Recent strides in allergy treatment aim to get severe allergy sufferers up and moving with new pill and liquid (oral drop) treatments. If approved, these allergy drugs could work more effectively than and eventually replace traditional allergy shots.

Allergies and hay fever can cause allergy sufferers serious discomfort. In addition to a runny nose and nasal congestion, hay fever can cause sinus pressure, itchy eyes and dark circles under the eyes called allergic shiners. Severe hay fever also can cause sleep issues and sinus infections (sinusitis), and may worsen asthma problems.

Some allergy sufferers rely on injections to address these severe symptoms, especially in the spring and fall when allergies and hay fever peak. Shots are given frequently—as often as twice weekly to twice monthly—for several years to build a tolerance to allergens. This therapy is now available orally in pill or drop form, known as sublingual immunotherapy.

Immunotherapy can cut symptoms by 20-30 percent, slightly higher than the use of nasal sprays (17 percent) and daily antihistamines (12-15 percent). Although immunotherapy drops and tablets have not yet made their way to the United States, they are already being used in Europe. Researchers are still investigating the long-term effectiveness of sublingual immunotherapy. One such investigation appears in the Journal of Allergy and Clinical Immunology.

In the meantime, you can learn more about allergy shots and how to manage allergies and hay fever from the Mayo Clinic website.

Do you suffer from recurring sinus problems? If so, a friend's cigarette could be to blame. Two out of five cases of chronic sinusitis may be due to exposure to secondhand smoke.

Sinusitis occurs when the sinuses become swollen or infected. According to Mayo Clinic, sinusitis is usually the result of a cold, allergies or other nasal problems, and can easily be treated with antibiotics, heat (to relieve sinus pressure) or a variety of over-the counter medications.

When the condition persists for more than eight weeks or recurs frequently, this is known as chronic sinusitis. Secondhand smoke contains over 50 known carcinogens; these chemicals can also cause heart problems, asthma attacks and nasal irritation.

Researchers from the Henry Ford Health System in Detroit, recruited 612 non-smokers to participate in a study investigating the relationship of secondhand smoke (SHS) and its source to chronic sinusitis. All had been exposed to SHS for five years prior to the study, and half had been diagnosed with chronic sinusitis (CRS).

Researchers focused on four locations where participants were primarily exposed—home, work, public places and social functions. All showed a marked relationship between secondhand smoke exposure and incidence of chronic sinusitis, especially at social functions (51 percent) and in public places (90 percent).

Although levels of exposure were significantly lower for nonsmokers who had not been diagnosed with chronic sinusitis, study co-author Amanda Holm, MPH, says even modest levels of exposure carry risk.

"The poisons found in secondhand smoke are quite an irritant to the sinus and nasal passages and are a major contributor to the development of rhinosinusitis," Holm said in a press release. “"Our findings reaffirm the health hazards of secondhand smoke."

Visit Mayo Clinic to learn more about chronic sinusitis, or learn more about Holm’s study in The Archives of Otolaryngology.

Stressing about losing your job may cause more harm than actual job loss. More than 1,700 participants in the American’s Changing Lives (ACL) and the Midlife in the United States (MIDUS) studies were asked: How likely is it that during the next couple of years you will involuntarily lose your job? Researchers from the University of Michigan and the University of California wanted to find the effects of job insecurity on employee health.

"It may seem surprising that chronically high job-insecurity is more strongly linked with health declines than actual job loss or unemployment," says Sarah Burgard, lead author of the study and research assistant professor in the University of Michigan’s Department of Sociology and School of Public Health, "but there are a number of reasons why this is the case.”

 The air quality in and around your home may have negative effects on your child’s intelligence, according to a study by Columbia University Center for Children’s Environmental Health (CCCEH).

The study, released a week ago by the National Institute of Environmental Health Sciences (NIEHS), found that children exposed to chemical pollutants called polycyclic aromatic hydrocarbons found in the air, water, and soil scored lower on IQ tests than children with lower exposure.

