Guidelines for Medical Providers Released
(Beyond Pesticides, November 7, 2005) Responding to mounting data that primary care providers need more environmental health training to prevent, recognize and treat diseases caused by environmental exposures, The National Environmental Education & Training Foundation (NEETF) today released Environmental Management of Pediatric Asthma: Guidelines for Health Care Providers. The guidelines are designed to help pediatric primary care providers advise families about environmental interventions to help reduce or eliminate triggers for children diagnosed with asthma, the nation¹s leading pediatric chronic illness.
"In many cases, controlling a child¹s exposure to environmental triggers is critical to managing asthma," said James R. Roberts, MD, MPH, Associate Professor, Department of General Pediatrics at the Medical University of South Carolina, and the primary author of the guidelines. "But today’s physicians and nurses haven¹t been sufficiently trained to help families understand environmental asthma triggers and how to limit their children’s exposure to specific triggers outdoors and indoors at home, school, or their day care setting."
The National Institute of Environmental Health Sciences (NIEHS), a component of the National Institutes of Health (NIH), funded development of the guidelines.
The role of environmental triggers of asthma is well documented and recognized Research, including the Inner-City Asthma Study about individualized, home-based environmental interventions for hundreds of children in major U.S. cities, has demonstrated that environmental interventions decreased allergen levels, resulting in reduced asthma symptoms.
"As a physician who treats patients with asthma and as a parent of an asthmatic child, I understand the importance of tools such as these to ensure environmental factors are considered as an aid in the diagnosis, treatment and prevention of asthma," said NIEHS Director David A. Schwartz, M.D. "There are simple steps parents can take to reduce allergens that trigger asthma in their children. By teaching parents how to reduce allergens, healthcare providers can create a partnership that involves the parents in the process of improving their child¹s health."
According to a recent study published in Environmental Health Perspectives, pediatric medical and nursing education currently lacks the environmental health content necessary to appropriately prepare pediatric health care professionals to prevent, recognize, and manage diseases related to environmental exposures.
"In general, neither medical and nursing curricula nor pediatric practices frequently or fully incorporate environmental management and environmental history-taking into pediatric asthma treatment," said Leyla Erk McCurdy, NEETF Senior Director of Health & Environment Programs. "Over half of practicing pediatricians recently surveyed had seen a patient with health issues related to environmental exposures, but fewer than one-fifth were trained in taking an environmental history."
More than six million American children have asthma, which is the leading cause of school absenteeism attributed to chronic conditions and the third-leading cause of hospitalizations among children under age 15. Asthma can be a life-threatening disease if not properly controlled through appropriate asthma care management, which relies on physicians’ and nurses’ clinical knowledge and skills, as well as parents’ and children’s daily attention to asthma triggers and medications. Environmental asthma triggers include allergens and pollutants. Allergens can be dust mites, cockroaches, animal allergens, molds, and pollens. Indoor and outdoor pollutants include secondhand smoke, chemicals, pesticides, combustion by-products, smog and fine particles.
The guidelines were developed and peer-reviewed by expert panels and are founded on the National Asthma Education and Prevention Program (NAEPP) Guidelines for the Diagnosis and Management of Asthma and are intended to be used in conjunction with its clinical and pharmacological components, as part of a child¹s comprehensive asthma management plan. Complete guidelines are available at http://www.neetf.org/Health/asthma.htm.
To learn about the link between pesticides and asthma, check out Beyond Pesticides’ 15-page color booklet, Asthma, Children and Pesticides: What you should know to protect your family. The booklet examines children's susceptibility to asthma, the differences between the causes of asthma and asthma triggers, specific pesticides linked to asthma, the demographics of asthma, tips for controlling pests linked to asthma without using pesticides and steps you can take to avoid asthma causes and triggers. The brochure is available online or by calling Beyond Pesticides, 202-543-5450 for hardcopies.