Armed with a five-year $6.5 million grant, Hopkins pediatricians and scientists will try to determine why 8 to 15 percent of Baltimore's school-aged children have asthma-- a rate that is higher than the national average of 7 percent. To help combat the problem, the Environmental Protection Agency and the National Institute of Environmental Health Sciences have named Baltimore's first Center of Excellence in Children's Environmental Health Research.
The program, to be run by the Children's Center and the School of Public Health, will study environmental factors and how they trickle into our homes, schools and daily lives.
A press conference announcing the project, held Dec. 3 at the Children's Center, was attended by Marty Wasserman, secretary, Maryland Department of Health and Mental Hygiene; and Devon Payne-Sturges, assistant commissioner for environmental health, Baltimore City Department of Health.
In Maryland, asthma is the most diagnosed pediatric illness, contributing to more visits to the emergency room than any other ailment. It also remains the No. 1 reason that children miss days at school, according to Peyton Eggleston, professor of pediatrics, who will co-direct the new center with Jouni Jaakkola, associate professor of epidemiology in the School of Public Health.
Nationally, asthma is the most common chronic disease of childhood, affecting nearly 5 million children. For reasons that are unclear, says Eggleston, the prevalence and severity of asthma have increased over the past 20 years despite improvements in asthma diagnosis and management. The rate of asthma is 40 to 50 percent higher among African American children, and hospitalization rates in this population are three to five times higher. Death rates are three times higher than in Caucasian children.
According to Eggleston, the reasons for these differences are complex and include increasing urbanization, exposure to indoor allergens and airborne pollutants, poor access to high-quality medical care and inappropriate use of medication. Recent data indicate that exposure to indoor allergens (such as mold, dust mites, cockroach allergies and cat dander) and pollutants (such as ozone, dust, smoke, nitric oxide from autos and fossil fuels) is excessive among inner-city families and can even lead to asthma deaths.
Eggleston and Jaakkola, together with 14 medical investigators and 15 staff members, will search for answers studying how, when, why and where school-aged children are exposed to substances that exacerbate asthma.
Over the next several years they will recruit inner-city families to participate in long-term assessments of their home and neighborhood environments. The researchers will monitor air quality, calculate children's allergic responses, determine how those responses affect asthma rates and launch neighborhood education programs.
Meanwhile, basic scientists will study how hereditary factors play a role in developing asthma based on exposure to different allergens.
Earlier this year, Vice President Al Gore announced the initiative for Baltimore and seven other cities, including Seattle, New York and Los Angeles; all have received similar grants to study asthma or, in some cases, pesticides.
Locally, the project will begin in 1999, when staffers will spread out across East Baltimore to begin data collection.