Summer 2011

CAP Webinar Series, Two More Webinars in 2011

Isam Herndon
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    In the last quarter, California Asthma Partners (CAP) presented two webinars in its ongoing series focused on the Strategic Plan for Asthma in California.  On May 18th, CAP presented a  webinar focused on Goal 3 of the Strategic Plan: Healthcare. Dr. Andrew Greenberg presented, "The Role of Bronchial Thermoplasty in the Treatment of Severe Asthma.” For many patients with severe persistent asthma, the primary therapy includes inhaled corticosteroid at higher doses plus a long-acting inhaled beta 2-agonist.
    Bronchial Thermoplasty is a fairly new Food and Drug Administration (FDA) approved, non-drug surgical procedure used to alleviate severe persistent asthma for patients 18 years or older whose asthma is not well controlled with inhaled corticosteroids and long acting beta agonists.
Bronchial Thermoplasty is a bronchoscopic procedure that involves delivering energy (heat) at several locations in the major airways in order to reduce the mass of smooth airway muscle and decrease bronchial constriction in severe asthmatics.
    Unfortunately most insurers do not cover the three treatment series, which can cost $12,000 to $20,000.  Bronchial Thermoplasty reduces asthma flare-ups by one-third, and emergency department visits by 85%.
    Dr. Greenberg is a pulmonologist at Alta Bates Summit Medical Center in Oakland and Berkeley, CA. He is one of a hand full of physicians performing Bronchial Thermoplasty across the country, and the only physician providing this service in the East Bay.

    On July 21st, CAP hosted “Urban Greening in California: What it means for Respiratory Health," a webinar related to Strategic Plan goal 5: Outdoor Environments.  Polly Escovedo and Julie Alvis of the California Natural Resources Agency and Dr. Rick Kreutzer of the California Department of Public Health were the presenters. The webinar focused on the many social, community, environmental and health benefits of urban greening initiatives and provided information about grant funding to support future urban greening efforts.

Recordings of these two webinars will soon be available on the CAP website. In the meantime, view previous webinar recordings here.

CAP Plans Two More Webinars in 2011
     CAP will be hosting a webinar in September, which will focus on the Affordable Care Act and its impact on asthma care. Another webinar slated for October will focus on asthma in schools.  More information on these webinars will soon be available here on the CAP website.
 

Childhood Asthma in Riverside County, 2009

Terry Roberts
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    Asthma affects Riverside County children of all backgrounds, but particularly those living in relative poverty.  In order to gauge the severity of childhood asthma and its impact on health care utilization across the county, hospital emergency department (ED) data was reviewed over a three year time period. 
    It should be noted that many areas of high need are not urban centers where the highest childhood asthma rates are usually expected.  Because this data is taken from ED visits it is not an indicator of asthma prevalence, rather an indicator of where childhood asthma is uncontrolled.  The reasons for lack of control may vary from zip code to zip code.  The lack of primary care providers (PCPs) may explain why uncontrolled asthma is resulting in ED usage.  Families need to be able to access the PCP, afford medications, understand and comply with prescriptions and identify and avoid triggers. 
    Hospitalization of a child for asthma is categorized as a preventable hospitalization by national and state agencies.  According to a recent study by the Centers for Disease Control and Prevention, the cost of treating asthma in the hospital is almost 40 times greater than an outpatient visit.
Improving asthma symptoms and helping families gain control is the primary goal of the Riverside County Department of Public Health’s Asthma Program.  The free services include asthma education, allergen-proof mattress and pillowcase covers, medication delivery devices and an environmental assessment. Click here to read the entire brief.
 

Secondhand Smoke in Multi-Unit Housing: Special Hazard for those with Asthma

Margo Sidener
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For the over 40% of Californians who live in dwellings that are attached to others, secondhand smoke can be not only a nuisance that leads to confrontations with neighbors, but also a serious health hazard.  The populations most at-risk include those with asthma and other respiratory diseases, children, and the elderly.  Their most common complaint is that neighbors allow their tobacco smoke to drift from their housing units, balconies and other outdoor areas into the homes of other residents.  Smokers tend to deny the damage that their smoking does, despite the proclamation of the US Surgeon General that, “There is no risk-free level of exposure to secondhand smoke.” 

    Recent research has shown that secondhand smoke from a neighbor’s home can reach startling high levels.  Dr. Neil Klepeis, a researcher from Stanford University, recently studied the level of contaminants in a condominium in San Jose and confirmed this.  At a press conference hosted by Breathe California of the Bay Area, Dr. Klepeis revealed that the level of hazardous tobacco chemicals in the nonsmoking victim’s home was as high as one would find in a gambling casino. 
    The declaration of the California Air Resources Board that secondhand smoke is a Toxic Air Contaminant that “may contribute to an increase in deaths or serious illnesses” needs to be taken seriously; multi-unit housing managers and owners need to be educated and encouraged to adopt smoke-free policies.  They need to be informed that such smoke-free policies would be popular since 84% of Californians do NOT smoke, and that they can lead to fewer fires, reduced insurance, and reduced maintenance.  Moreover, clear policies will reduce the time spent arbitrating tenants’ arguments, since polls show 40%-50% of owners/managers have had to deal with complaints about secondhand smoke.  In Santa Clara County, 96% of apartment residents expressed that smokers should not be able to smoke where they want, and 84% would support a no-smoking policy for their complex (Santa Clara Public Health Dept. survey, 2009).
    Unfortunately, in this economy building owners/managers are especially reluctant to make changes, even ones that might prove popular.  Therefore, the best route to protection is getting laws passed.  In January, the Santa Clara County Board of Supervisors passed an ordinance that bans all smoking in multi-unit residences including apartments, condominiums, and senior citizen residences.  The ordinance, one of the strongest in the US, applies to all unincorporated areas in the County.  Approximately twenty-five communities in California, and many more in the US, have adopted smoke-free housing laws of varying types.  Others like San Jose have adopted resolutions that encourage builders/owners to go smoke-free.

Until such laws are commonplace, those who have asthma need to take steps to protect themselves:

  • Check out listings of smoke-free housing such as www.smokefreeapartments.com or call your local apartment association for information.
  • Read rental or home owners' association documents thoroughly before signing them.  Determine the exact smoking policies and enforcement methods and confirm with the agent. 
  • Do not accept anecdotal information that the agent may provide; stick to what is written on the agreement.
  • If your options are limited, by factors such as location or cost considerations, try to get an apartment or condominium next to nonsmokers and get the owner to create smoke-free future spaces by only renting/selling to nonsmokers adjacent to your unit (in writing).
  • Take a physical tour of the exact unit, not a model, and look for proximity to others’ balconies and patios.   Also check any intake air vents and their position relative to areas where there might be smoke.  Absent wind, smoke tends to go up, so avoid living above smokers as much as next door.
  • Report violations of any policies immediately and continuously.
  • Get to know your neighbors.  A request not to let smoke drift from someone you know and like is harder to ignore than an a request form an unknown neighbor.
  • Best of all, form a group of tenants who want smoke-free housing and advocate to the owner/manager regularly.
 
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