Vitamin D Won't Help Prevent Colds in People with Asthma

THURSDAY, Dec. 10, 2015 (HealthDay News) — If you have asthma, vitamin D supplements won’t protect you against colds, new research suggests.

The study found that taking vitamin D supplements didn’t reduce the number or severity of colds in adults with mild-to-moderate asthma.

More than 400 participants, all of whom had low vitamin D levels, took either vitamin D supplements or a placebo for 28 weeks. During that time, about half of them got at least one cold. Eighty-two percent of those in the supplement group had sufficient levels of vitamin D after 12 weeks, but that didn’t boost their resistance to colds, the research revealed.

The study was published recently in the American Journal of Respiratory and Critical Care Medicine.

The findings surprised the researchers because they had previously shown that asthma flare-ups fell 40 percent in patients who took vitamin D supplements to increase low levels of the vitamin. Colds often cause asthma flare-ups, and the study authors thought vitamin D supplements would reduce the number and severity of colds in asthma patients.

“Other studies of vitamin D and colds have produced mixed results. Most of those studies were conducted among healthy patients. We wanted to ask the same question of a patient population in which the impact of a cold carries greater risk,” study leader Dr. Loren Denlinger, an associate professor of medicine at the University of Wisconsin, said in a journal news release.

Based on the findings, “we can’t recommend vitamin D for the prevention of colds,” Denlinger said.

More information

The U.S. National Heart, Lung, and Blood Institute has more about asthma.


Vitamin D May Protect Against Common Cold

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By Theresa TamkinsMONDAY, Feb. 23, 2009 (Health.com) — Vitamin D may protect people—especially those with asthma and other chronic lung conditions—from colds and other respiratory tract infections, according to the largest study to date to look at the link.

Unlike with other vitamins, a deficiency of vitamin D (which is known as the sunshine vitamin because sun exposure triggers production in the body) is quite common in the United States—particularly in winter. At least 50% of people in the new study, which included nearly 19,000 people 12 and older, had levels that suggested less-than-optimal protection against respiratory tract infections, according to the report in the Archives of Internal Medicine.

“People think that if they have a good, balanced diet that they will get enough vitamin D, and that’s actually not true,” says Michal Melamed, MD, an assistant professor at Albert Einstein College of Medicine in New York. “Unless you eat a lot of fish and drink a lot of milk, you can’t get enough vitamin D from diet.”

In the study, Adit Ginde, MD, of the University of Colorado Denver School of Medicine, and colleagues at Harvard Medical School and Children’s Hospital Boston, found that people who had low blood levels of vitamin D were more likely to report having had a recent cold than those with higher amounts. What’s more, the risk of a recent cold or other respiratory infection seemed to rise as vitamin D levels dropped.

Overall, 24% of people with the lowest levels (under 10 ng/ml) had had a recent cold, compared with 20% of those with slightly higher levels (10 to 29 ng/ml) and 17% of those with the highest levels (30 ng/ml). The link was even stronger in people with asthma, who had about six-fold greater risk of colds with low vitamin D, and in those with chronic obstructive pulmonary disease, who had a two- to three-fold greater risk.

Next page: Why vitamin D isn’t like other vitamins

However, there are limitations to these types of studies: They often suffer from a chicken-and-egg problem. It’s not clear if low levels of vitamin D boost your susceptibility to colds or if colds cause vitamin D levels to drop, possibly because people who feel sick stay inside and out of the sun.

The researchers don’t think it’s the latter, however, because it can take two to three weeks for vitamin D levels to change, while most colds last only three to four days. To truly answer the “Can vitamin D prevent colds?” question, Dr. Ginde suggests that researchers need to give some people the vitamin, give others a placebo, and see who’s more likely to catch a cold in an average winter. Those studies are under way, he says.

That said, Dr. Melamed notes that vitamin D is garnering a lot of interest from scientists lately. “There is some other research that suggests that this is a real finding,” says Dr. Melamed, who was not involved in the new study.

The interest in vitamin D is not limited to cold research. Recent findings (including a study by Dr. Melamed) suggest that people with higher levels of vitamin D have a survival advantage and may be less likely to die in a given time period than people their same age with lower levels of the vitamin.

