Atlanta's Ranking Falls with a Breath of Fresh Air

GFP Note: Atlanta's ranking dropped from number 4 in 2008 to number 9 in 2009 as America's most challenging place to live with asthma.

St. Louis Named Top Asthma Capital

/PRNewswire/ -- St. Louis, MO, is ranked as the No.1 Asthma Capital – the most challenging place to live with asthma in the U.S.(1,a,1) – according to the Asthma and Allergy Foundation of America (AAFA), which conducted the study. This ranking was determined based on an analysis and scoring of 12 factors in the 100 largest U.S. metro areas.(1,b,5) St. Louis was ranked No.1 this year in part due to worse than average scores in crude death rate due to asthma (2.2%), higher than average pollen counts over the previous year and the lack of “100-percent" public smoke-free laws, which many other large cities are enacting.(1,a,1)

St. Louis topped the study after being ninth last year (2,a,1) due to a variety of factors, including poor air quality and a rise in the percentage of uninsured residents (2,a,1). It is interesting to note, however, that the prevalence of asthma, both estimated and self-reported in this city decreased slightly over the last year.(1,a,1; 2,a,1)

In 2008, Knoxville, TN, ranked No.1 (2,b,1) but moved to the number seven spot in 2009 (1,b,1) because both the estimated and self-reported prevalence of asthma decreased, and reported pollen levels were lower than the national average, among other factors. (1,b,1) Of note, all of the top 10 Capitals scored “below average” with regard to whether these cities embraced “100-percent” public smoke-free laws.(1,d,1) The complete rankings with detailed data for each city can be found at www.asthmacapitals.com.

For six years, AAFA has scientifically researched and evaluated conditions in the largest metropolitan areas in America and ranked them based on quality of life for people with asthma in each city. The Foundation reviews 12 factors: Crude death rate (CDR-recorded metro area deaths from asthma) for asthma; the estimated prevalence of adult and pediatric asthma; risk factors, such as air pollution, pollen counts and public smoking bans; and medical factors, such as the number of asthma medications used per patient and the number of asthma specialists in the area.(1,e,5)

“For the last several years, I have seen an increase in the severity of asthma in our patients and how their life is affected by it,” (1,a,1;2,a,1) said Mario Castro, MD, MPH, Professor of Medicine and Pediatrics, Washington University in St. Louis. “The lack of a smoke-free public environment for our patients with respiratory problems, especially asthma, (1,a,1) in St. Louis is appalling. Our return to the No. 1 Asthma Capital ranking is very concerning news for St. Louis asthma patients and physicians.”(1,a,1) Asthma, if left uncontrolled, can result in serious consequences.(3,a,1) In fact, sudden asthma episodes account for an estimated 1.8 million emergency room visits (3,b,4) and nearly 500,000 hospital admissions (3,c,4) each year in the United States.

AstraZeneca sponsored this research to better understand the environmental factors and health policies that impact people with asthma, specifically around asthma control. For the last 20 years, AstraZeneca has helped millions of people manage their respiratory conditions through discovery and development of asthma medications.

“Although St. Louis was found to be a particularly difficult place for people with asthma to live, asthma triggers are present in every American city,” says Mike Tringale, AAFA's Director of External Affairs. “There is no way for asthma patients to escape their disease,(4,a,1) but no matter where they live, patients can work with their physicians to find ways to effectively control their symptoms.” (5,a,1)

“We hope this survey ranking encourages asthma patients everywhere to talk to their doctors about how to avoid asthma triggers and about effective asthma control,” said Dr. Castro. “While asthma may not be curable, (4,a,1) it can be kept under control by following an asthma action plan that may in some cases include a controller treatment, as prescribed by a physician.” (6, a, 1;6,b,1)

Top 2009 Asthma Capitals

The top 10 Asthma Capitals for 2009, considered to be the most challenging places to live with asthma, are:
1.St. Louis, MO
2.Milwaukee, WI
3.Birmingham, AL
4.Chattanooga, TN
5.Charlotte, NC
6.Memphis, TN
7.Knoxville, TN
8.McAllen, TX
9.Atlanta, GA
10.Little Rock, AR(1,d,1)

