Asthma is a disorder of the bronchial tubes (the smaller airways in the
lungs) characterized by over sensitivity of these airways. During an
asthma attack, the muscles that wrap around these bronchial tubes
tighten, and there is more sticky mucous secreted. This narrowing and
mucous plugging of the bronchi make it more difficult for air to move
into and out of the lungs, and cause the wheezing sound and cough that
is characteristic of an asthma attack. There are about two million
children in the U.S. that have asthma.
No one really understands why certain children have overly sensitive
airways. Sometimes, the tendency toward asthma is inherited, and
occasionally it may be secondary to lung damage early in life as in
certain premature babies that are born with severe breathing problems.
It is not contagious. Often, no real cause for the asthma can be found.
However, we do know that certain conditions can set off an episode of
asthma in children that have the predisposition:
- Allergy - Most asthmatic children older than 5 years may have
symptoms caused by allergy. Usually this is due to something inhaled in
the air (e.g. pollen, dust, mold, animal dander). In infants, wheezing
can occaisionally be caused by food allergy. Children with asthma often
have other allergic problems, such as hayfever or eczema.
- Infection - Viral upper respiratory infections (colds) are the
most common cause of episodes of asthma in children younger than 5.
Some children actually seem to be "allergic" to the virus. Some doctors
call this type of asthma "bronchitis", "wheezy bronchitis", "asthmatic
bronchitis", or "reactive airways disease". Unlike the type of
bronchitis found in adults that smoke, antibiotics will not usually help
children with wheezing because the cause is not a bacteria, but a virus,
allergy, or both.
There is reason to be optimistic: 75% of children with viral-related
wheezing will "outgrow" it as their bronchial tubes become larger.
- Exercise - Many children with allergic asthma can also develop
"exercise-induced asthma". This usually starts 5 minutes or so after
exercise starts and manifests as cough, chest tightness, and wheezing.
It is more likely to happen in cold, dry air or if there are pollutants
or allergens (e.g. pollens) in the air.
- Irritants - Though not a true allergy by medical definitions,
some children wheeze when they breathe cigarette smoke, smog, hairspray,
insect repellant, paint, etc.
- Drugs - 25% of children with chronic asthma may have more
wheezing if they take aspirin. Acetaminophen (Tylenol) is usually
- Other - Some children may develop asthma if they have a sinus
infection, pneumonia, or emotional upset. Asthma is often worse at
night. Occasionally, nothing in particular can be pinpointed as the
cause of an asthma exacerbation.
Unfortunately, there is no cure for asthma. However, in almost all
children, the symptoms can be controlled, and the child can lead a
normal life with modern medical therapy.
- Environmental control - Allergens and irritants should be avoided
as much as possible. There should be no cigarette smoking in the house
of an asthmatic child. The bedroom should be kept dust-free. Don't use
a vaporizer, as this can promote mold growth.
- Medication - There is now availabile a variety of medications to
help the asthmatic child. You, your child and your doctor will
determine which medicine or combination of medicines is best for your
child based on his age, severity of symptoms, frequency of attacks, side
effects, and, often, by trial and error.
- Bronchodilators - These work by relaxing the muscles that
surround the bronchial tubes:
- Theophylline - This can be given as a liquid or tablet every
six hours or in a long acting tablet or capsule that can be sprinkled on
food every 8 to 12 hours.
- Adrenergics - These can be given as shots (adrenaline),
"breathing treatments" (metaproterenol), pocket-sized inhalers
(metaproterenol, albuterol, terbutaline), or orally as liquid or tablets
- Anticholinergics - These have only recently been used for
asthma. They must be inhaled.
- Cromolyn - This drug must be inhaled. It is not used to treat
wheezing, but is used in certain patients to prevent wheezing.
- Steroids - Prednisone or other steroid medicines work by
reducing the inflamation in the bronchial tubes. Occasional short term
use of these drugs will not have significant side effects and can be of
great help in stopping severe attacks and preventing hospitalizations.
However, if used frequently or over a long period of time there can be
severe side effects, so doctors are careful to use these only when
necessary. Recently, pocket nebulizers for inhaling steroids have
become available that are free of the side effects seen with oral
steroids, so these are sometimes used in patients with chronic asthma.