One reason vitamin D is so interesting is that unlike other vitamins, vitamin D acts as a hormone in the body and is known to help regulate at least a thousand genes, says Dr. Melamed. It’s a cell-signaling molecule that may play a role in controlling the immune system, fighting cancer, improving cardiovascular health, and possibly regulating blood sugar. (There are vitamin D receptors in blood vessels and in the pancreas, which regulates blood sugar.)

For now, the jury is still out on vitamin D’s link to respiratory infections. But it’s a tantalizing link, Dr. Melamed notes: “People have always said you get more colds in the winter because you’re indoors, you’re around other people who might be sick, you get cold, and you can’t fight off infections—these are all the things you’ve heard,” she says. “Maybe it is really just that our vitamin D levels go lower so we are more at risk for infection.”

Next page: How you can get more vitamin D

Currently the recommended intake of vitamin D is 200 to 600 International Units per day (depending on age, with 400 IU recommended for those 51 to 70 years of age), which are based on the amount needed to maintain bone health. (A severe vitamin D deficiency can cause childhood rickets, a condition of weakened and abnormal bone growth.)

“A lot of people feel that 400 IU is really not enough vitamin D to get to what people would call adequate levels,” says Dr. Melamed. “Data suggest you need at least 800 IU a day, especially in the winter.”

About 4 million people in the United States have levels that were considered low in the study, and that number may be even higher, says Dr. Melamed, given that the study used data from 1988 to 1994.

“We spend a lot less time in sun [than in the past], and when we are out in the sun we put sun block on because we’re afraid of getting melanoma,” she says. “We are, as a community, very vitamin D deficient.”

Dr. Melamed recommends 10 to 15 minutes’ daily exposure to sun (without sunscreen) to spur vitamin D production in the body.

Dr. Ginde notes that although sunscreen is recommended to prevent skin cancer, it’s OK to get a little bit of sun for vitamin D purposes. “Like everything with medicine, it’s all about weighing the risks and benefits,” says Dr. Ginde. “There’s probably a role for judicious, moderate amounts of sunlight exposure where you’re not burning your skin but you are getting a little bit of sunlight on it.”

However, the safest way is probably to take a supplement, he says. Although he does note that is it possible to take too much vitamin D; excess intake can cause kidney stones and other problems.


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Study: Flu Shot May Not Keep Kids With Asthma Out of Hospital

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By Denise MannTHURSDAY, May 21, 2009 (Health.com) — If your child has asthma, you may have been shocked to hear that a flu shot—long recommended for kids with asthma—doesn’t seem to prevent flu-related hospitalizations. The findings were presented this week at the annual meeting of the American Thoracic Society in San Diego. But don’t use that as an excuse to skip the flu shot, experts warn.

“Asthma is a risk factor for more serious flu and people who have asthma are more at risk for flu complications like pneumonia and hospitalizations, so if you can do anything to prevent the flu in that group, it’s important,” says E. Neil Schachter, MD, medical director of respiratory care at Mount Sinai Medical Center in New York City. “If your child has asthma, the recommendations remain the same.”

The Centers for Disease Control and Prevention in Atlanta and the American Academy of Pediatrics both recommend the flu shot for all children over the age of 6 months. The National Asthma Education and Prevention Program says that children with asthma should get flu shots as well.

“It is too early to do an about-face on something that makes sense to do, and has been proven safe and effective in many other studies,” Dr. Schachter says. “The flu shot, although not 100% effective, is known to prevent the flu. Getting the flu shot, whether you are asthmatic, nonasthmatic, a child, or an adult, means you will be less likely to come down with the flu. This is based on bigger studies of wider numbers.”

Next page: What the study found

In the new study, the researchers analyzed hospitalization rates among 263 children age 6 months to 18 years who had the flu between 1996 and 2006. Overall, children who had received the flu shot were three times more likely to be hospitalized than their counterparts who had not received the vaccine. What’s more, children with asthma who received the vaccine (in this case, the trivalent inactivated vaccine given as a shot) were more likely to be hospitalized than their counterparts who did not receive the vaccine.

The severity of the child’s asthma, insurance issues, and other factors that can affect hospitalization didn’t seem to explain the results. The researchers did not look at other types of flu vaccines, such as the nasal spray.

“The flu shot did not have any protection against hospitalization in all children and also in the subset of children with asthma,” says lead study author Avni Joshi, MD, a pediatrician at the Mayo Clinic in Rochester, Minn.

