A Silent Epidemic Has Struck: The Mystery Is Why

Ten year old Giovanni Delgado had his second asthma attack in three days. He felt as if he were drowning in a dark sea. Giovanni’s fate would be in the hands of a Passaic county, New Jersey school nurse - either sent to the emergency room, or being treated and going back to class.

Fifty miles to the west, Ainsworth Scott, the 68 year-old mayor of Belvidere, New Jersey, reaches for his vial of medicine. He is trying to explain why there is this strange rise in asthma in his tiny bucolic village tucked along the Delaware River.

In the past 20 years, asthma has enveloped the United States, nearly doubling its reach in a medical mystery story that puzzles scientists. Some of the most surprising chapters are being written in New Jersey.

In Passaic, New Jersey, 22% of the children have asthma, nearly three times the national average. However, in rural Warren County, amid lush mountains and smog-free air, another team of scientists log the same numbers.

Scientists know what triggers asthma attacks – pollution, dust, and mold – but the reason people develop the disease remains unclear. Asthma is now in the center of one of the most divisive political battles – the fight over pollution rules for heavy industry. The dirty air spewing from smokestacks in the Midwest and South drifts over New Jersey. It is blamed for a third of the state’s air pollution. Revised pollution standards actually make it easier for plants to upgrade and reduce pollution. However, other new rules would allow utilities to continue to spew smog and soot over New Jersey for years to come.

Asthma kills 4,500 people per year. It killed 123 New Jerseyans in 2001. Roberto Nachajon, a respiratory pulmonologist at St. Joseph’s Regional Medical Center in Paterson, N.J. states, “I would say every one of those deaths can be prevented.”

Most asthma attacks are allergic reactions, the body protecting itself from what it sees as a foreign invader. When a strange whiff of smoke from a power plant that could be 400 miles away, or a speck of roach droppings finds their way to the air passages, an overactive immune system counteracts, flooding the lungs with antibodies. This causes the inner linings of the airways to swell, narrowing the tunnels through which oxygen reaches the blood vessels. Muscles squeeze the airflow further. Mucus clogs up the remaining space.
The death rate from asthma has been dropping across the United States, thanks to an arsenal of new drugs and better-educated patients. However, the disease stills exacts a heavy toll: drugs, ER visits, missed workdays, and other costs of coping with asthma total $13 billion annually nationwide.

Still, nobody knows why so many are suffering from asthma. Scientists argue asthma is not one disease, but several – allergic asthma, exercise-induced asthma, elderly asthma, and other varieties, with different triggers and treatments.

Theories abound: secondhand smoke, sedentary lifestyles, a Western diet of processed foods, tighter buildings that trap more indoor pollutants, and the “hygiene hypothesis” – the theory that today’s children are too shielded from viruses and bacteria that their immune systems don’t get the proper shakedown early in life.

On the other side, there is mounting evidence that pollution, even at low levels, leaves a lasting mark on your lungs. Researchers at the University of California completed an 11-year old study tracking thousands of youngsters in the nation’s dirtiest air. They found that those youngsters who lived in the smoggy cities were three times as likely to develop asthma. The lungs of children in more polluted air grew more slowly, and they move air less efficiently.

Another UCLA study showed that individuals exposed to both diesel particulates and dust mites had triple the immune response of those exposed to dust mites alone. Still, air pollution isn’t the final word as a cause for asthma. In Beijing, China’s air continues to worsen as China industrializes, yet only 8 percent of school-age children there have asthma, reports Noreen Clark, dean of the University of Michigan’s School of Public Health. By contrast, the air is cleaner and people smoke less in Detroit, yet 20% of the city’s students have the disease, she says.

An answer could be in the fact that even individuals in suburban areas are still breathing air that blows in from nearby and distant urban areas. In New Jersey, suburbs and cities are so close together that residents of both breathe the same tainted air. In addition, suburban sprawl has caused an increase of cars on the road. The fact that children may spend less time walking and biking, slowing the growth of their lungs, may make them more susceptible to respiratory problems.

This theory is particularly evident in the town of Belvidere, New Jersey. Across the Delaware River in this pristine town is Martins Creek, a power plant that produces sulfur dioxide. In addition to Martins Creek, says Ainsworth Scott, “All across Pennsylvania they burn, and we get the westerly winds.” In addition, Roche Vitamins announced that its plant in the town of Belvidere was emitting excessive amounts of toxic air pollutants for years.

In the end, there’s not just one smoking stack behind the asthma woes.

(Summarized from THE RECORD, Hackensack, NJ; copyright Knight-Ridder Newspapers: Distributed by Knight-Ridder / Tribune Information Services.)