Still breathless: Asthma rates rising even as smoking and pollution decline

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Asthma rates in the U.S. have increased over the past ten years, according to the CDC. However, as Ileana Arias, principal deputy director of the CDC says, no one quite knows why: the increase of 4.3 million Americans with asthma since 2001 comes even as air quality has increased and smoking rates have decreased. And since researchers have adopted different means of measuring asthma incidence in the population, a direct comparison to rates in the 1990s isn’t possible. The positive note in the CDC’s report, though, is that the rate of death from asthma has declined.

In his commentary on this report, Paul Garbe, chief of the CDC’s air pollution and respiratory health branch, observed that one of the key means of treating asthma — a written action plan for patients — is too often neglected by physicians. Such plans effectively teach patients how to manage their symptoms, including how to avoid triggers, properly take medication and (notes ACSH’s Dr. Gilbert Ross) monitor their air flow with a peak flow meter.

ACSH’s Dr. Josh Bloom comments that, although the increase in incidence is not understood, the decrease in deaths is almost certainly due to improved therapies. “Advair, one of the top selling drugs in the world, was introduced in the U.S. in 1998. It, and similar products, have revolutionized the treatment of asthma. The total number of asthma-related deaths, as well as death rates, have fallen sharply since then and continue to do so.”

We direct any readers who’d like to know more about risk factors, triggers and treatments for asthma to our 2008 report by Columbia University pulmonologist Dr. Emily DiMango, Asthma: Causes, Diagnosis and Treatment.