Calling the findings “intriguing,” Dr. Joshi says that the children who are most likely to be vaccinated are also those most at risk for landing in the hospital if they get the flu. Respiratory infections of any kind can aggravate asthma in children and adults, which can lead to breathing difficulties that require hospitalization.

During the time of the study, flu shots weren’t recommended for all children age 6 months to 18 years (that was a new recommendation for the 2008-’09 flu season.) At that time, only high-risk children—those most likely to end up in the hospital—would have been given a flu shot, which may partly explain the higher hospitalization risk seen in the study.

The finding does suggest that flu shots are doing a less-than-perfect job at protecting children, particularly those who are at the most risk, says Dr. Joshi.

Dr. Joshi, however, is not telling parents of children with asthma to skip the shot; in fact, quite the opposite. “The flu shot is very safe. The efficacy has been shown in previous studies about preventing influenza,” she says. “Our study was a specific focus on influenza-related hospitalization, which showed no benefit. But this does not mean that the shot is no good. The shot is good, but we need to look at better options for preventing hospitalization.”

And she says that the study was relatively small and mostly included children who were sick in three different flu seasons—including one season when the flu vaccine was a poor match for the viruses circulating in the community.

Next page: Experts agree: flu shots still a good idea

Greg Yapalater, MD, a New York City pediatrician in private practice, also urges caution in interpreting the findings of this study. “This is just one study that looked at one particular aspect—hospitalizations,” he says. “There are other important questions, such as, ‘Does the flu shot reduce sick days or the incidence of flu?’ and the answers to these questions tend to be, ‘Yes it does’.”

Don’t jump to any conclusions based on one study, Dr. Yapalater says. “Talk to your pediatrician and get his or her input on the best ways to prevent the flu and hospitalization.”

Harold J. Farber, MD, an associate professor of the pediatric pulmonary section at Baylor College of Medicine and Texas Children Hospital in Houston, and the author of Control Your Child’s Asthma: A Breakthrough Program for the Treatment and Management of Childhood Asthma, also says flu shots do more good than harm in general, and particularly among children with asthma.

“This is a very preliminary report that requires further investigation,” he says. “This would not change my practice about using the influenza vaccine in children with asthma.” That said, the flu shot is not the only way to prevent viral, asthma-related flare-ups.

“Washing hands with soap and water and using antibacterial hand sanitizers will prevent more than just the flu,” he says. “Also, cover your mouth and nose when you sneeze and cough.”


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Stressed

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By Denise MannMONDAY, July 20, 2009 (Health.com) — There may be a reason why children’s asthma rates are so high in urban areas. Youngsters with stressed-out parents and exposure to air pollution have a higher risk of asthma, according to a study in the journal Proceedings of the National Academy of Sciences.

“The new study raises some questions about why stress-plus-pollution leads to worse problems than either alone,” says Harold J. Farber, MD, an associate professor of the pediatric pulmonary section at Baylor College of Medicine and Texas Children Hospital, in Houston, and the author of Control Your Child’s Asthma. “Why is it that this combination is somewhat more toxic than either alone?”

In the United States, about 22 million people—including 6 million children—have asthma. City-dwelling children have about a 22% to 45% higher risk of developing asthma than their peers living elsewhere.

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In the new study, a research team led by Rob S. McConnell, MD, a professor of preventive medicine at the Keck Institute of Medicine at the University of Southern California at Los Angeles, tracked 2,497 children from the region. The children were ages 5 to 9 and had no history of asthma or wheezing.

Children with stressed-out parents who lived around high levels of traffic-related pollution were at a higher risk of developing asthma during the three-year study period than children without stressed parents. Stressed parents tend to have children who report more stress too, but the researchers did not measure the children’s stress levels. Parents were considered stressed if they said their lives were unpredictable, uncontrollable, and overwhelming.

Next page: Why air pollution is so bad

Air pollutants can cause an inflammatory response in the airways, which is a primary feature of asthma. Stress may increase a person’s susceptibility to air pollutants by lowering immune system function or affecting the autonomic nervous system, which helps regulate breathing, the authors say.

The study helps to pinpoint the children most at risk for the respiratory disorder, says Dr. Farber, who was not involved in the new research.

