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W.Va. fifth-worst state for asthma, study finds

By VICKI SMITH
Associated Press Writer

MORGANTOWN, W.Va. (AP) -- West Virginians have one of the highest rates of asthma in the country, and a new report says the chronic lung condition was the primary cause of death in an average of 35 people per year between 1991 and 2000.

"That's unacceptable because it's a controllable disease,'' said David Deutsch, manager of the West Virginia Asthma Education and Prevention Program, created in 2001 under a three-year federal grant.

Two years ago "there was some evidence we had at least as big a problem as -- or bigger than -- other states,'' Deutsch said Wednesday. "In reality, we have indications the problems here are greater than most other states.''

The 80-page report being released Thursday represents the first comprehensive look at a disease that affected 9.3 percent of the state's adult population -- or about 130,118 people -- in 2001.

That ranks West Virginia fifth-worst for asthma and reflects an increase from the previous year, when 8.5 percent were living with the disease.

The report is based in part on a 2000 survey by the Centers for Disease Control and Prevention's Behavioral Risk Factor Surveillance System. It also includes data from the U.S. Environmental Protection Agency and the 2002 West Virginia Youth Tobacco Survey.

The report will serve as the foundation for intervention strategies by a coalition of state agencies, the American Lung Association and the West Virginia Asthma Coalition, which are meeting Thursday and Friday in Morgantown.

Especially striking in the report was the discovery that more than 20 percent of school-age children had been diagnosed with asthma as of last year, Deutsch said. The rates were 23.2 among middle schoolers and 21.1 percent among high school students, for a total of 32,757 children.

More than 14,000 of those children had suffered at least one attack in the preceding year, indicating their asthma was poorly controlled. Among those children, about 20 percent had missed 11 or more school days.

"This is breathtaking,'' said Dr. Michael Romano, a pediatrician at the West Virginia University School of Medicine and chairman of the West Virginia Asthma Coalition.

"Certainly, one of the issues we ought to devote ourselves to is trying to minimize the number of missed school days,'' he said.

Romano's coalition, composed mainly of medical professionals, will likely focus on advocacy as well as education.

It may weigh in, for example, on a state Board of Education proposal that would regulate the way medications are handled in schools, Romano said. Some states have passed laws giving children the right to carry inhalers and other asthma medications so the issue is not left to individual school officials.

Although experts are not certain why some people develop asthma, symptoms can be triggered by secondhand smoke, air pollution, strong chemical odors and allergens such as pet dander.

The EPA estimates secondhand smoke exacerbates asthma in as many as 1 million children per year and causes as many as 26,000 new cases in children per year.

In 2001, West Virginia had the fourth-highest smoking rate in the country at 28 percent. The national average among 54 states and territories was 23 percent, the CDC found.

Romano, who once ran a pediatric asthma clinic at Texas Tech, said children from smoking environments are usually sicker, and their asthma is harder to control.

The report also found that only 46 percent of West Virginia's asthmatic adults are using a daily anti-inflammatory medication called an inhaled corticosteroid to control the underlying condition.

Some may be relying on inhalers like Albuterol, which relieves only the symptoms, not the underlying condition.

"Less than half of the patients are taking medications that they might be able to benefit from, and why that is the case is unclear,'' Romano said.

Access, information and the cost of medicine could all be factors.

"Most people can be profoundly helped with current therapy, but it's a question of getting providers to utilize current therapy and getting patients to understand it's a long-term process,'' Romano said.

"People -- and many providers -- associate wheezing with asthma and think if you're not wheezing, you must be OK,'' he said. "And that's not the case.''

------

On the Net:

National Institutes of Health: http://www.nhlbi.nih.gov/health/public/lung/index.htm†asthma

AP-ES-10-02-03 0002EDT





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