Asthma and Buildings – California and US Trends in Asthma

Buildings are too often neglected in the asthma equation. Asthma is sometimes defined as a symptom of poor indoor air quality, and other times defined as a Building Related Illness. This blog references the recently released report, “Asthma in California: A Surveillance Report,” compiled by the CA Breathing Asthma Program at the CA Dept of Public Health (CDPH). Healthy Building Science is most interested in the Asthma and Buildings connection, and any big picture summary report such as this is informative to our practices.

Asthma in California – National & State Statistics

For Californians with asthma who see this report as too broad, asthma data for each of California’s 58 counties can be found in the County Asthma Profiles at www.californiabreathing.org.

Asthma in California Report – Key Findings

•  About 10% of adults and 5% of children with current asthma are exposed to secondhand smoke in their home.
• On average, people with current asthma are exposed to three asthma triggers in the home, including: mold; cockroaches, mice, or rats; pets; carpeting in the bedroom; wood burning fireplace or stove; gas used for cooking; unvented gas fireplace or stove; or smoking in the home.
• On average, people with current asthma report taking about 3.5 actions to reduce asthma triggers in the home, including: using sealed plastic mattress or pillow covers, washing sheets in hot water, not allowing pets in the bedroom, using exhaust fans, using air cleaners, and using dehumidifiers.
• About 40% of people with asthma are renters, about 5% live in duplexes, and about 20% live in multi-unit buildings. Although these are not significantly higher than people who do not have asthma, renting a housing unit or living in a unit with shared walls can affect the level of control people have over asthma triggers in their home.

Type of Housing by Asthma Status

• Approximately five million Californians – or one in eight people – have been diagnosed with asthma.
• In 2010, there were almost 35,000 asthma hospitalizations in California, which resulted in over $1 billion in annual charges.
• There are dramatic differences in asthma by race/ethnicity. This is most striking for Blacks, who have 40 percent higher asthma prevalence, four times higher asthma ED visit and hospitalization rates, and two times higher asthma death rates than Whites.

Lifetime and Current Asthma Prevalence by Race:Ethnicity and Age

• Areas with lower median incomes have higher rates of asthma hospitalizations and ED visits, and adults with lower incomes are less likely to have well-controlled asthma.

Overall, Californians suffer from asthma less than the average American:

Lifetime and Current Asthma Prevalence Among Adults, California and the U.S.

If you’ve got asthma in California, you may want to avoid the Central Valley:

Number of Days per Year Above the CA 8-HR Ozone Standard

Estimated Number of Days per Year Above the California 24-hour PM10 Standard

I was surprised to learn that rural Californians are suffering asthma as much (or more than) as urban Californians, but perhaps the maps above help explain this phenomenon:

Lifetime and Current Asthma Prevalence by Urban:Rural Residence, California 2009

I was also surprised to learn it’s not the young dying for asthma, it’s the old:

Age-Adjusted Asthma Deaths per 1,000,000 California Residents by Age and Sex

Asthma and Healthy Building Science

We routinely perform Healthy Building Inspections for families concerned about asthma in their homes or offices. We’ve read similar studies and books about sick buildings, and are trained in picking up visual cues of potential asthma triggers indoors to find the link between asthma and buildings. Most often we make helpful recommendations based solely on a thorough visual inspection, however, under some circumstances we perform Environmental Testing for common indoor allergens and asthma triggers. If you suffer from asthma or are concerned about others in your building with respiratory problems, consider further educating yourself or hiring an expert like us to help. There are ALWAYS improvements that can be made, and most are free or low-cost strategies.

For questions or comments on the report, or to request a hard copy, please email california.breathing@cdph.ca.gov. Thank you to Janet Tobacman, Healthy Housing Program Manager at CDPH, for broadcasting this report.