“It also reinforces basic things, like parental stress and traffic-related pollution are bad things for children and things that we need to decrease our  children’s exposure to,” he says, noting that this is easier said than done. “Managing stress and pollution are important, and if two things occur together, it’s important to be on top of them.”

What’s more, parental stress also seemed to exacerbate the effect of maternal smoking during pregnancy, according to the study. Children who had stressed-out parents and were exposed to cigarette smoke during pregnancy were 2 to 3 times more likely to develop asthma than children exposed to cigarette smoke alone. Stress and low socioeconomic conditions (such as not finishing high school) on their own did not increase a child’s risk of developing asthma.

If your child develops any signs or symptoms of asthma—such as a chronic cough or wheezing—get it checked out as soon as possible, Dr. Farber advises. “If you think your child may be predisposed to asthma, don’t live near a freeway; if you do live near a freeway, get on top of your stress and look at stress management programs and/or moving.”

Neil Schachter, MD, the director of respiratory care at Mt. Sinai Medical Center, in New York City, and the author of The Good Doctor’s Guide to Colds and Flu, agrees.

“Stress alone does not provoke or make asthma worse, unless it is in conjunction with other known risk factors such as traffic-related air pollution,” he says. “If a child lives in the country and is not exposed to air pollution, parental stress does not make it worse.”

Dr. Schachter’s advice? “Go green where you can,” he says. “Use a home air cleaner to remove small particles that are in the air. You may not be able to control the outdoor air quality on your own, but you can try and control your indoor air quality by banning smoking inside the house and choosing green cleaning products, which do not contain harsh chemicals that can affect indoor air quality.”


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Dust Exposure After 9/11 Linked to High Asthma Rates

(LIFE.com)

By Karen PallaritoTUESDAY, Aug. 4, 2009 (Health.com) — About 1 in 7, or 13.5%, of adults who encountered intense dust clouds after the collapse of the World Trade Center on 9/11 were later diagnosed with asthma, compared with just 8.4% who had no dust cloud exposure, researchers in Atlanta and New York City reported on Tuesday.

Likewise, among various groups of people connected to the Twin Tower collapse, rescue and recovery workers were more likely to be diagnosed with asthma (12.2%) than passersby (8.4%).

The results are from a survey, conducted from November 2006 through December 2007, to assess the health status of more than 46,000 adults five to six years after the disaster.

That such a horrific event left lasting physical and emotional scars is, perhaps, no great surprise. Among adults with no prior diagnosis of posttraumatic stress disorder (PTSD), 23.8% have reported symptoms after 9/11, and the prevalence of symptoms has increased over time, researchers reported in the Journal of the American Medical Association.

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The mental health effects, which can be debilitating and often chronic, “seem to be the largest health problem coming out of 9/11” says Lorna Thorpe, PhD, the deputy commissioner of the New York City Department of Health and Mental Hygiene Division of Epidemiology and one of the coauthors of the study. “But immediately after the 9/11 event, I don’t think there was a clear understanding of what the physical impacts would be.”

People in the vicinity of the collapse had “the potential to inhale huge amounts of particulate matter,” observes Joan Reibman, MD, an associate professor of medicine and environmental medicine at the New York University School of Medicine and the director of the school’s Bellevue Asthma Center, who was not involved in the study. “We think that could act as a real irritant to the airways.”

Some 23 million Americans have asthma, a lung condition that causes airway swelling and inflammation. People with asthma may experience repeated bouts of coughing, wheezing, shortness of breath, and tightness in the chest.

Next page: Asthma rates higher in kids, too

Anthony M. Szema, MD, an assistant professor of medicine and surgery and the head of the allergy diagnostic unit at SUNY Stony Brook School of Medicine, has studied the effects of the World Trade Center collapse on children living in Manhattan’s Chinatown. His team’s most recent study, accepted for publication in Allergy & Asthma Proceedings, will show that the rate of asthma at the closest elementary school to the World Trade Center (29%) is high compared to the rate of asthma in children in the general population. According to the Centers for Disease Control and Prevention (CDC), 9.3% of U.S. children have asthma.

“[The new study] is entirely congruous with our findings,” he says.