Polycyclic aromatic hydrocarbons, or PAHs, are chemical pollutants that can be found in the air, water, and soil. PAHs are typically released from the burning of fossil fuels (coal, diesel, oil, gas, etc.), tobacco and other natural substances. Auto emissions are a major source of PAHs in the United States, especially in heavily trafficked urban areas.

Doctor Frederica Perera, lead author and professor of Environmental Health Sciences at Columbia University Mailman School of Public Health, compares the exposure to such pollutants to low-level lead exposure. “These findings are of concern because these decreases in IQ could be educationally meaningful in terms of school performance,” she says. “IQ is an important predictor of future academic performance.”

A child’s developing fetal and nervous system is more vulnerable than an adult’s, and PAHs have been associated with higher cancer risk, asthma, allergies, low birth weight, and a reduced head circumference. Reduced head circumference, according to CCCEH, is connected with lower cognitive functioning and academic performance. In this study, the first of its kind, researchers hoped to study the relationship of in utero PAH exposure on a child’s intelligence.
 
Participants were non-smoking black and Dominican-American women, aged 18-35, residing in Washington Heights, Harlem and South Bronx, N.Y.—areas with higher pollutant exposure. During pregnancy participants regularly completed questionnaires and were asked to wear monitors that measured PAH levels.

Researchers followed the children, measuring IQ levels at age three and again at age five using the Wechsler Preschool and Primary Scale of the Intelligence. Of the 249 children, 140 had higher than the average 2.26 n/m3 level of exposure. The mean score for all children was 98.72, with a mean score of 96.6 for children whose exposure was classified as “high” and 101.6 for children with lower exposure. Scores differed by 4.67 on the verbal and 4.31 points on the full-scale test.

Researchers will continue to follow children to age 11 to learn more about the effects of PAHs on intelligence and child development. “It should serve as a warning bell to us all,” says Linda Birnbaum, Ph.D., director of NIEHS. “We need to do more to prevent environmental exposures from harming our children.”

Want more information about health during pregnancy? Visit Healia's Pregnancy Community or take the Healia Pregnancy Quiz!

New laws in Louisiana, Connecticut, Georgia and Pennsylvania give students the right to carry and self-administer their own medications, including an asthma inhaler.
At this back-to-school time, find out how to tell if your child with asthma is ready to carry and use an inhaler on his or her own. Age and grade-level matter less than individual readiness, according to the Allergy&Asthma Network Mothers of Asthmatics (AANMA).

Parent/Child Asthma Inhaler Quiz
See how your answers to the following questions match up with your child’s answers. These are the best clues to determining your child’s readiness to self-manage asthma symptoms at school:

1. Does your child use an inhaler (preferably with a holding chamber) correctly at home? 

2. Does she know the name of her medication and when to use it? 

3. Does he stay calm when having asthma symptoms? 

4. Does she tell you when she is having symptoms or when she has used the inhaler? 

5. Does he use a peak flow meter? 

6. Does your child carry the inhaler at all times? 

7. Does he understand that the inhaler is not a toy and should not be shared with friends? 


If you and your child answer “Yes” to most of these questions, you have a child ready to learn about and take responsibility for his or her inhaler.
 
Asthma self-management begins at home. Parental instruction should be backed up by plenty of low-pressure practice. At school, teachers should be aware of the condition and supportive of the process.
Students who self-manage symptoms must be willing to notify teachers, the school nurse or designated administrator when they need to use their inhalers to treat symptom. They must be willing to tell their parents about all medication use or symptoms experienced while away from home.

Back-to-School Asthma To-Do List for Parents
Ensure that backup medication is available in the school clinic should the child become separated from his medication at any time.
Complete required forms and keep them updated during the school year if contact information or emergency treatment plans change.
 

Not yet time for self-use of an inhaler? School personnel will need to ensure that the student’s medication travels with him from one classroom to the next to prevent treatment delays in times of need. Your child’s allergy or asthma management plan should specify this.
• For answers to common asthma questions, check the Healia Health Guide to Asthma.
• Test your knowledge of asthma—take this informative asthma quiz.
• Student-athletes with asthma and allergies can thrive on the playing field as long as they’re careful and follow these tips.

