc. and the University of Southern California.

Using updated techniques that count asthma cases attributable to air pollution for the first time and including a broader range of health care costs such as parents' missed work days, extra doctor visits and travel time along with prescriptions, the researchers found that a single episode of bronchitic symptoms cost an average $972 in Riverside and $915 in Long Beach. Bronchitic symptoms (daily cough, congestion or phlegm, or bronchitis for three months in a row) are a critical outcome for children with asthma.

Further, people who live in cities with high traffic-related air pollution bear a higher burden of these costs than those in less polluted areas, they say.

Not all children have the same asthma symptoms, and these symptoms can vary from episode to episode in the same child. Possible signs and symptoms of asthma in children include:

Frequent coughing spells, which may occur during play, at night, or while laughing or crying
A chronic cough (which may be the only symptom)
Less energy during play
Rapid breathing (intermittently)
Complaint of chest tightness or chest "hurting"
Whistling sound when breathing in or out - called wheezing.
See-saw motions in the chest from labored breathing. These motions are called retractions.
Shortness of breath, loss of breath
Tightened neck and chest muscles
Feelings of weakness or tiredness

While these are some symptoms of asthma in children, your child's doctor should evaluate any illness that complicates your child's breathing. About half of infants and toddlers with repeated episodes of wheezing with shortness of breath or cough (even though these illnesses usually respond to asthma medications) will not have asthma by the age of 6. Because of this, many pediatricians use terms like "reactive airways disease" or bronchiolitis when describing such children (instead of labeling them as asthmatic).