Breathing Lessons

Nothing is more basic than breathing. Increasingly, though, American children and adolescents find it difficult to do. Asthma is the most common chronic condition of childhood, affecting almost 5 million youngsters. According to the National Heart, Lung and Blood Institute, the incidence of asthma increased 74 percent in children ages 5 to 14 from 1980 to 1994. Among children 4 years of age and younger, the increase was even greater -- 160 percent. 
Many cases of childhood asthma are caused by an allergic reaction, says Dr. Pauline Johnson, professor and director of the graduate program at Baylor's Louise Herrington School of Nursing and a consultant with the Baylor Medical Center Asthma and Pulmonary Rehab Center. Exposure to allergens such as animal dander, cockroach waste, dust mites and mold can irritate airways and trigger asthma symptoms. These symptoms -- coughing, wheezing, shortness of breath and chest tightness -- are caused by swelling and inflammation of the airways, which make it harder to move air in and out of the lungs.
Although the reason for the sharp rise in cases of childhood asthma is not known, one theory points to increased exposure to indoor allergens. "It's possible children spend more time indoors these days, where, due to energy concerns, buildings are tighter with less ventilation," Dr. Johnson says. "As a result, children are in more frequent contact with substances that trigger asthma."
Tobacco smoke is another airway irritant that can trigger asthma in children. Dr. Johnson says several studies have documented an increase of the disease in young children who live with a smoker. In addition, recent research suggests that diesel exhaust particles in the air may contribute to the development of asthma, she says.
The majority of children with asthma -- between 50 percent and 80 percent -- develop symptoms before age 5. Because asthma can masquerade as other medical conditions, parents should be alert for the symptoms of the disease, especially if a child appears to have allergies, Dr. Johnson says. Based on a child's history and symptoms, physicians can test for allergies and offer suggestions on how to limit exposure to allergens. There also are several effective medications available to help control and manage the disease. 
 

Beal is a lecturer in Baylor's Louise Herrington School of Nursing, where she teaches "The Experience of Illness." She received her BS from Columbia University and her MN from Emory. She is a freelance health and medical writer.