Search tips
Search criteria 


Logo of envhperEnvironmental Health PerspectivesBrowse ArticlesAbout EHPGeneral InformationAuthorsMediaProgramsPartnerships
Environ Health Perspect. 1995 September; 103(Suppl 6): 59–62.
PMCID: PMC1518936
Research Article

Environmental risk factors of childhood asthma in urban centers.


Asthma morbidity and mortality are disproportionately high in urban centers, and minority children are especially vulnerable. Factors that contribute to this dilemma include inadequate preventive medical care for asthma management, inadequate asthma knowledge and management skills among children and their families, psychosocial factors, and environmental exposure to allergens or irritants. Living in substandard housing often constitutes excess exposure to indoor allergens and pollutants. Allergens associated with dust mites (DM) and cockroaches (CR) are probably important in both onset and worsening of asthma symptoms for children who are chronically exposed to these agents. Young children spend a great deal of time on or near the floor where these allergens are concentrated in dust. Of children (2 to 10 years of age) living in metropolitan Washington, DC, 60% were found to be sensitive to CR and 72% were allergic to DM. Exposure to tobacco smoke contributes to onset of asthma earlier in life and is a risk factor for asthma morbidity. Since disparity of asthma mortality and morbidity among minority children in urban centers is closely linked to socioeconomic status and poverty, measures to reduce exposure to environmental allergens and irritants and to eliminate barriers to access to health care are likely to have a major positive impact. Interventions for children in urban centers must focus on prevention of asthma symptoms and promotion of wellness.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (721K), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Wissow LS, Gittelsohn AM, Szklo M, Starfield B, Mussman M. Poverty, race, and hospitalization for childhood asthma. Am J Public Health. 1988 Jul;78(7):777–782. [PubMed]
  • Halfon N, Newacheck PW. Childhood asthma and poverty: differential impacts and utilization of health services. Pediatrics. 1993 Jan;91(1):56–61. [PubMed]
  • Carr W, Zeitel L, Weiss K. Variations in asthma hospitalizations and deaths in New York City. Am J Public Health. 1992 Jan;82(1):59–65. [PubMed]
  • Neighbors HW. Ambulatory medical care among adult black Americans: the hospital emergency room. J Natl Med Assoc. 1986 Apr;78(4):275–282. [PMC free article] [PubMed]
  • Hubbell FA, Waitzkin H, Mishra SI, Dombrink J. Evaluating health-care needs of the poor: a community-oriented approach. Am J Med. 1989 Aug;87(2):127–131. [PubMed]
  • Rea HH, Scragg R, Jackson R, Beaglehole R, Fenwick J, Sutherland DC. A case-control study of deaths from asthma. Thorax. 1986 Nov;41(11):833–839. [PMC free article] [PubMed]
  • Kang B. Study on cockroach antigen as a probable causative agent in bronchial asthma. J Allergy Clin Immunol. 1976 Sep;58(3):357–365. [PubMed]
  • Kang B, Vellody D, Homburger H, Yunginger JW. Cockroach cause of allergic asthma. Its specificity and immunologic profile. J Allergy Clin Immunol. 1979 Feb;63(2):80–86. [PubMed]
  • Friedman GD, Petitti DB, Bawol RD. Prevalence and correlates of passive smoking. Am J Public Health. 1983 Apr;73(4):401–405. [PubMed]
  • Weiss ST. Passive smoking and lung cancer. What is the risk? Am Rev Respir Dis. 1986 Jan;133(1):1–3. [PubMed]
  • Harlap S, Davies AM. Infant admissions to hospital and maternal smoking. Lancet. 1974 Mar 30;1(7857):529–532. [PubMed]
  • Colley JR, Holland WW, Corkhill RT. Influence of passive smoking and parental phlegm on pneumonia and bronchitis in early childhood. Lancet. 1974 Nov 2;2(7888):1031–1034. [PubMed]
  • Pedreira FA, Guandolo VL, Feroli EJ, Mella GW, Weiss IP. Involuntary smoking and incidence of respiratory illness during the first year of life. Pediatrics. 1985 Mar;75(3):594–597. [PubMed]
  • Gortmaker SL, Walker DK, Jacobs FH, Ruch-Ross H. Parental smoking and the risk of childhood asthma. Am J Public Health. 1982 Jun;72(6):574–579. [PubMed]
  • Murray AB, Morrison BJ. The effect of cigarette smoke from the mother on bronchial responsiveness and severity of symptoms in children with asthma. J Allergy Clin Immunol. 1986 Apr;77(4):575–581. [PubMed]
  • Evans D, Levison MJ, Feldman CH, Clark NM, Wasilewski Y, Levin B, Mellins RB. The impact of passive smoking on emergency room visits of urban children with asthma. Am Rev Respir Dis. 1987 Mar;135(3):567–572. [PubMed]
  • Fielding JE, Phenow KJ. Health effects of involuntary smoking. N Engl J Med. 1988 Dec 1;319(22):1452–1460. [PubMed]
  • Platts-Mills TA, Tovey ER, Mitchell EB, Moszoro H, Nock P, Wilkins SR. Reduction of bronchial hyperreactivity during prolonged allergen avoidance. Lancet. 1982 Sep 25;2(8300):675–678. [PubMed]
  • Platts-Mills TA, Ward GW, Jr, Sporik R, Gelber LE, Chapman MD, Heymann PW. Epidemiology of the relationship between exposure to indoor allergens and asthma. Int Arch Allergy Appl Immunol. 1991;94(1-4):339–345. [PubMed]
  • Michel O, Ginanni R, Duchateau J, Vertongen F, Le Bon B, Sergysels R. Domestic endotoxin exposure and clinical severity of asthma. Clin Exp Allergy. 1991 Jul;21(4):441–448. [PubMed]
  • Sporik R, Holgate ST, Platts-Mills TA, Cogswell JJ. Exposure to house-dust mite allergen (Der p I) and the development of asthma in childhood. A prospective study. N Engl J Med. 1990 Aug 23;323(8):502–507. [PubMed]
  • Gillies DR, Littlewood JM, Sarsfield JK. Controlled trial of house dust mite avoidance in children with mild to moderate asthma. Clin Allergy. 1987 Mar;17(2):105–111. [PubMed]

Articles from Environmental Health Perspectives are provided here courtesy of National Institute of Environmental Health Science