The CDC’s Robert M. Brackbill, PhD, MPH, led the team of New York City and Columbia University researchers whose study examined the longer-term health impact of exposure to Ground Zero and its varying effect across groups of people.

The analysis is based on data from the World Trade Center Health Registry, described as the largest post-disaster-exposure registry in U.S. history. More than 71,000 rescue and recovery workers, lower Manhattan office workers, nearby residents, and passersby enrolled in the registry.

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Participants were interviewed from September 2003 through November 2004 to record their exposure to the disaster and document their pre- and post-event health status, and again in 2006—2007.

For each group followed, intense exposure to the dust plume was associated with new asthma diagnoses. Among rescue and recovery workers, for example, the asthma risk was highest for those who worked on the pile on 9/11. The risk diminished with later start dates.

However, even downtown office workers and lower Manhattan residents were affected. Among these people, the risk of asthma was highest if there was a heavy coating of dust in their home or office, compared with no such damage.

“It shows that people who had heavy dust exposure in the initial period, that this was a risk to developing asthma but not the only risk,” says Dr. Reibman, who also serves as the director of New York City’s World Trade Center Environmental Health Center, one of three centers dedicated to treating 9/11-related conditions.

Dr. Reibman says the new study is important because, in addition to corroborating previous studies, it should help people with 9/11-related asthma realize that their symptoms are real.

“I think it helps us understand that there’s a cause for many of these symptoms,” she says. She encourages people to recognize their symptoms and seek a proper diagnosis and treatment.


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There’s no normal amount of sex that a couple should have, even though experts agree that sex is not only important to your relationship but also good for your well-being. Still, this survey reports that when it comes to health priorities, women are more concerned about drinking enough water than having enough sex. [Cooking Light]

Once a doctor decides that a patient likely has Alzheimer’s disease, it’s often too late to stop it. Noticing the subtle, early clues is, therefore, crucial to treatment. Researchers are testing a new way to do that, by monitoring changes in a person’s typing style as an alert to early stages of dementia. [New Scientist]

We’re wary of many health hazards hidden in college dorms. Now, we can add asthma to the list. Asthma attacks may be triggered by newfound independence—Mom’s not around to dole out inhaler reminders—and unexpected unhealthy situations, like roommates smoking in nonsmoking dorms. [USA Today]

From infrequent flossing, to re-wearing clothes, to leaving the dishes in the sink, we can admit that every once in a while we skimp on cleanliness. Turns out the rest of America’s pretty dirty too. This list of the worst hygiene crimes Americans commit makes us want to wash our hands immediately! [AOL Health]


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Years Later, 9/11 Rescue Workers Still Show Decreased Lung Function

(Life.com)

By Denise Mann

WEDNESDAY, April 7, 2010 (Health.com) — When the twin towers of the World Trade Center collapsed on Sept. 11, 2001, they produced a dense cloud of smoke and vaporized concrete and drywall.

New York City Fire Department rescue workers who were exposed to this polluted air—as well as the kicked-up dust and diesel exhaust that accompanied the rescue effort—had reduced lung function in the weeks and months following the attacks, researchers in New York found at the time.

Now, in a new study in the New England Journal of Medicine, the same researchers report that the lung impairment they observed in the rescue workers appears to be lasting. Firefighters and emergency medical personnel continued to have decreased lung function up to seven years after 9/11, the study found.

“This group has suffered real declines that need to be addressed with regular monitoring and aggressive treatment, because they are now at higher risk for developing future lung problems,” says the senior author of the study, David J. Prezant, MD, the chief medical officer of the New York City Fire Department and a professor of pulmonary medicine at the Albert Einstein College of Medicine, in the Bronx. “We confirmed that the drop in lung function that occurred during that first year was substantial, and for the first time we showed that this drop is persistent.”

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In 2001 and 2002, Dr. Prezant and his colleagues measured the lung function of more than 12,000 fire department rescue workers who worked at Ground Zero, comparing the results to lung-function tests given to the same group before 9/11 as part of their routine department physicals. On average, the lung function of the workers at the World Trade Center site declined by an amount equivalent to 12 years of natural aging, they found.

In the new study, the researchers continued to follow these firefighters and medical personnel for an average of six years, measuring their lung function every 12 to 18 months to see if the initial decline persisted. (Lung function was measured using spirometry, which involves blowing into a device that records the amount of air you exhale.)

