1. + Asthma & your premature baby Julie Grutzmacher PUBH-6165-2 Environmental Health Dr. Patrick Tschida Walden University April 22, 2012

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3. + Goals of Presentation Increase awareness of Asthma and its triggers Empower you to modify or eliminate the Asthma triggers Reduce hospital admissions from Asthma attacks

4. + What is Asthma? Swelling and narrowing of the airways that carry air to and from the lungs Caused by some environmental irritant Increase in the production of mucus which makes breathing even harder Centers for Disease Control and Prevention. (2012). Basic Information: What is Asthma? Retrieved April 10, 2012 from http://www.cdc.gov/asthma/faqs.htm

5. + Impact of Asthma Nearly 7 million children affected Among infants and children, boys are more likely to have it Black and Hispanic children at higher risk (12.1% & 7.3%) Black children more likely to die from Asthma related complications National Heart Lung and Blood Institute. (2011). Who is at risk for Asthma? Retrieved April 10, 2012 from http://www.nhlbi.nih.gov/health/health-topics/topics/asthma/atrisk.html

6. + Asthma in Illinois In 2009, 9.2% of total population of children were found to have Asthma Illinois has one of the nation’s highest child mortality rates from Asthma (the majority occur in Chicago & within Cook county) Close to half of all children in Illinois (49.3%) were diagnosed with Asthma sometime between birth and 2 years of age Illinois Department of Public Health. (2011). Asthma Burden Update. Who Has Asthma. Retrieved April 11, 2012 from http://www.idph.state.il.us/about/chronic/asthma.htm

7. + How do I know if my baby has Asthma? As your baby gets older, things to look out for are: Coughing, Wheezing chest tightness shortness of breath National Heart Lung and Blood Institute. (2011). What are the signs and symptoms of Asthma? Retrieved April 10, 2012 from http://www.nhlbi.nih.gov/health/health-topics/topics/asthma/signs.html

8. + What provokes Asthma attacks? Secondhand smoke Dust mites Molds Cockroaches and pests Pets Nitrogen dioxide Chemical irritants Environmental Protection Agency (2011). Asthma Triggers: Gain Control. Retrieved April 10, 2010 from http://www.epa.gov/asthma/triggers.html

9. + Asthma Triggers Secondhand smoke Dust mites Molds Environmental Protection Agency (2011). Asthma Triggers: Gain Control. Retrieved April 10, 2010 from http://www.epa.gov/asthma/triggers.html

10. + Asthma Triggers Cont’d Cockroaches, pests Pets Nitrogen Dioxide Chemical Irritants Environmental Protection Agency. (2012). Asthma Triggers: Gain Control. Retrieved April 12, 2012 from http://www.epa.gov/asthma/triggers.html

11. + Why is my baby at risk? Biologically, a baby’s lungs are not mature until 35 or 36 weeks gestation Surfactant, while present at 24 weeks gestation, is not fully present until 34 to 36 weeks gestation Wechsler Linden, D., Trenti Paroli, E., Wechsler Doron, M. (2000). Preemies: The Essential Guide for Parents of Premature Babies. New York, NY: Pocket Books.

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13. + Prematurity and Asthma Infants born 37 weeks or less are 7% more likely than full term babies to develop Asthma Babies born between 23 and 27 weeks gestation are at increased risk of developing Asthma in young adulthood Crump, C., Winkleby, M.A., Sundquist, J., Sundquist, K. (2011). Risk of Asthma in Young Adults Who Were Born Preterm: A Swedish National Cohort Study. Pediatrics. 127(4), e913-e920 McCormick, M.C., Litt, J.S., Smith, V.C., & Zupancic, J.A.F. (2010). Prematurity: An Overview and Public Health Implications. Annual Review of Public Health. 32, 15.1-15.13

14. + What can I do as the parent? Stop smoking Develop an action plan with your Pediatrician and ask for a referral for services Try to reduce/eliminate as many triggers as possible Rauh, V.A., Horton, M.K., Miller, R.L., Whyatt, R.M., Perera, F. (2010). Neonatology and the Environment: Impact of Early Exposure to Airborne Environmental Toxicants on Infant and Child Neurodevelopment. Neoreviews. 11. 363-369.

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16. + References Centers for Disease Control and Prevention. (2012). Basic Information: What is Asthma? Retrieved April 10, 2012 from http://www.cdc.gov/asthma/faqs.htmhttp://www.cdc.gov/asthma/faqs.htm Crump, C., Winkleby, M.A., Sundquist, J., Sundquist, K. (2011). Risk of Asthma in Young Adults Who Were Born Preterm: A Swedish National Cohort Study. Pediatrics. 127(4), e913-e920 Environmental Protection Agency. (2012). Asthma Triggers: Gain Control. Retrieved April 12, 2012 from http://www.epa.gov/asthma/triggers.htmlhttp://www.epa.gov/asthma/triggers.html Illinois Department of Public Health. (2011). Asthma Burden Update. Who Has Asthma. Retrieved April 11, 2012 from http://www.idph.state.il.us/about/chronic/asthma.htm http://www.idph.state.il.us/about/chronic/asthma.htm

17. + References Continued Krieger, J. (2010). Home is Where the Triggers Are: Increasing Asthma Control by Improving the Home Environment. Pediatric Allergy, Immunology, and Pulmonology. 23(2), 139-145 McCormick, M.C., Litt, J.S., Smith, V.C., & Zupancic, J.A.F. (2010). Prematurity: An Overview and Public Health Implications. Annual Review of Public Health. 32, 15.1-15.13 National Heart Lung and Blood Institute. (2011). Who is at risk for Asthma? Retrieved April 10, 2012 from http://www.nhlbi.nih.gov/health/health- topics/topics/asthma/atrisk.htmlhttp://www.nhlbi.nih.gov/health/health- topics/topics/asthma/atrisk.html Rauh, V.A., Horton, M.K., Miller, R.L., Whyatt, R.M., Perera, F. (2010). Neonatology and the Environment: Impact of Early Exposure to Airborne Environmental Toxicants on Infant and Child Neurodevelopment. Neoreviews. 11. 363-369. Wechsler Linden, D., Trenti Paroli, E., Wechsler Doron, M. (2000). Preemies: The Essential Guide for Parents of Premature Babies. New York, NY: Pocket Books.

18. + Additional Resources American Lung Association. (2012). For Parents With Children Who Have Asthma. Retrieved April 18, 2012 from http://www.lung.org/lung-disease/asthma/living-with-asthma/parents- with-children.htmlhttp://www.lung.org/lung-disease/asthma/living-with-asthma/parents- with-children.html Centers for Disease Control and Prevention Environmental Protection Agency Illinois Department of Public Health National Heart Lung and Blood Institute Nemours. (2011). Asthma Basics. Retrieved April 16, 2012 from http://kidshealth.org/parent/medical/lungs/asthma_basics.html# Wechsler Linden, D., Trenti Paroli, E., Wechsler Doron, M. (2000). Preemies: The Essential Guide for Parents of Premature Babies. New York, NY: Pocket Books