August 2008

Take asthma action in National Asthma Week

Asthma in older adults satellite broadcast

Advancing Asthma Where? Conference reminder

Infant wheezing not clearly linked to antibiotics

Health impacts of winter air pollution

Research Funding Opportunities

Conference Diary

Take asthma action in National Asthma Week

The first week of September is National Asthma Week and the National Asthma Council Australia is urging the two million plus Aussies with asthma to make sure they have a current written asthma action plan.

According to National Asthma Council Australia chairman, Professor John Wilson, asthma prevalence in this country is relatively high but we can minimise its impact through greater awareness and understanding.

“In the same way that daylight savings signals the time to change your smoke alarm battery, National Asthma Week is the time to make a resolution to consult your GP and prepare a written asthma action plan, or if you already have a plan, make sure it is up-to-date,” Prof Wilson urged.

These written instructions help people with asthma, as well as their family, carers and neighbours, recognise how to tell if asthma symptoms are getting worse, and what action to take.

“Research shows that written action plans keep people with asthma in control of their condition. They are better equipped to recognise deterioration of their symptoms and can respond appropriately,” Prof Wilson said.

Unfortunately, many Australians with asthma do not have a written asthma action plan, despite evidence that shows that asthma self-management programs that involve a written action plan have a greater reduction in hospitalization than those that do not.

“People who have a written action plan have better controlled asthma, fewer asthma symptoms and fewer days off work or school because of asthma,” Prof Wilson explained.

Poorly managed asthma can be fatal.

According to the latest statistics, 402 Australians died from asthma in 2006.

“There is no cure for asthma, but many asthma deaths are preventable – we just need to continue to take it seriously,” Prof Wilson said.

Resources

Written Asthma Action Plan Templates

Asthma in older adults satellite broadcast

Up to one-third of older people with asthma remain undiagnosed due to a combination of under-reporting of symptoms and complexity of diagnosis.

Older adults may consider their breathlessness to be a frustrating but natural consequence of ageing, unaware that respiratory disease might be the cause. Yet the prevalence of asthma and chronic obstructive pulmonary disease (COPD) both increase with age.

The risk of dying from asthma also increases with age, and acute asthma attacks are more rapidly fatal in older adults. However, up to one-third of elderly people with asthma are not identified as such by their doctors through a combination of under-reporting of symptoms and complexity of diagnosis. COPD is also under-diagnosed in the elderly.

To help address this growing problem, the National Asthma Council Australia will host a special Rural Health Education Foundation satellite broadcast program on September 9, 2008, funded by the Australian Government Department of Health and Ageing. The program, “Breathlessness in the Older Adult: Is it Asthma?”, will be chaired by ABC Radio National’s Dr Norman Swan and will feature a panel of experts who will explore the differential diagnosis and management of asthma in older adults with breathlessness, with interrelated discussion of COPD, and address ‘live’ questions from viewers.

This program will cover the differential diagnosis and management of asthma in older adults with breathlessness, with interrelated discussion of COPD. The distinction between asthma and COPD is important, even when they co-exist, as there are significant differences in the optimal management of each condition. Clinical case studies will be used to frame the discussion.

Speakers

• Chair: Dr Norman Swan, Presenter of the Health Report on ABC Radio National
• Assoc Prof Christine McDonald, Respiratory Physician, Austin and Repatriation Medical Centre, Melbourne, VIC
• Dr Gary Kilov, General Practitioner, Clarinda Clinic, Melbourne, VIC
• Ms Toni Riley, Community Pharmacist, Bendigo, VIC
• Ms Vanessa McDonald, Respiratory CNC, Hunter New England Health, Newcastle, NSW

The 60-minute program will be broadcast on Channel 4 of the Rural Health Education Foundation's satellite network on Tuesday 9 September 2008 at:

• 8.00pm in ACT, NSW, VIC, QLD & TAS.
• 7.30pm in SA & NT.
• 6.00pm in WA (& repeated in WA at 8.00pm on channel 23).

The program will be repeated on Channel 23 of the Foundation’s satellite network on Friday 12 September 2008 at:

• 12.30pm in ACT, NSW, VIC, QLD & TAS.
• 12 noon in SA & NT.
• 10.30am in WA.