As allergy season is already underway in many places, today we provide a list of the states that have the best policy record regarding school-based management of asthma and allergies. The Asthma and Allergy Foundation of America (AAFA) created the 2008 State Honor Roll of Asthma and Allergy Policies for Schools to help encourage states to recognize and develop better state-wide school-based policies and practices for students with asthma and allergies.

AAFA researchers identified 18 "core policy standards" related to asthma and allergies policy that are currently in place in states across the U.S. The policy standards formed three broad categories: medication&treatment, awareness, and school environment. The states with the most of these 18 policy standards in place were considered to be states to be at the forefront asthma and allergy school advocacy. Six states with a minimum of 15 out of the 18 policy standards in place were named "Honor Roll" states for their leadership in mandating comprehensive state-wide school policies that address the needs of students with asthma, food allergies, anaphylaxis and other related allergic diseases in primary and secondary schools. These states appear below, followed by the number (out of 18) policy standards they currently have in place. Thirteen other states made honorable mention, having 14 of the 18 policy standards in place, while the remaining 31 states still have some work to do to catch up.

The top 6 "Honor Roll" states for school asthma and allergy policies are:

1. Connecticut (17 of 18 policy standards)
2. New Jersey (17)
3. Vermont (17)
4. Rhode Island (16)
5. Massachusetts (15)
6. Washington (15)

For more information about seasonal allergies, consult the Healia Health Guide to Outdoor Allergies. For information on other types of allergies or asthma, see the Healia Health Guide on Allergies, or the Healia Health Guide to Asthma. Share your own experiences with asthma or allergies in the schools at the Healia Health Community for Asthma or the Healia Health Community for Allergy.

_{Source: Asthma and Allergy Foundation of America, 2008 State Honor Roll of Asthma and Allergy Policies for Schools, 9/08. Available at: http://aafa.org/pdfs/FINALv2_STATE_HONOR_ROLL%20Full%20Report%202008.pdf}

_{Photo: The TruthAbout..., Flickr, Creative Commons}

Researchers in the UK report finding that young children who watch more than two hours of television a day nearly double their risk of developing asthma by the time they are teenagers. According to scientists, time spent watching TV may be a proxy measure of a sedentary lifestyle, which may be the root cause of the increase in asthma risk.

The study, published in the journal Thorax, tracked the health of over 3,000 children in the UK from birth to age 11½. As part of the study, parents were asked to report on the time their kids spent watching TV starting from age 3½. The parents were also asked about symptoms of wheezing among their children and whether their child had been diagnosed with asthma. None of the children involved in the study had symptoms of asthma as infants and toddlers.

By the time the children had reached almost twelve years of age, 6% had developed asthma. The children whose parents reported that they watched TV for more than two hours a day were nearly twice as likely to have been diagnosed with asthma as those who watched less TV.

Among the children diagnosed with asthma, 2% did not watch TV, 20% watched TV for less than one hour a day, 24% watched 1-2 hours of TV a day, and 44 % watched more than two hours of TV daily.

The researchers believe that inactivity is the cause of the increase in asthma risk instead of TV watching per se. Kids who watch more TV tend to have a more sedentary lifestyle and get less overall physical activity. Other studies have found a relationship between asthma risk, lack of activity, and being overweight. It may be that physical activity, which requires deeper breathing, somehow stretches and conditions the lungs, protecting the airways. Scientists have found some evidence that breathing patterns may affect the responsiveness of smooth muscles in the lung airways, muscles that become hyper-responsive in those with asthma. Perhaps failure to stretch these muscles in childhood can increase the likelihood that these muscles will become hyper-responsive.

The study authors note that it is unlikely that the children who developed asthma simply watched more TV because they had breathing problems and could not perform physical activity, because none of the children involved in the study had any asthma symptoms at the study’s outset. Also, there was little difference in the exercise levels of those with asthma and those without at age 11½.

