Clearing the Air: Asthma and Indoor Air Exposures / Edition 1

Clearing the Air: Asthma and Indoor Air Exposures / Edition 1

by Committee on the Assessment of Asthma and Indoor Air, Division of Health Promotion and Disease Prevention, Institute of Medicine
     
 

ISBN-10: 0309064961

ISBN-13: 9780309064965

Pub. Date: 05/05/2000

Publisher: National Academies Press

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

Overview

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.

Product Details

ISBN-13:
9780309064965
Publisher:
National Academies Press
Publication date:
05/05/2000
Edition description:
New Edition
Pages:
456
Product dimensions:
6.00(w) x 9.00(h) x (d)

Table of Contents

Executive Summary 1(1)
Organization and Framework
2(2)
Conclusions about the Relationship between Indoor Exposures and Asthma
4(12)
General Research Recommendations and Conclusions
16(3)
Major Issues in Understanding Asthma
19(20)
Origin of the Study
19(1)
Summary of the Indoor Allergens Report
20(2)
Definitions of Asthma
22(2)
Clinical Presentation of Asthma
24(4)
Risk Factors for Asthma
28(1)
Trends in the Prevalence of Asthma
29(2)
Mechanisms of Asthma
31(2)
Evaluating the Effectiveness of Interventions to Reduce Asthma
33(6)
Methodological Considerations in Evaluating the Evidence
39(28)
Evaluating the Evidence
40(8)
Summarizing Conclusions Regarding the Evidence
48(3)
Assessing Exposures to Agents in Indoor Air
51(11)
Other Considerations
62(5)
Patterns of Asthma Morbidity and Mortality
67(20)
The Burden of Asthma
67(1)
Mortality
68(1)
Utilization of Health Care Services
69(1)
Prevalence
70(5)
Severity
75(2)
Trends in Risk Factors
77(1)
Twin, Adoption, and Migrant Studies
78(1)
Socioeconomic Status Versus Race or Ethnicity
79(1)
Asthma Rates in Germany---A Natural Experiment
80(1)
Reflections on the Trends
81(6)
Pathophysiological Basis of Asthma
87(18)
Airway Inflammation in Asthma
88(8)
The Airway Smooth Muscle in Asthma
96(2)
The Genetics of Asthma
98(1)
Conclusion
99(6)
Indoor Biologic Exposures
105(118)
Animals
106(18)
Cockroach
124(12)
House Dust Mites
136(14)
Endotoxins
150(8)
Fungi
158(17)
Infectious Agents
175(9)
Houseplants
184(2)
Pollen
186(37)
Indoor Chemical Exposures
223(40)
Nitrogen Dioxide
224(10)
Pesticides
234(3)
Volatile Organic Compounds
237(6)
Formaldehyde
243(4)
Fragrances
247(3)
Plasticizers
250(1)
Other Chemical Exposures in the Indoor Environment
251(12)
Exposure to Environmental Tobacco Smoke
263(35)
Definition of Environmental Tobacco Smoke (ETS)
264(1)
Factors Controlling Exposure to ETS
265(6)
Evidence of a Relationship between ETS and Asthma
271(9)
Conclusions Regarding the Health Impacts of ETS with Respect to Asthma
280(1)
Evidence Regarding Means of Source Mitigation or Prevention
281(7)
Conclusions Regarding ETS Source Control or Mitigation: Feasibility and Benefits
288(2)
Research Needs
290(8)
Indoor Dampness and Asthma
298(18)
Indoor Water Sources and Removal Processes
299(8)
Indoor Dampness and Respiratory Disease
307(3)
Dampness Control
310(1)
Research Needs
311(5)
Asthma and Nonresidential Indoor Environments
316(11)
Building-Related Asthma
316(5)
Studies of Schools
321(3)
Conclusion
324(1)
Research Needs
324(3)
Impact of Ventilation and Air Cleaning on Asthma
327(67)
Theoretical Background
327(4)
Building Ventilation
331(29)
Particle Air Cleaning: Introduction and Review of Conventional Practice
360(34)
Summary of Research Recommendations and Overall Conclusions
394(31)
Pathophysiologic Basis of Asthma
394(1)
Animal Allergens
394(2)
Cockroach
396(1)
House Dust Mites
396(1)
Endotoxin
397(1)
Fungi
398(1)
Infectious Agents
398(1)
Plants
399(1)
Nitrogen Dioxide (NO2)
399(1)
Pesticides
399(1)
Plasticizers
400(1)
Volatile Organic Compounds
400(1)
Fragrances
400(1)
Environmental Tobacco Smoke (ETS)
401(1)
Indoor Dampness, Moisture Problems and Moisture Control
402(1)
Nonresidential Indoor Environments
402(1)
Ventilation
403(1)
Air Cleaning
404(1)
Overall Conclusions
405(4)
APPENDIXES
A Theoretical Considerations Relevant to the Influence of Ventilation and Air Cleaning on Exposures to Indoor-Generated Pollutants
409(6)
B Workshop Summaries
415(3)
C Committee and Staff Biographies
418(7)
Index 425

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