The researchers were surprised to see “little or no” improvement in average lung function, according to the study.

In addition to raising the rescue workers’ risk of future lung problems, this persistent decline in lung function has potential short-term consequences, according to Dr. Prezant. “It places them at a higher risk for shortness of breath, cough, wheeze, [and] impairments in their ability to exercise and perform physically demanding jobs,” he says.

Next page: 9/11 health claims controversial

Lung function declined regardless of whether the study participants had ever smoked, although people who smoke (or used to) did show a slightly steeper decline in their lung function than their nonsmoking counterparts, the study showed. “There is a slight additional impact from smoking, but a post-9/11 aggressive tobacco cessation helped cut smoking rates among these firefighters,” says Dr. Prezant.

Neil Schachter, MD, a professor of pulmonary medicine at Mount Sinai Medical Center, in New York City, says the findings confirm the respiratory effects that have been attributed to the air at the World Trade Center site.

“You didn’t have to be sick to be affected by the dust at Ground Zero,” he says. “The toxic, irritant fumes caused a sudden and relatively dramatic decline in lung function among healthy first responders. There was a significant effect of the exposure in this group of otherwise healthy individuals.”

The decline in lung function observed in the study “was not insignificant for a one-shot deal,” Dr. Schachter adds. Everyone’s lung function declines as they age, but this decline gives the exposed rescue workers a head start and “they may become impaired at an earlier age as a result,” he says.

Whether the firefighters and other rescue workers at Ground Zero do, in fact, develop future lung problems as a result of their exposure is certain to be followed closely—by lawyers as well as by doctors and researchers.

The purported connection between post-9/11 dust exposure and chronic diseases and conditions has been controversial, and some observers have challenged the research linking work at Ground Zero to respiratory symptoms such as shortness of breath, wheezing, and what came to be known as “World Trade Center cough.”

Considerable financial interests are at stake in the debate. Last month, New York City officials reached a settlement of up to $657.5 million with some 10,000 firefighters, police officers, construction workers, and other responders who claimed that they developed chronic conditions such as asthma after being exposed to Ground Zero dust. (A week later, however, a federal judge objected to the terms of the settlement and said it would be renegotiated.)

Unlike subjective reports of symptoms, Dr. Prezant says, the lung function reported in the new study provides an objective measure of the respiratory impact of Ground Zero exposure. “This study clearly shows in a non-biased and scientific way that the findings in firefighters and [emergency medical] workers are real,” he says.

The study did have some limitations. Dr. Prezant and his colleagues used the amount of time a firefighter spent at the World Trade Center site to estimate his or her exposure to dust, which is only a rough measure. Nor could they determine which workers wore protective masks, and for how long.

As a result of the study, Dr. Prezant says, the New York City Fire Department is going to be more aggressive about offering preventive treatment to firefighters who were at Ground Zero and who may be at risk for lung ailments. These efforts will include campaigns to vaccinate firefighters against flu, swine flu, and pneumonia, he says.

Air Pollution, Asthma Linked to Suicide

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By Tammy Worth

THURSDAY, July 14 (Health.com) — When most people think of suicide, they think of psychological problems such as depression and anxiety. But new research suggests that lung trouble may also play a role.

Two new studies conducted in Asia and published in the American Journal of Psychiatry report that asthma—and even days of unusually bad air pollution—appear to increase the risk of suicide.

As improbable as the link may sound, researchers suggest that respiratory problems may worsen a person’s mental state.

In the air pollution study—the first to examine a possible connection with suicide—researchers in South Korea tracked air quality and suicides in seven cities during 2004.

More than 4,300 suicides were reported that year. Just under half of those who committed suicide had at least one chronic health condition, such as heart disease, diabetes, cancer, chronic obstructive pulmonary disease (COPD), or mental illness.

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When particulate matter (a common form of air pollution) spiked, the risk of suicide increased by 9% over the next two days, the researchers found. Among people with heart disease, the increased risk was even greater, about 19%.

John Mann, MD, a psychiatrist and professor of translational neuroscience at Columbia University, in New York City, says that while the study highlights an interesting statistical association, it does not prove a direct link between air pollution and suicides—or explain what might cause such a link.

The study offers an “intriguing and puzzling finding that clearly needs to be explored in more detail,” he says.

