The chronic condition involves repeated irritation and inflammation of the airways. If properly treated, it can often be controlled well enough that most of the time patients have only mild symptoms. However, two factors are leading to its increasingly severe impact on global health: first, the warming of the planet, urbanization, industrialization, and pollution are raising the number and extent of environmental factors that cause or exacerbate severe breathing difficulties; and, second, at least tens of millions of people are not receiving the medical care they need to limit its effects.

In the US, there are known to be close to 20 million asthma sufferers, roughly a third of them children, but it is believed that the number could be significantly higher. One trouble with an accurate count is that many only seek health care when their or their offspring's problems have already become pronounced. As in the rest of the world, the incidence here is going up dramatically, particularly among the youngest segment of the population.

In a report released not long ago by Paul Epstein and his colleagues at the Center for Health and the Global Environment at Harvard Medical School, it was noted that recently there had been a 160% increase in the number of US patients aged 3-5 years old. There are thus many more of us becoming susceptible to the rising levels of pollen, molds, and other negative stimuli associated with global warming.

The overall problem is particularly complex and intractable. For instance, growing levels of urbanization involve: 1. higher carbon dioxide and other auto emissions, leading to increased smog; 2. likely greater global warming, that in turn stimulates the growth of organic hazards to asthmatic patients; 3. loss to development of forests (that tended to absorb excess carbon dioxide and so were beneficial); 4. added vulnerability in population centers to both minor and major floods, associated with harmful fungal growth; and 5. poor air quality from building material toxins.

Global warming leads to additional respiratory hazards. More heat waves and droughts result in a greater number and severity of grass and forest fires, which put asthma stimulating particles into the air. More wind-, dust-, and sandstorms associated with changing weather patterns also increase the noxious atmospheric "soup" that people must breath. Longer summer-like seasonal conditions, before a relatively short winter sets in, plus the stimulation to plants caused by higher levels of carbon dioxide in the air, lead to substantially increased organic air-borne irritants such as ragweed.

A combination of less regular or effective medical care, high ozone concentrations at ground level, and the generally greater amounts of pollen, spores, and particulates mean that inner city residents are at the most risk in this country. Among them, pre-school children are terribly vulnerable today. Recent studies in Chicago found that already one-fourth to one-third of the children in the city's poorest communities have asthma. Similar results were noted in Harlem.

In Asian urban areas, the situation may be worse. They often have even more environmental hazards contributing to serious respiratory problems, but there seems to be more fatalism about them and less awareness in the public health community that asthma is highly treatable.

Currently, the prospects for avoiding a more serious global asthma crisis do not appear good. The trends of increasing population, urbanization, auto use, pollution, and global warming, combined with rationing of health care, or ignorance of how it might best be used to limit the problem, are likely to still be factors in the future.

Ultimately, it will be important to get a better handle on our species' burning of coal, natural gas, oil, wood, gasoline, diesel, and other carbon based commodities or products. They contribute to the problem both directly and indirectly.

In the US, with a population roughly 5% of the world's, we produce about 25% of the fossil fuel pollution. (Thus far, in China, often mentioned as a cause of increasing global warming and pollution difficulties, those figures are almost exactly reversed.) While this is significantly because of our high use of individual vehicles, it is almost equally because the food we eat is so costly in terms of its environmental impact. The creation and transport of what goes on our plates consumes vast amounts of fossil fuel, not least because of the long distances (averaging 1500 miles) our food is typically moved from where it is grown to where it is processed and then finally to where it is purchased, prepared, and eaten.

If we wish to begin to make a dent in the asthma problem, then, good first steps for many of us may be to shop for produce from local farmers and food co-ops or to grow and eat more of our own food. It could well lead to a healthier diet too!

Sources:
Out of Breath. Rene Ebersole in National Wildlife, Vol. 43, No. 3, pages 14-15; April-May, 2005.

Asthma On the Rise in Asia Due to Mounting Urbanization, Pollution. In TerraDaily; February 17, 2004.