- Immunotherapy ("Allergy shots")- If your doctor feels that your
child's symptoms can't be adequately controlled with medication, he
will refer him to an allergist for skin tests and possibly shots to
"desensitize" the child. Allergy shots may be of help to some
asthmatics whose symptoms are due to allergies, but will not be useful
when symptoms are caused by viral infection, exercise, etc.
- General Health - Good nutrition and physical fitness are as
important for children with asthma as they are for everyone. Children
should also drink plenty of fluids to keep the bronchial secretions
loose. With appropriate medication, nearly all children with asthma can
take physical education class and can participate in competitive sports.
As a matter of fact, 75 members of the 1984 U.S. Olympic Team had
As much as possible, avoid exposure to cold and flu viruses and pay
attention to careful handwashing to help lessen the number of
respiratory infections that might trigger an asthmatic episode. If your
child has severe asthma, your doctor may recommend a yearly "flu" shot.
When should I call the doctor's office?
Asthma severity can range from the patient who has only a nagging cough
without wheezes, to a life threatening emergency. Fortunately, in most
children, asthma is mild and easily controlled with medication.
However, if your child has mild symptoms that do not clear in a few days
with his usual medication, please call us. Likewise, if he seems to be
having difficulty breathing and is not relieved after his medication is
started, call us right away. It's always better to start asthma therapy
"too early" rather than too late. If you are unsure about whether to
give a particular medicine, how much to give, or whether your child
needs to see the doctor, please call us. When you bring your child to
see the doctor for asthma, either bring his medicines with you, or write
down the names and dosages.
For additional information, you may write to:
Asthma and Allergy Foundation of America
1302 18th St., NW, Suite 103
Washington, D.C. 20032
American Lung Association
909 12th Street
Sacramento, CA 95814
Medical Sciences Bulletin Contents
Role of Vitamin C in Asthma Unclear
Reprinted from the November 1994 issue of Medical Sciences Bulletin ,
published by Pharmaceutical Information Associates, Ltd.
Unconventional therapy, which includes the use of vitamins and minerals, is
on the rise in the United States. The $3 billion per year that Americans pay
for vitamins indirectly increases health care costs, yet vitamin therapy has
no clearly defined cost effectiveness. Great controversy surrounds the use
of daily recommended doses or megadoses to combat disease and enhance health
and immunity. Leonard Bielory and Rinki Gandhi, physicians at the New Jersey
Medical School, Newark, have reviewed the medical literature to assess one
aspect of vitamin use: vitamin C in the treatment of asthma.
Asthma, an episodic disease in which air passages narrow as a secondary
response to the hyperresponsiveness of the tracheobronchial tree, is either
extrinsic or intrinsic. In its extrinsic, or allergic form, mucosal
hyperresponsiveness triggers atopy, rhinitis, sinusitis, elevated serum
Immunoglobulin E (IgE) levels, nasal polyps, and increased bronchial
responsiveness to methacholine-, histamine-, or cold air-provocation. The
intrinsic, or idiosyncratic form occurs in the absence of these stimuli.
Antigen-antibody interaction probably occurs on the surface of pulmonary
mast cells, causing degranulation of those cells and the release of major
basic protein, superoxide radicals, and eosinophilic cationic protein into
the air passages. Ciliary function stops, mucosal integrity is disrupted,
and cells exfoliate, resulting in obstruction and bronchoconstriction.
As long ago as 1803, an association was observed between vitamin C (ascorbic
acid) deficiency and convulsive asthma in patients with scurvy. Found
predominantly in citrus fruit, potatoes, and green vegetables, vitamin C --
a water-soluble vitamin -- is a reducing agent. In 1953, an Irish study
concluded that vitamin-C deficiency was related to asthma; during acute
asthma, vitamin-C excretion was reduced. During the 1970s, one study
demonstrated low levels of vitamin C in asthmatics, but no significant
difference in levels among different grades of asthma. Vitamin C levels were
not related to atopy or the duration of asthma. More recent studies have
shown that 500 mg vitamin C exerts antibronchospastic action, with
significant changes in one-second forced expiratory volume (FEV1) and forced
vital capacity (FVC). One double- blind randomized study reported a decrease
in the frequency and severity of acute asthma; however, since the study was
conducted during the rainy season, the results may stem from vitamin C's
action in preventing infection. FEV1 increased with increased dietary
vitamin-C intake in one large-scale study of 2526 healthy and asthmatic
adults. Methacholine- induced bronchospasm decreased after vitamin-C intake,
possibly because vitamin C interferes with metabolism of arachidonic acid, a
mediator of asthma.
