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Higher rate of exercise-induced wheezing seen in asthma ‘hotspots’
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Asthmatic children who lived in areas with higher prevalence asthma rates were twice as likely to experience exercise-induced wheeze compared with children who lived in neighborhoods with lower asthma rates, according to study findings published online.
Timothy Mainardi, MD, of Columbia University Medical Center, and researchers from Dartmouth-Hitchcock Medical Center reviewed data on 195 middle-income children aged 7 and 8 years with asthma who lived throughout New York City. The children, who lived in areas with varying asthma prevalence, were given a clinical evaluation, and their caregivers completed a health survey that included whether they had experienced exercise-induced wheeze one or more times during the past year.
Overall, 43% of the children experienced exercise-induced wheeze. Those living in asthma “hotspots” were twice as likely to have experienced symptoms after exercise and more likely to have an urgent visit with their doctor or an ED visit because of breathing problems, even after adjusting for neighborhood, income and other factors.
Mainardi and colleagues found that one-third of the children experiencing exercise-induced wheeze had not used an inhaler before exercising, which, researchers said, meant that many of these symptoms are preventable.
Matthew Perzanowski
“Our findings suggest that exercise-induced wheeze may help identify asthmatic children that are likely to seek urgent medical care for asthma from their doctor or an ED. The higher frequency of this indicator of rapid-onset asthma exacerbation in lower income neighborhoods could be contributing to the higher burden of ED visits in these neighborhoods,” Matthew Perzanowski, PhD, associate professor, Mailman School of Public Health, Columbia University, and senior author on the study. “Caregivers and physicians treating children in these urban neighborhoods with a high burden of asthma prevalence should discuss appropriate interventions, such comprehensive asthma education and medical treatment to prevent exercise-induced exacerbations.”
Exactly why asthma hotspots have higher rates of this symptom remains a mystery. Although inadequate use of a bronchodilator inhaler before exercise was part of the story, it did not fully explain the findings, according to the investigators.
Disclosure: The researchers reported no relevant financial disclosures.
Matthew Perzanowski, PhD, can be reached at EHS Department, 722 West 168th Street, 11th Floor, New York, NY 10032; email: mp2217@columbia.edu.
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