Although the authors of the study can’t say for sure what explains the link, they do have a few guesses. Substances in particulate matter—such as lead, mercury, or diesel exhaust—may somehow impact neurological functioning, they suggest. Or, particulate matter may cause inflammation, which is associated with cognitive problems and depression.

Inflammation is a factor in a wide range of other health conditions, including heart disease, and according to the researchers a third explanation may be that poor air quality worsens the symptoms of chronic illness, leading to psychological distress.

Next page: Suicide-asthma link seen

In the second study, a separate team of researchers followed more than 160,000 Taiwanese teenagers with and without asthma for over a decade.

While suicide was a very rare occurrence overall, the asthmatic teenagers were more than twice as likely to kill themselves during that time, the study found. The likelihood of suicide was even higher among teens who experienced several asthmatic symptoms, such as night cough or severe wheezing.

In all, about 1 in 14 of the suicides may have been due to asthma, according to the study. The researchers suggest that a confluence of physical, psychological, and social challenges related to asthma may be to blame.

The finding wasn’t a total surprise, as previous research in the U.S. has linked asthma to suicide, as well as to anxiety and depression.

The study “is very provocative and needs replication,” says Wayne Katon, MD, the chief of psychiatric services at the University of Washington Medical Center, in Seattle. “The implication is that doctors should be screening for depression, anxiety, and suicidality in their patients with asthma.”

There may be a genetic connection between asthma and depression, Dr. Katon says, but many young people with asthma also face everyday difficulties that may contribute to psychological distress. For instance, they may have to avoid some social activities (such as athletics), they are disproportionately likely to live in poverty, and they have to take medications.

In fact, some asthma medications have been linked to suicide risk in the past. The Food and Drug Administration (FDA) began a review of asthma drugs in 2008 after reports of mood changes and suicidal behavior in people taking the drug Singulair, but so far the agency hasn’t found any firm evidence of such a connection.

The main weakness of the study, according to Dr. Katon, is that the researchers didn’t track which individuals developed anxiety or depression during the study, which prevented them from fully assessing how mental health may have affected suicide independent of asthma.

Childhood Asthma Rates Leveling Off, Except Among This One Group

By Steven ReinbergHealthDay Reporter

MONDAY, Dec. 28, 2015 (HealthDay News) — Rates of childhood asthma appear to have plateaued, except among the poor and kids aged 10 to 17, U.S. health officials report.

Researchers found that childhood asthma rates increased from 2001 to 2009 — a trend that began in 1982. The rate peaked in 2009 at close to 10 percent, then leveled off before dropping to slightly more than 8 percent in 2013.

“Trends in childhood asthma have recently stopped increasing,” said lead researcher Dr. Lara Akinbami, who’s with the U.S. Centers for Disease Control and Prevention’s National Center for Health Statistics.

“This is mainly due to the leveling off of prevalence among black children, who previously had large increases in the prevalence of asthma,” she said.

“However, more years of data are needed to clarify if asthma prevalence among children will continue to decline, or if it will plateau around current levels,” she added.

The report was published online Dec. 28 in the journal Pediatrics.

For the study, researchers used data from the 2001 to 2013 National Health Interview Survey to analyze the prevalence of asthma in children from birth to the age of 17.

“We found that not all groups of children had the same trends,” Akinbami said.

Among children who are living in families with income below the poverty level and those aged 10 to 17, researchers found that asthma rates increased between 2001 and 2013.

“Trends increased and then leveled out among children aged 5 to 9 years and children living just above the poverty level,” Akinbami added.

Among white and Puerto Rican children, the prevalence of asthma remained the same from 2001 to 2013, Akinbami said. Puerto Rican children had the highest prevalence of asthma compared with all other groups, she said.

These overall findings are good news on two fronts, Akinbami said. First, if asthma rates stop increasing, fewer children are at risk for poor asthma outcomes, such as emergency room visits or even death, she said.

Second, among white and black children, the racial disparity in asthma rates has stopped increasing, Akinbami said. “Previously, asthma prevalence was increasing among black children, but not white children,” she said.

Black children were disproportionately at risk for poor asthma outcomes because they were more likely to have asthma, she said. In 2001, the asthma rate was 30 percent higher among black children than white children. But by 2011, it was over 100 percent higher. This increase in disparity now seems to be stopping, Akinbami said.

