Clearing the Air

Since about 1980, asthma prevalence and asthma-related hospitalizations and deaths have increased substantially, especially among children. Of particular concern is the high mortality rate among African Americans with asthma.Recent studies have suggested that indoor exposures—to dust mites, cockroaches, mold, pet dander, tobacco smoke, and other biological and chemical pollutants—may influence the disease course of asthma. To ensure an appropriate response, public health and education officials have sought a science-based assessment of asthma and its relationship to indoor air exposures.Clearing the Air meets this need. This book examines how indoor pollutants contribute to asthma—its causation, prevalence, triggering, and severity. The committee discusses asthma among the general population and in sensitive subpopulations including children, low-income individuals, and urban residents. Based on the most current findings, the book also evaluates the scientific basis for mitigating the effects of indoor air pollutants implicated in asthma. The committee identifies priorities for public health policy, public education outreach, preventive intervention, and further research.Table of ContentsFront MatterExecutive Summary1 Major Issues in Understanding Asthma2 Methodological Considerations in Evaluating the Evidence3 Patterns of Asthma Morbidity and Mortality4 Pathophysiological Basis of Asthma5 Indoor Biologic Exposures6 Indoor Chemical Exposures7 Exposure to Environmental Tobacco Smoke8 Indoor Dampness and Asthma9 Asthma and Nonresidential Indoor Environments10 Impact of Ventilation and Air Cleaning on Asthma11 Summary of Research Recommendations and Overall ConclusionsAppendix A: Theoretical Considerations Relevant to the Influence of Ventilation and Air Cleaning on Exposures to Indoor-Generated PollutantsAppendix B: Workshop SummariesAppendix C: Committee and Staff BiographiesIndex