Studies of histamine-induced bronchoconstriction have not demonstrated a
clear effect for vitamin C. Five hundred milligrams vitamin C was found to
be ineffective against ragweed antigen. Among 10 asthmatic children in an
uncontrolled study, vitamin C produced an insignificant decrease in total
IgE, restoration of normal chemotaxis in 2 patients, and normal lymphocytic
transformation in 4 patients. A single-blind study of 16 asthmatic children
showed that when 1 g ascorbic acid was administered each day,
polymorphonuclear leukocyte motility improved significantly.
The reviewers concluded that the medical literature does not support a
definite indication for the treatment of asthma and allergy with vitamin C.
However, chronic use of vitamin C may have effects that could not be
measured in the short-term studies they examined. Further studies are
therefore required to define the effects of vitamin C in asthma and to
determine its cost-effectiveness. (Bielory L et al. Annals of Allergy. 1994;
The following is an excerpt from the work of Julia Kendall (1935 - 1997); distributed by EHN, 415.541.5075. You can find the full text of the information below at: Twenty Most Common Chemicals Found in Thirty-One Fragrance Products
Principal chemicals found in scented products are:
Found in: cologne, dishwashing liquid and detergent, nail enamel remover
On EPA, RCRA, CERCLA Hazardous Waste lists. "Inhalation can cause dryness
of the mouth and throat; dizziness, nausea, incoordination, slurred speech,
drowsiness, and, in severe exposures, coma." "Acts primarily as a central
nervous system (CNS) depressant."
Found in: perfume, cologne, hairspray, laundry bleach, deodorants, detergent,
vaseline lotion, shaving cream, shampoo, bar soap, dishwasher detergent
Narcotic. Sensitizer. "Local anesthetic, CNS depressant"... "irritation to
the mouth, throat, eyes, skin, lungs, and GI tract, causing nausea and
abdominal pain." "May cause kidney damage." "Do not use with contact
- BENZYL ACETATE
Found in: perfume, cologne, shampoo, fabric softener, stickup
air freshener, dishwashing liquid and detergent, soap, hairspray, bleach,
after shave, deodorants
Carcinogenic (linked to pancreatic cancer); "From vapors: irritating to
eyes and respiratory passages, exciting cough." "In mice: hyperanemia of
the lungs." "Can be absorbed through the skin causing systemic effects."
"Do not flush to sewer."
- BENZYL ALCOHOL
Found in: perfume, cologne, soap, shampoo, nail enamel remover, air freshener,
laundry bleach and detergent, vaseline lotion, deodorants, fabric softener
"irritating to the upper respiratory tract" ..."headache, nausea, vomiting,
dizziness, drop in blood pressure, CNS depression, and death in severe
cases due to respiratory failure."
Found in: perfume, shaving cream, nail enamel, fabric softener, dishwasher detergent,
nail color, stickup air freshener
"local irritant and CNS stimulant" ..."readily absorbed through body
tissues" ..."irritation of eyes, nose and throat" ..."dizziness, confusion,
nausea, twitching muscles and convulsions" "Avoid inhalation of vapors."
Found in: perfume, hairspray, shampoo, fabric softener, dishwashing
liquid and detergent, laundry detergent, shaving cream, soap, vaseline
lotion, air fresheners, nail color and remover, paint and varnish remover
On EPA Hazardous Waste list; symptoms: "...fatigue; irritating to eyes and
upper respiratory tract even in low concentrations..." "Inhalation of
ethanol vapors can have effects similar to those characteristic of
ingestion. These include an initial stimulatory effect followed by
drowsiness, impaired vision, ataxia, stupor..." Causes CNS disorder.