“The not so good news is that asthma prevalence still seems to be increasing among children living in poverty,” she said.

These statistics can’t pinpoint the reasons why changes in asthma rates are happening, Akinbami said.

“However, the increase in asthma rates among poor children may be due to their having greater or more persistent exposures to environmental factors that increase the risk for asthma,” she said.

Dr. Jeffrey Biehler, chair of pediatrics at Nicklaus Children’s Hospital in Miami, said, “It’s not unexpected that asthma rates would level off at some point. It’s also not surprising that asthma rates haven’t leveled off among poor children.”

Biehler said that poorer children are often exposed to environmental factors that increase their risk for asthma. These include tobacco smoke, mold and mildew, pet dander, dust mites, cockroaches and smog, he said.

In addition, the stress associated with poverty may increase the risk for asthma, Biehler said.

“We need to continue decreasing environmental exposures and help children at every level to reduce their chances of having asthma,” he added.

More information

Find out more about asthma from the U.S. National Heart, Lung, and Blood Institute.


Prenatal Exposure to Asthma Drug May Increase Autism Risk

By Amy NortonHealthDay Reporter

WEDNESDAY, Jan. 6, 2016 (HealthDay News) — Children whose mothers took certain asthma drugs during pregnancy may have a slightly increased risk of autism, a new study suggests.

The study, published online Jan. 6 in Pediatrics, found a connection between autism risk and prenatal exposure to drugs called beta-agonists. They are most often used to control asthma, and include inhaled medications such as albuterol, salmeterol (Serevent) and formoterol (Foradil).

Researchers said the findings do not prove cause and effect, and stressed that women with asthma should not simply abandon their medication during pregnancy.

“Uncontrolled asthma in pregnancy has been associated with poor birth outcomes, such as preterm birth, low birth weight and admission to the neonatal intensive care unit,” said lead researcher Nicole Gidaya, of Drexel University, in Philadelphia.

What’s more, preterm delivery and low birth weight have been tied to an increased autism risk.

Geraldine Dawson, director of the Duke Center for Autism and Brain Development at Duke University, in Durham, N.C., made the same point.

Taking beta-agonists during pregnancy has both potential benefits and potential risks for the developing fetus, said Dawson, who wrote an editorial published with the study.

“It’s important for a woman taking these drugs to talk with her physician and make an individual decision based on her unique circumstances,” Dawson said.

Researchers are still trying to understand the precise causes of autism spectrum disorders, which affect an estimated one in 68 children in the United States, according to the U.S. Centers for Disease Control and Prevention.

Beta-agonists come in both short-acting forms—which are used to treat asthma attacks—and long-acting forms, which are taken regularly to help prevent attacks. Gidaya said her study did not differentiate between the two.

Scientists generally agree, though, that autism arises from a combination of genetic vulnerability and certain environmental exposures. Many genes have been linked to autism risk, and the list of environmental suspects is growing.

Birth complications—especially ones that cause oxygen deprivation—are among them, according to the advocacy group Autism Speaks. So are prenatal exposures to certain infections, air pollution and some medications, such as the anti-seizure drug valproic acid, the group said.

According to Gidaya, it’s plausible that beta-agonists could affect fetal brain development in a way that raises the risk of autism. Given to pregnant lab rats, the drugs can affect fetal nerve cell development.

For the new study, Gidaya’s team combed through Denmark’s system of national databases to find information on 5,200 children diagnosed with an autism spectrum disorder. The researchers compared them with 52,000 children of the same age without autism.

Overall, just under 4 percent of children with autism had been exposed to a beta-agonist, versus just under 3 percent of other kids.

When the researchers controlled for other factors—including mothers’ asthma, parents’ age and birth complications—children exposed to beta-agonists in the womb were still 30 percent more likely to develop autism.

But while that number might sound big, it is actually a “modest” increase in autism risk, Dawson said.

Plus, there are other factors the researchers could not account for, such as exposure to pollutants, Gidaya said.

According to Dawson, more research is needed to confirm the link between beta-agonists and autism.

If the drugs are a risk factor, Gidaya said, studying the biology behind it could help researchers gain a better understanding of how autism arises.

More information

Autism Speaks has more on environmental risk factors for autism.