Exposure to certain triggers can cause patients with asthma to suffer exacerbations and become hospitalized with an asthma attack. These stays in hospital can be long and in severe cases can result in visits to the intensive care unit. Triggers of exacerbations include allergens (animal dander, pollen, mold), weather changes, chest infections, influenza, and cigarette smoke (first or second hand). Minimizing exposure to these triggers can help ensure that children with asthma do not wind up in the hospital. Unfortunately, children cannot always control the environment in which they are placed and so are more likely to be exposed to these triggers. In the past 30 years, many cities in the US and Canada have adopted policies that ban smoking indoors in public places. These policies were aimed at preventing second hand smoke exposure in non-smokers, particularly in children and those with lung disease. With secondhand smoke being a known trigger for asthma exacerbations, the hope was that these policies would decrease the hospitalization rates of children and reduce the burden of asthma associated health care costs on the system. To assess whether these policies had any meaningful impact on hospital visits in children, a group of researchers from Missouri collected hospitalization data on over 330,000 children across the US.
In this retrospective analysis, scientists measured the asthma hospitalization rate for children in 20 US hospitals in the 3 years before the laws were passed and again in the 3 years after the law was passed. If the policies were having an effect on child health, then the researchers would except to see a decrease in the hospitalization rate after the policy was implemented. This is exactly what they found. There was a 17% decrease in the number of children being hospitalized for asthma exacerbations 3 years after smoking indoors was banned. The researchers were also able to see a reduction after only 1 year of the policy (8% reduction) and 2 years of the policy (13% reduction). To make sure that what they were measuring wasn’t just a general decrease in asthma hospitalization rates across the country, the scientists picked an arbitrary date after the policy had been implemented and measured the asthma hospitalization rates 3 years before and after that date. In this paper that data was January 1, 2007. They found that there was no significant decrease in asthma hospitalization rates at the different cites after this date indicating that the results the measured before were significant and real.
This study shows nicely how science and implementation of public policy can impact our general health. Science was able to show numerous times that cigarette smoke, primary or second hand, can trigger exacerbations in asthmatics and subsequent hospitalization of the person. Taking this knowledge and putting in policies to limit a person’s exposure to cigarette smoke has allowed us to prevent a number of people from having to go to the hospital. Any regions without this type of policy should seriously consider implementing it immediately.
Image Credit: Flickr Kittyz202