- ETHYL ACETATE
Found in: after shave, cologne, perfume, shampoo, nail color, nail enamel remover,
fabric softener, dishwashing liquid
Narcotic. On EPA Hazardous Waste list; "...irritating to the eyes and
respiratory tract" ..."may cause headache and narcosis (stupor)"
..."defatting effect on skin and may cause drying and cracking" ..."may
cause anemia with leukocytosis and damage to liver and kidneys" "Wash
thoroughly after handling."
Found in: perfume, cologne, disinfectant spray, bar soap, shaving cream, deodorants,
nail color and remover, fabric softener, dishwashing liquid, air fresheners,
after shave, bleach, paint and varnish remover
Carcinogenic. "Prevent its contact with skin or eyes because it is an
irritant and sensitizer." "Always wash thoroughly after using this material
and before eating, drinking, ...applying cosmetics. Do not inhale limonene
Found in: perfume, cologne, bar soap, shampoo, hand lotion, nail enamel remover,
hairspray, laundry detergent, dishwashing liquid, vaseline lotion, air
fresheners, bleach powder, fabric softener, shaving cream, after shave,
Narcotic. ..."respiratory disturbances" ... "Attracts bees." "In animal
tests: ataxic gait, reduced spontaneous motor activity and depression ...
development of respiratory disturbances leading to death." ..."depressed
frog-heart activity." Causes CNS disorder.
- METHYLENE CHLORIDE
Found in: shampoo, cologne, paint and varnish remover
Banned by the FDA in 1988! No enforcement possible due to trade secret laws
protecting chemical fragrance industry. On EPA, RCRA, CERCLA Hazardous
Waste lists. "Carcinogenic" ..."Absorbed, stored in body fat, it
metabolizes to carbon monoxide, reducing oxygen-carrying capacity of the
blood." "Headache, giddiness, stupor, irritability, fatigue, tingling in
the limbs." Causes CNS disorder.
Found in: bar and liquid soap, cologne, perfume, shaving cream, deodorants,
dishwashing liquid, air freshener
Sensitizer (damaging to the immune system).
Found in: cologne, perfume, soap, shaving cream, deodorant, air freshener
"Causes asthma and CNS disorders."
Found in: perfume, cologne, laundry detergent, bleach powder, laundry bleach,
fabric softener, stickup air freshener, vaseline lotion, cologne, soap,
hairspray, after shave, roll-on deodorant
..."highly irritating to mucous membranes"... "Aspiration into the lungs
can produce pneumonitis or even fatal edema." Can also cause "excitement,
ataxia (loss of muscular coordination), hypothermia, CNS and respiratory
depression, and headache." "Prevent repeated or prolonged skin contact."
95% of chemicals used in fragrances are synthetic compounds derived from
petroleum. They include benzene derivatives, aldehydes and many other known
toxics and sensitizers - capable of causing cancer, birth defects, central
nervous system disorders and allergic reactions. Neurotoxins: At Home and
the Workplace, Report by the Committee on Science & Technology, U.S. House
of Representatives, Sept. 16, 1986. (Report 99-827)
Central Nervous System disorders (brain and spine) include Multiple
Sclerosis, Parkinson's Disease, Alzheimer's Disease, Sudden Infant Death
Chloroform was found in tests of fabric softeners: EPA's 1991 study.
A room containing an air freshener had high levels of p-dichlorobenzene (a
carcinogen) and ethanol: EPA's 1991 study.
An FDA analysis (1968-1972) of 138 compounds used in cosmetics that most
frequently involved adverse reactions, identified five chemicals (alpha-
terpineol, benzyl acetate, benzyl alcohol, limonene and linalool) that are
among the 20 most commonly used in the 31 fragrance products tested by the
EPA in 1991!
Thirty-three million Americans suffer from sinusitis (inflammation or
infection of sinus passages).
Ten million Americans have asthma. Asthma and asthma deaths have increased
over 30% in the past 10 years.
Headaches cost $50 billion in lost productivity and medical expenses and
157 million lost work days in 1991. "Focus on Fragrance and Health," by
Louise Kosta, The Human Ecologist, Fall 1992.