For more information on asthma prevention, read "How Can I Prevent Asthma?" in the Healia Health Guide to asthma. Share your own experiences with asthma at the Healia Health Community for Asthma.

_{Photo: Axel Buhrmann, Flickr, Creative Commons}

Every year, the Asthma and Allergy Foundation of America (AAFA) evaluates conditions in the 100 largest cities in America and ranks them based on the quality of life in each city for people living with asthma. Researchers at AAFA review 12 factors that impact the quality of life for people with asthma, including: the estimated prevalence of adult and pediatric asthma; the crude death rate for asthma; risk factors, such as air pollution, pollen counts and public smoking; and medical factors, such as the number of asthma medications used per patient and the number of asthma specialists in the area. Below is a list of the cities that rank best in quality of life for people with asthma in 2009.

This year’s top 10 best cities in the U.S. to live in if you have asthma are:

1. Cape Coral, FL
2. Seattle, WA
3. Minneapolis, MN
4. Colorado Springs, CO
5. Portland, OR
6. Palm Bay, FL
7. Daytona Beach, FL
8. San Francisco, CA
9. Portland, ME
10. Boise City, ID

No matter where you live, having uncontrolled asthma significantly impact your life and lead to missed school or work, emergency room visits, hospitalization, and even death. If your asthma is poorly controlled, talk to your doctor about making changes to your asthma action plan include adjustments in your current asthma prevention medications. Not sure if your asthma is well controlled? Take the Asthma Quiz Challenge and find out how much you know about uncontrolled asthma symptoms. Learn more by reading the Healia Health Guide to Uncontrolled Asthma.

<sub>Source: Allergy and Asthma Foundation of America, Asthma Capitals 2009, Jan 2009. http://www.aafa.org/pdfs/2009ACPublicList.PDF 

Photo: pink_Fish13, Flickr, Creative Commons</sub>

For the past six years, the Asthma and Allergy Foundation of America (AAFA) has evaluated conditions in the 100 largest cities in America and ranked them based on the quality of life each affords for people with asthma. Researchers at AAFA review 12 factors that impact the quality of life for people with asthma, including: the crude death rate for asthma; the estimated prevalence of adult and pediatric asthma; risk factors, such as air pollution, pollen counts and public smoking; and medical factors, such as the number of asthma medications used per patient and the number of asthma specialists in the area. Below is a list of the cities that rank worst in quality of life for people with asthma in 2009.

This year’s top 10 worst cities in the U.S. to live in if you have asthma are:

1. St. Louis, MO. This Midwest city tops the list this year after coming in ninth last year, due to a variety of factors, including poor air quality and a rise in the percentage of uninsured residents.
   
   
2. Milwaukee, WI. Climbing up one spot from last year, Milwaukee has rates of self-reported asthma and estimated asthma prevalence that are higher than average, poor air quality, and only below average use of asthma control medications.
   
   
3. Birmingham, AL. Jumping all the way up from number 13 on the list last year, Birmingham saw an increase in estimated asthma prevalence and ranks poorly in air quality and public smoke free laws. In fact, all of the cities that make the top 10 lack public smoking bans.
   
   
4. Chattanooga, TN. Rising twelve spots from last year, this Appalachian city saw an increase in the crude asthma death rate and a decline in the use of rescue medications from last year. Chattanooga also ranks below average in air quality.
   
   
5. Charlotte, NC. While this Southern city has an above average rate of estimated asthma prevalence, Charlotte saw a jump in its annual pollen score, which accounts for its rise from last years position in the number seven spot.
   
   
6. Memphis, TN. A small bright spot on the list, Memphis improved in self-reported asthma incidence, annual pollen score, and uninsured rate from last year, causing it to drop one spot from last year’s list. High crude death rates from asthma and poor air quality still negatively impact people living with asthma in Memphis.
   
