(OCTOBER 22, 2003, SANTA ROSA, CA) A new report released by the Sonoma County Asthma Coalition today shows that the asthma epidemic is impacting Sonoma County. More than 43,000 residents live with the chronic lung disease, which causes the airways to become inflamed and can make breathing difficult. Asthma rates have increased in epidemic proportions over the last two decades, rising 74 percent between 1980 and 1996.

The Sonoma County Asthma Coalition’s Asthma Status Report shows that the disease is costing the county in preventable deaths, healthcare costs, and lost school days. Local data on asthma was compiled to get a statistical glimpse of asthma in Sonoma County, where 9.4 percent of residents have the lung disease. However, there are serious gaps in available data that make it difficult to get a true picture of asthma and how it is impacting the county.

“We know from available data that asthma is a significant public health problem in Sonoma County,” said Mary Maddux-Gonzalez, MD, MPH, Sonoma County Public Health Officer. “But all you need to do is talk to doctors, school nurses and emergency personnel to see that the problem may be even worse than the numbers are showing us.”

The number of deaths in Sonoma County is tragic with 102 people dying from asthma between 1990 and 2000. What is most shocking about that figure is asthma is a treatable disease. No one should ever die from asthma.

While currently there is no cure for asthma, it can be treated with medication and by reducing exposure to environmental irritants that trigger asthma symptoms such as air pollution, pesticides, pollen, secondhand smoke, mold, animal dander, and dust mites, just to name a few.

Asthma is taking a financial toll as well. Hospital charges alone for asthma totaled more than $20.8 million in Sonoma County between 1990 and 2000. In 2000, 265 people were hospitalized in Sonoma County with asthma. In 2001, approximately 2,500 people had to go to the emergency room or an urgent care facility to get help with their asthma.

Asthma hits kids hardest. A higher percentage of children (11.6) in Sonoma County suffer from asthma symptoms compared to adults (8.7) and the highest hospitalization rate is for children under age 5.

Kids with asthma often have a hard time keeping up in school and staying physically active. In a nationwide survey of children with asthma, 24 percent said they were limited in their activities because of the lung disease.

Asthma is the number one cause of school absenteeism due to chronic illness. Each year, 14 million school days are missed nationwide due to the lung disease. Local data on school absenteeism could not be compiled because there is no uniform system for recording school absences and their causes.

Schools are key to fighting the asthma epidemic because children spend so much time in the classroom. But few schools in Sonoma County have written indoor air quality plans and adherence to model indoor air quality policies adopted by the Environmental Protection Agency varies from district to district.

“What is most disturbing about these numbers is that it doesn’t have to be this way,” said Michael Martin, MD, one of only a few asthma and allergy specialists in Sonoma County. “Asthma is a treatable lung disease, but proper management is key. People with asthma shouldn’t have to go to the hospital to get help breathing. Children with asthma shouldn’t have to miss school or avoid activity.”

It is not clear why asthma has become such a public health problem, but there are a number of contributing factors in Sonoma County to consider.

Access to healthcare is a major issue as many Sonoma County residents struggle to get consistent healthcare because they lack health insurance. There are 8,000 uninsured children in the county and another 20,000 who are underinsured, which means many with asthma may not be getting the treatment and medicines they need to keep their disease under control.

The number of physicians in Sonoma County is shrinking while the population is growing, and there are few asthma specialists.

There are also a variety of environmental factors in Sonoma County that can make asthma worse, including high pollen counts, mold and fungus, use of wood-burning stoves and fireplaces, agricultural burning, and high pesticide use.

While ozone air pollution declined 11 percent in the rest of the country between 1982 and 2001, ozone levels in Sonoma County do not show a decreasing trend. In fact, current ozone and particulate matter levels are already near the maximum allowable standards to protect the health of sensitive members of the population, including those with asthma. The growing number of cars, buses and trucks in Sonoma County will continue to add to the air pollution problem.

“Even small amounts of air pollution can irritate the lungs,” said Dr. Martin. “Studies have linked premature death as well as increased hospital admissions, emergency room visits and asthma episodes with exposure to particulate matter air pollution and diesel exhaust. We must look at the connection between the environment and lung health here in Sonoma County.”

Large amounts of pesticides are also used in Sonoma County, which ranked 18 out of 58 counties for pesticide use in 2001. Studies of pesticide exposure in both humans and laboratory animals suggest that pesticides can cause or contribute to asthma and other respiratory ailments.

Secondhand smoke is another concern. Data collected from 742 Sonoma County families with newborns shows that secondhand smoke was present in 9.6 percent of their homes. Children who live in households with secondhand smoke have more episodes of breathing difficulties, need to take more medications, and have more emergency room visits than children who live in smoke-free homes. Secondhand smoke is also connected with more respiratory-related school absences, especially among those with asthma.

Mold in homes is a growing health issue in Sonoma County with the number of calls to the Environmental Health Division of the Sonoma County Department of Health Services increasing 67 percent from 2001 (75 calls) to 2002 (125 calls).

From mold to air pollution to asthma management in the schools, the asthma epidemic is a complex problem that can’t be solved by one sector alone. It will require a coordinated effort by healthcare workers, school personnel, policymakers, parents, and the community at large.

“The Asthma Status Report is the first attempt to gather baseline data so we can begin to understand how asthma is affecting Sonoma County and what needs to be done to fight the asthma epidemic,” said Elisabeth Chicoine, RN, Director of Health Programs for Community Action Partnership of Sonoma County and Chair of the Sonoma County Asthma Coalition.

The Sonoma County Asthma Coalition is fighting the asthma epidemic by mobilizing the community to reduce environmental triggers such as air pollution and ensuring that everyone has access to proper asthma treatment, which includes an asthma action plan that addresses environmental triggers.

“We are working with the American Lung Association to secure county and city resolutions to reduce the use of diesel vehicles in their government fleets,” Chicoine said.

The coalition is also working to establish a countywide system of tracking data on asthma that includes at least six basic indicators: asthma deaths, asthma hospitalization rates, emergency department visits, ozone air pollution levels, particulate matter air pollution, and secondhand smoke in homes. School districts need a unified system in place for collecting data on asthma prevalence rates and absences due to asthma.

“It will take a community-wide effort to reduce the suffering caused by asthma,” Chicoine said. “We all have to take responsibility for improving the quality of air we breathe and stopping the asthma epidemic in its tracks.”

The Sonoma County Asthma Coalition is funded by a grant from The California Endowment through its Community Action to Fight Asthma project. The American Lung Association of California-Redwood Empire Branch is the lead organization and houses the coalition at its office at 115 Talbot Avenue in Santa Rosa.

The Sonoma County Asthma Coalition collected and compiled existing data to prepare the Asthma Status Report. Sources are provided for all data presented in the report.

For a complete report or more information about the Sonoma County Asthma Coalition, call 707.527.5864 or visit www.sonomaasthma.org.