References:
1.2009 Allergy Foundation of America Asthma Capitals study results. Available at www.asthmacapitals.com. Accessed on 1/22/09.
2.2008 Allergy Foundation of America Asthma Capitals study results. Available at www.asthmacapitals.com. Accessed on 1/22/09.
3.Centers for Disease Control. “Asthma Prevalence, Health Care Use and Mortality, 2003-2005” Available at http://www.cdc.gov/nchs/products/pubs/pubd/hestats/ashtma03-05/asthma03-05.htm. Accessed 1/22/09.
4.Asthma and Allergy Foundation of America. “Asthma Facts and Figures.” http://www.aafa.org/display.cfm?id=8&sub=42. Accessed 1/22/09.
5.Asthma and Allergy Foundation of America. “Asthma Overview Prevention.” http://www.aafa.org/display.cfm?id=8&cont=9. Accessed 1/22/09.
6.National Heart, Lung and Blood Institute. “How Is Asthma Treated and Controlled?” http://www.nhlbi.nih.gov/health/dci/Diseases/Asthma/Asthma_Treatments.html. Accessed 1.22.09.

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American Lung Association Faults Environmental Protection Agency for Ignoring Deadly Particle Pollution in Five U.S. Cities in List Released Today

/PRNewswire-USNewswire/ -- The American Lung Association faults the U.S. Environmental Protection Agency (EPA) for leaving five U.S. cities off its list of those required to take immediate action to reduce particle pollution in the air. This deadly omission puts public health in the following metropolitan areas at considerable risk: Houston, Texas; Augusta, Georgia; Columbus, Georgia; Greenville, South Carolina; and Fairmont, West Virginia. In addition, EPA left many individual counties off the list despite the impact of emissions from those counties on pollution in metropolitan areas.

Particle pollution is typically a mixture of ash, soot, diesel exhaust, chemicals, metals and aerosols. It can trigger heart attacks and strokes, and cause irregular heartbeats, lung cancer and premature births. Breathing particle pollution year-round can shorten life by one to three years. The five cities omitted from the EPA's list all showed unhealthy year-round levels of fine particulate matter, known as PM2.5. In its list released today, the EPA only identified counties and metropolitan areas that experience unhealthy spikes in particulate matter pollution over the course of a 24-hour period.

The Clean Air Act requires that the EPA officially notify all localities with documented unhealthy levels of particulate air pollution so that leaders can begin to make necessary changes.

"The Clean Air Act plainly requires the EPA to identify all the places where air pollution poses a threat to public health," said Paul G. Billings, Vice President, National Policy and Advocacy of the American Lung Association. "This process is essential to reducing the burden of air pollution in these communities, because it triggers critical protective measures to reduce air pollution and protect public health."

According to EPA records, year-round particulate matter levels in Houston and Columbus, Georgia, have worsened and people in these communities are at risk. Particle pollution harms people in many ways, even when the particle levels are very low. Particle pollution worsens serious respiratory disorders, including asthma and causes wheezing and coughing. People most at risk include children and teens, seniors, people with asthma and other lung diseases, people with cardiovascular diseases and diabetics.

In 2006, the EPA set new limits, called standards, for unhealthy levels of PM2.5, triggering a two-year process to identify which counties fail to meet the standards. In today's official action, the EPA formally determines, or "designates" counties that fail to meet, or "attain," the standards. Those counties then fall into a classification of "nonattainment" that triggers specific measures to be put in place to reduce emissions. Other counties do not have to comply with these requirements.

EPA misses many individual counties, limiting clean-up in larger cities

The Lung Association also found that EPA's official "nonattainment" list omitted many counties that are part of larger metropolitan areas with recognized unhealthy levels of particle pollution. Large sources of particle pollution, such as highways, railroads and industries are usually spread throughout a metropolitan area. To tackle the complex clean up of these widespread sources, the planning area needs to include all the counties where sources exist. Omitting these counties makes it harder for the rest of the metropolitan area to meet the standard. The American Lung Association previously advised EPA that all the counties should be included in any metropolitan area that monitored unhealthy levels.

"It's naive to act as if air pollution is trapped by the invisible lines that define our counties' borders," said Billings. "The EPA has a responsibility to do more to protect public health when it comes to air pollution."

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