   
7. Knoxville, TN. Home to the University of Tennessee, Knoxville improved its ranking considerably over last year when it held the top spot. Knoxville improved because both the estimated and self-reported prevalence of asthma decreased, and reported pollen levels were lower than the national average. However, poor air quality and low adherence to asthma medications keep Knoxville in the top 10.
   
   
8. McAllen, TX. Perhaps not a household name, this border town near Brownsville jumps all the way up from number 26 last year. While the air quality ranking actually improved from last year, increases in the estimated and self-reported asthma prevalence and the annual pollen score are responsible for the precipitous rise.
   
   
9. Atlanta, GA. The "Jewel of the South" improved its ranking from last year, moving down from the number four spot thanks to improvements in crude asthma death rate, poverty rate, rate of uninsured people, and use of quick-relief asthma medications. Below average air quality and low numbers of asthma specialists are still a problem in Atlanta.
   
   
10. Little Rock, AK. Rounding out the top 10, Little Rock rose 12 spots from last year to just make the list. Increases in the annual pollen score, air pollution levels, and self-reported asthma rates offset a nice improvement in crude asthma death rate.

No matter where you live, having asthma that is uncontrolled can significantly impact your life and lead to missed school or work, emergency room visits, hospitalization, and even death. If your asthma is poorly controlled, talk to your doctor about making changes to your asthma action plan include adjustments in your current asthma prevention medications. Not sure if your asthma is well controlled? Take the Asthma Quiz Challenge and find out how much you know about uncontrolled asthma symptoms. Learn more by reading the Healia Health Guide to Uncontrolled Asthma.

_{Source: Allergy and Asthma Foundation of America, Asthma Capitals 2009, Jan 2009. http://www.aafa.org/pdfs/2009ACPublicList.PDF}

_{Photo: IllinoisHorseSoldier, Flickr, Creative Commons}

On December 31^st, 2008, asthma inhalers are set to go “green” – in more ways than one. Rescue inhalers containing fast-acting medications such as albuterol that are used to ease symptoms of an asthma attack will no longer use chlorofluorocarbons (CFCs) as a propellant. Instead, by year's end, all albuterol inhalers must be powered by the more eco-friendly chemical hydrofluoroalkane (HFA).

While these green inhalers use propellant that is gentler on the ozone layer, they also cost a lot more, even though the medicine they contain is identical to older, CFC-powered inhalers: $30 to $60 for green inhalers compared to as little as $5 or $10 for the older CFC inhalers. What’s more, HFA inhalers must be used differently than the older CFC versions. Patients report that the medicine feels and tastes different, despite claims that the two types of inhalers work equally well.

While most of the nation’s 20 million asthma patients have already made the switch, about 20% of albuterol prescriptions were still being filled with the old CFC inhalers in mid-November. When these asthma sufferers go to refill their rescue inhaler prescriptions after the end of the year, they will find that not only does it cost a lot more, it also works differently. Pharmacists may not even notice the switch since the medication contained within is the same. This can leave patients on their own to figure out how to use the new inhalers.

Rescue inhalers containing albuterol are for quick relief of wheezing, not for daily asthma management. Patients also need daily medication to control their asthma and prevent flare-ups. If you are using your albuterol inhaler more than a few times a month, your asthma is not well-controlled. Talk to your doctor about adjusting your daily asthma control medications.

Recent research suggests only one in five children has their asthma under good control and no one knows how many adults have uncontrolled asthma. Find out more about asthma control by taking the Healia Asthma Quiz or by reading our guide, the Healia Health Guide on Uncontrolled Asthma.

Quick tips about the new HFC inhalers:

• Expect a softer puff instead of the older version's cold blast of air in the back of the throat.
• The new inhalers clog more often because HFA makes the drug stickier. Clean the hole weekly, following the specific instructions for each brand.
• Never get the whole device wet.

If you have asthma and have not been properly instructed on how to use the new HFA inhalers, make an appointment with your doctor or ask your pharmacist to show you how to use them. To find out more about asthma, see the Healia Health Guide on Asthma or join the Healia Health Community for Asthma.

 

_{Photo: spcummings, Flickr, Creative Commons}