DENVER -- Learning how much time a child has between a significant increase in air pollution and the start of a severe asthma attack could help doctors throughout the United States better treat their pediatric patients.

In a two year, $220,000 Environmental Protection Agency (EPA) grant, National Jewish Medical and Research Center pediatric asthma specialist Nathan Rabinovitch, M.D., seeks to learn how spikes in air pollution may impact children with severe asthma who live in the inner city. By monitoring changes in air quality, doctors could be able to anticipate asthma attacks hours or days in advance.

“We hope to determine the amount of time between a sharp rise in pollution levels and the start of the kids’ asthma symptoms,” Dr. Rabinovitch said. “So far, studies have not been consistent in identifying how long this takes. If we find, for example, the lag time is five days, in that time we can run tests to see what body mechanisms are affected. This will give us an idea where to go with further research and treatment options.”

About 5.3 million children in the United States and 67,000 in Colorado have asthma, which is responsible for 10 million lost school days each year. Asthma prevalence in non-Hispanic Blacks is almost twice as high as that reported by non-Hispanic Whites, according to the American Lung Association. Black children are three times as likely as Whites to be hospitalized for asthma treatment, according to the group.

“The quality of asthma medications has increased, but childhood asthma continues to get worse and more children are dying,” Dr. Rabinovitch said. “Minorities do worse than Caucasians in the inner-city; minorities outside the inner-city do much better controlling asthma.”

The EPA bases air quality on particulate matter (PM) 10 micrometers in size. Congress is now considering whether to establish a much smaller particulate size, PM 2.5 micrometers, as the standard. These microscopic particulates, including dust, diesel and gasoline exhaust, and plant pollens, are small enough to enter the lungs and trigger asthma attacks in some children. Other triggers of the lung disease include cockroaches, smoke and perfume.

Monitors used in this study record levels of PM 2.5 and PM 10. “The EPA funded this study because they want to know if current standards are effective,” Dr. Rabinovitch said. “National Jewish will be able to tell the EPA what needs to be done. The study results can have a major impact on large cities such as New York, Los Angeles, Denver and Dallas, and on the kids, especially minorities, who live there.”

Forty children, 6 to 12 years old, from National Jewish’s Kunsberg School are participating in the study. Three-fourths of the Kunsberg students in the study are minorities. Twice daily, Monday through Friday, the children’s medication use is recorded and asthma symptoms are rated.

This information is compared against measurements taken from air monitors located at National Jewish. To detect varying levels of air pollution exposure among the students, researchers have built monitoring stations at a National Jewish parking lot, in downtown Denver and inside the Kunsberg School to gather air samples that the children breathe.

Next month, 10 children in the group will carry personal monitors that constantly sample air. The device, about the size of a paperback book and weighing about 2 pounds, is worn in a backpack. The children will keep the monitor with them at all times, Monday through Friday, for four weeks. The monitor measures a child’s exposure to ambient particulate matter in his or her wider environment, primarily the home. The filters will be changed twice each school day and the particulates captured will be analyzed.

“This study has the potential of giving the strongest data ever collected about the impact of air pollution on children with asthma,” he said.

In addition to treating patients at National Jewish’s main facility, Dr. Rabinovitch treats children at National Jewish’s Thorton, Colo., clinic.

The Number 1 Respiratory Hospital in the U.S. for Two Consecutive Years, U.S. News & World Report, 1998-2000.

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• Asthma
• Children's Health

• Tropospheric ozone
• Wheeze
• House dust mite
• Hypoallergenic
• Hay fever
• Indoor air quality