St. Louis is worst place to live for people with asthma
By Blythe Bernhard
Wednesday, Jan. 28 2009, ST. LOUIS POST-DISPATCH

St. Louis wheezed past all other cities last year to become the most dangerous
place for people with asthma to live.

The Asthma and Allergy Foundation of America today named the St. Louis region
the nation's worst, based on factors including an above-average death rate from
asthma, a lack of smoke-free laws and high pollen counts.

Breathing hasn't been easy in St. Louis for years, but this is the first time
the region reigns as the asthma capital, jumping up eight spots from 2007.

Doctors said they weren't surprised by the No. 1 ranking.

"We're seeing that more patients have severe asthma that really is disabling
for them," said Dr. Mario Castro, a pulmonologist and professor at Washington
University School of Medicine.

Nearly one in eight people in the St. Louis area has asthma, according to the
St. Louis Regional Asthma Consortium, a group of doctors and public health
officials who study the problem. In some schools in the region, one out of
every five students has been diagnosed with the chronic lung disease.

Many more asthmatics may be missing out on medical care, doctors said.

"What I fear every day is this is a disease that's so common, that's very
controllable and very treatable, yet there are a number of patients out there
that are downplaying their symptoms and just living with it," Castro said. "All
of a sudden they encounter something and they go into full-blown attack and can
die."

Chronic respiratory disease, which includes asthma, is the fourth-leading cause
of death in the St. Louis area. Asthma accounts for more than 12,000 emergency
room visits in the region each year, according to the Missouri Department of
Health and Senior Services.

While some people have asthma symptoms year-round, seasonal asthma peaks in the
spring and summer because of the blooming grasses and trees. Last year was
particularly challenging for asthmatics because above-average rainfall brought
corresponding high mold and pollen counts.

At this time of year, cold and flu viruses can trigger asthma attacks. And
secondhand smoke is a continuous culprit that irritates the lungs.

Moving away won't help, Castro said. Twenty or 30 years ago, doctors might have
advised their local patients with asthma to move to a dry, warm climate like
Arizona's. Today, doctors believe that allergens and asthma triggers are
everywhere, and people become sensitized to the local triggers, wherever they
live.

Asthma is marked by symptoms including shortness of breath, wheezing, chest
tightness and persistent coughing. Doctors can generally control asthma
symptoms with medications.

The asthma foundation knocked St. Louis for not having enough lung specialists
to care for the population and for having a high percentage of people who lack
health insurance.

Too many children with asthma aren't getting appropriate medical treatment,
said Dr. Lee Choo-Kang, a pediatric pulmonologist at St. John's Mercy Medical
Center in Creve Coeur.

"They don't have access to health care and they don't recognize how serious
their asthma is," Choo-Kang said. Choo-Kang said he has seen children
hospitalized who haven't received any previous medical attention for their
asthma.

"Eventually we find this history of this child being medically disabled up
until that point and no one really felt there was a problem," he said.

Parents should seek medical help for a child who wheezes, coughs at night or
routinely sits on the sidelines during physical activities.

Patients can participate in about 10 clinical trials for asthma treatments in
the St. Louis area. For more information, call 1- 866-362-5656 or visit
vfh.wustl.edu.

bbernhard@post-dispatch.com | 314-340-8129