The Journal of Allergy and Clinical Immunology
Volume 113, Issue 3 , Pages 420-426, March 2004

Clinical deterioration in pediatric asthmatic patients after September 11, 2001☆

  • Anthony M Szema, MD

      Affiliations

    • Department of Medicine, State University of New York at Stony Brook School of Medicine, Stony Brook, NY, USA
    • Corresponding Author InformationReprint requests: Anthony M. Szema, MD, Allergy and Asthma Center, Department of Medicine, T16, Room 041, SUNY Stony Brook School of Medicine, Stony Brook, NY 11794-8161
    • ,
  • Meera Khedkar, MD

      Affiliations

    • Department of Medicine, State University of New York at Stony Brook School of Medicine, Stony Brook, NY, USA
    • ,
  • Patrick F Maloney, MD

      Affiliations

    • Department of Medicine, State University of New York at Stony Brook School of Medicine, Stony Brook, NY, USA
    • ,
  • Patricia A Takach, MD

      Affiliations

    • Department of Medicine, State University of New York at Stony Brook School of Medicine, Stony Brook, NY, USA
    • ,
  • Michael S Nickels, MD, PhD

      Affiliations

    • Department of Medicine, State University of New York at Stony Brook School of Medicine, Stony Brook, NY, USA
    • ,
  • Harshit Patel, MD

      Affiliations

    • Department of Medicine, State University of New York at Stony Brook School of Medicine, Stony Brook, NY, USA
    • ,
  • Francesmary Modugno, PhD, MPH

      Affiliations

    • Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, Pa, USA
    • ,
  • Alan Y Tso, MD

      Affiliations

    • Charles B. Wang Community Health Center, New York, NY, USA
    • ,
  • Deborah H Lin, MD

      Affiliations

    • Charles B. Wang Community Health Center, New York, NY, USA

Received 14 October 2003; received in revised form 20 November 2003; accepted 1 December 2003.

Abstract 

Background

New York City residents were exposed to a variety of inhaled substances after the collapse of the World Trade Center. Exposure to these substances might lead to an increase in asthma severity, with residential distance from Ground Zero predictive of the degree of change.

Objective

We sought to assess the effect of the World Trade Center collapse on local pediatric asthmatic patients.

Methods

We retrospectively reviewed the charts of 205 pediatric patients with established asthma from a clinic in lower Manhattan's Chinatown. Clinical data were obtained for the year before and the year after September 11, 2001. Measurements included numbers of visits, asthma medication prescriptions, oral corticosteroid prescriptions, weekly doses of rescue inhaler, and peak expiratory flow rates. Residential zip codes were used to compare the asthma severity of patients living within and beyond a 5-mile radius of Ground Zero.

Results

After September 11, 2001, these children had more asthma-related clinic visits (P = .002) and received more prescriptions for asthma medications (P = .018). No significant differences in oral steroid or rescue inhaler use were noted. Those living within 5 miles had more clinic visits after September 11, 2001 (P = .013); the increase in clinic visits for patients living more than 5 miles from Ground Zero was not significant. Mean percent predicted peak expiratory flow rates decreased solely for those patients living within 5 miles of Ground Zero during the 3 months after September 11, 2001.

Conclusions

Asthma severity worsened after September 11, 2001, in pediatric asthmatic patients living near Ground Zero. Residential proximity to Ground Zero was predictive of the degree of decrease in asthma health.

Keywords:  Asthma, pediatric, World Trade Center, September 11 2001, peak flow

Abbreviations:  CBWCHC, Charles B. Wang Community Health Center, PEFR, Peak expiratory flow rate, WTC, World Trade Center

 

☆ Supported by a research grant and medical student scholarships from the Chinese-American Medical Society, the SUNY Dean's Clinical Scholar Targeted Research Opportunities Award, the Allergy and Asthma Center of the Stony Brook Foundation, and the Howard Hughes Undergraduate Fellowship Award.Drs Szema, Khedkar, Maloney and Takach contributed equally to this study.

PII: S0091-6749(03)02777-5

doi:10.1016/j.jaci.2003.12.015

The Journal of Allergy and Clinical Immunology
Volume 113, Issue 3 , Pages 420-426, March 2004

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