Since about 1980, asthma prevalence and asthma-related hospitalizations and deaths have increased substantially, especially among children. Of particular concern is the high mortality rate among African Americans with asthma.
Recent studies have suggested that indoor exposures--to dust mites, cockroaches, mold, pet dander, tobacco smoke, and other biological and chemical pollutants--may influence the disease course of asthma. To ensure an appropriate response, public health and education officials have sought a science-based assessment of asthma and its relationship to indoor air exposures.
Clearing the Air meets this need. This book examines how indoor pollutants contribute to asthma-- its causation, prevalence, triggering, and severity. The committee discusses asthma among the general population and in sensitive subpopulations including children, low-income individuals, and urban residents. Based on the most current findings, the book also evaluates the scientific basis for mitigating the effects of indoor air pollutants implicated in asthma. The committee identifies priorities for public health policy, public education outreach, preventive intervention, and further research.
Contents
- THE NATIONAL ACADEMIES
- COMMITTEE ON THE ASSESSMENT OF ASTHMA AND INDOOR AIR
- PREFACE
- ACKNOWLEDGMENTS
- EXECUTIVE SUMMARY
- 1. MAJOR ISSUES IN UNDERSTANDING ASTHMA
- 2. METHODOLOGICAL CONSIDERATIONS IN EVALUATING THE EVIDENCE
- 3. PATTERNS OF ASTHMA MORBIDITY AND MORTALITY
- 4. PATHOPHYSIOLOGICAL BASIS OF ASTHMA
- 5. INDOOR BIOLOGIC EXPOSURES
- 6. INDOOR CHEMICAL EXPOSURES
- 7. EXPOSURE TO ENVIRONMENTAL TOBACCO SMOKE
- DEFINITION OF ENVIRONMENTAL TOBACCO SMOKE (ETS)
- FACTORS CONTROLLING EXPOSURE TO ETS
- EVIDENCE OF A RELATIONSHIP BETWEEN ETS AND ASTHMA
- CONCLUSIONS REGARDING THE HEALTH IMPACTS OF ETS WITH RESPECT TO ASTHMA
- EVIDENCE REGARDING MEANS OF SOURCE MITIGATION OR PREVENTION
- CONCLUSIONS REGARDING ETS SOURCE CONTROL OR MITIGATION: FEASIBILITY AND BENEFITS
- RESEARCH NEEDS
- REFERENCES
- 8. INDOOR DAMPNESS AND ASTHMA
- 9. ASTHMA AND NONRESIDENTIAL INDOOR ENVIRONMENTS
- 10. IMPACT OF VENTILATION AND AIR CLEANING ON ASTHMA
- 11. SUMMARY OF RESEARCH RECOMMENDATIONS AND OVERALL CONCLUSIONS
- PATHOPHYSIOLOGIC BASIS OF ASTHMA
- ANIMAL ALLERGENS
- COCKROACH
- HOUSE DUST MITES
- ENDOTOXIN
- FUNGI
- INFECTIOUS AGENTS
- PLANTS
- NITROGEN DIOXIDE (NO2)
- PESTICIDES
- PLASTICIZERS
- VOLATILE ORGANIC COMPOUNDS
- FRAGRANCES
- ENVIRONMENTAL TOBACCO SMOKE (ETS)
- INDOOR DAMPNESS, MOISTURE PROBLEMS, AND MOISTURE CONTROL
- NONRESIDENTIAL INDOOR ENVIRONMENTS
- VENTILATION
- AIR CLEANING
- OVERALL CONCLUSIONS
- APPENDIX A THEORETICAL CONSIDERATIONS RELEVANT TO THE INFLUENCE OF VENTILATION AND AIR CLEANING ON EXPOSURES TO INDOOR-GENERATED POLLUTANTS
- APPENDIX B WORKSHOP SUMMARIES
- APPENDIX C COMMITTEE AND STAFF BIOGRAPHIES
- Expand All
- Collapse All
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- Support for this study was provided by the U.S. Environmental Protection Agency (contract no. X825863-01-3). The views presented in the book are those of the Institute of Medicine Committee on the Assessment of Asthma and Indoor Air and are not necessarily those of the funding organization.
NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance.
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