Induction of Asthma and the Environment: What We Know and Need to Know MaryJane K. Selgrade,1 Robert F. Lemanske Jr.,2 M. Ian Gilmour,1 Lucas M. Neas,1 Marsha D.W. Ward,1 Paul K. Henneberger,3 David N. Weissman,3 Jane A. Hoppin,4 Rodney R. Dietert,5 Peter D. Sly,6 Andrew M. Geller,1 Paul L. Enright,3 Gillian S. Backus,4,7 Philip A. Bromberg,8 Dori R. Germolec,4 and Karin B. Yeatts8 1National Health and Environmental Effects Research Laboratory, U.S. Environmental Protection Agency, Research Triangle Park, North Carolina, USA; 2Division of Pediatric Allergy, Immunology, and Rheumatology, University of Wisconsin, Madison, Wisconsin, USA; 3National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA; 4National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, North Carolina, USA; 5Department of Microbiology and Immunology, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA; 6Center for Child Health Research, University of Western Australia, Perth, Australia; 7Curriculum in Toxicology, and 8Center for Environmental Medicine, Asthma and Lung Biology, School of Medicine, University of North Carolina, Chapel Hill, North Carolina, USA Abstract The prevalence of asthma has increased dramatically over the last 25 years in the United States and in other nations as a result of ill-defined changes in living conditions in modern society. On 18 and 19 October 2004 the U.S. Environmental Protection Agency and the National Institute of Environmental Health Sciences sponsored the workshop "Environmental Influences on the Induction and Incidence of Asthma" to review current scientific evidence with respect to factors that may contribute to the induction of asthma. Participants addressed two broad questions: a) What does the science suggest that regulatory and public health agencies could do now to reduce the incidence of asthma? and b) What research is needed to improve our understanding of the factors that contribute to the induction of asthma and our ability to manage this problem? In this article (one of four articles resulting from the workshop) , we briefly characterize asthma and its public health and economic impacts, and intervention strategies that have been successfully used to prevent induction of asthma in the workplace. We conclude with the findings of seven working groups that focus on ambient air, indoor pollutants (biologics) , occupational exposures, early life stages, older adults, intrinsic susceptibility, and lifestyle. These groups found strong scientific support for public health efforts to limit in utero and postnatal exposure to cigarette smoke. However, with respect to other potential types of interventions, participants noted many scientific questions, which are summarized in this article. Research to address these questions could have a significant public health and economic impact that would be well worth the investment. Key words: air pollution, allergy, asthma economic impact, asthma induction, asthma prevalence, biologics, indoor environment, occupational exposure, public health, susceptibility. Environ Health Perspect 114: 615-619 (2006) . doi:10.1289/ehp.8376 available via http://dx.doi.org/ [Online 26 January 2006] This article is part of the mini-monograph "Environmental Influences on the Induction and Incidence of Asthma." Address correspondence to M.J. Selgrade, U.S. EPA, MD B143-01, Research Triangle Park, NC 27711 USA. Telephone: (919) 541-1821. Fax: (919) 541-0026. E-mail: selgrade.maryjane@epa.gov This paper has been reviewed by the National Health and Environmental Effects Research Laboratory, U.S. EPA, and approved for publication. Approval does not signify that the contents necessarily reflect the views and policies of the agency, nor does mention of trade names or commercial products constitute endorsement or recommendation for use. This workshop was supported by the U.S. EPA Office of Children's Health Protection and the Office of Research and Development, the NIH NIEHS intramural and extramural research programs, the American Petroleum Institute, and GlaxoSmithKline. The authors declare they have no competing financial interests. Received 2 June 2005 ; accepted 13 October 2005. The full version of this article is available for free in HTML or PDF formats. |