The program will be available to view online approximately one week after the initial broadcast.

For more information see NAC Asthma Programs with the Rural Health Education Foundation

Advancing Asthma Where? Conference reminder

The biennial Australian Asthma Conference will take place from 20 - 21 October 2008 at the Australian Technology Park Sydney.

The conference program aims to see how the nation can work together to develop ideas and actions responding to the changing world of asthma in Australia influencing and informing future asthma agendas.

The program seeks to involve a wide cross section of people connected with asthma including:

• consumers,
• health professionals,
• scientists and researchers,
• policy makers from State and Federal Governments
• Asthma Foundations of Australia staff and
• National Asthma Council Australia representatives.

Expert speakers include:

More information

Go to www.asthmaconference2008.com

Infant wheezing not clearly linked to antibiotics

Children who are given antibiotics in their first three months often wheeze by 15 months of age, but latest research from the University of Otago, Wellington shows the wheezing is probably more due to chest infections than to the use of antibiotics.

These are the key findings in a study led by the Director of the Wellington Asthma Research Group, Professor Julian Crane, and published in this month's edition of Clinical and Experimental Allergy.

The study followed a cohort of approximately 1000 children from Wellington and Christchurch from birth through to four years, collecting data on chest infections and antibiotic exposure at three months, 15 months and then yearly until four years of age. This longitudinal study allowed more accurate analysis of clinical cause and effect, compared to previous cross-sectional studies which only look at a sample of children at one particular point in time.

The analysis of the data showed that by the time the children had reached 15 months nearly three quarters (72.1%) had been given antibiotics. In addition 11.8% had asthma, 39.6% had eczema and 21.2% had a recurring itchy scaly rash. The question is, can these health effects be linked to antibiotic use?

"Our results strongly suggest that the reason that some children who've been given antibiotics appear to develop asthma is because they had a chest infection and the symptoms of the chest infection in young children can be confused with the start of asthma. Antibiotics are then given to treat this respiratory condition, which may or may not be asthma, and are not a cause as has been previously suggested," says Professor Crane.

"However our study still leaves open the possibility that antibiotics have something to do with the development of eczema and itchy skin by four years, and allergic hypersensitivity by 15 months."

Professor Crane says one of the background reasons for this study is that there has been debate in recent years over the role that antibiotics play in the development of asthma. The theory is that asthma has increased in line with antibiotic use over the last forty years. The contention has been that antibiotics reduce exposure to bacterial infection and may alter the normally healthy bacteria in the gut. In turn this may facilitate the development of allergy and asthma.

The study concludes, however, that much of the effect of antibiotics on the development of asthma in infancy can be explained by chest infections which are often difficult to distinguish from asthma at an early age

Reference

Wickens K, Ingham T, Epton M et al. The association of early life exposure to antibiotics and the development of asthma, eczema and atopy in a birth cohort: confounding or causality? Clin Exp Allergy 2008; 38: 1318-24.

Health impacts of winter air pollution

Serious air pollution in Christchurch, mainly from wood smoke, does have an impact on the respiratory health of young people, but the immediate effect is not major according to new research by the University of Otago, Christchurch.

The study, which has recently been published in Environmental Health, examined the respiratory and physiological effects of particulate air pollution on the lung function of 93 male secondary students, 26 of whom had asthma, who were boarding at Christ's College. Each boy measured their lung function morning and evening throughout the winter, and those with asthma noted the use of their reliever. Researchers also tested students in more detail on very high pollution days.

Lead investigator and respiratory physician Dr Michael Epton says the study, undertaken by researchers from the Canterbury Respiratory Research Group, the Geography Department of the University of Canterbury, LandCare Research, and Environment Canterbury, arrived at a number of significant conclusions regarding the impact of air pollution and the health of children in areas of high wood smoke from home heating.

"Principally we show that air pollution, as measured by particulate matter in smoke or PM10, does affect the health of boys who have problems with asthma. Although the health impact isn't great, there were small decreases in lung function during very high pollution days for boys with asthma," he says.

"The majority of students, on the other hand, who didn't have respiratory problems were not affected. However all students coughed slightly more on high pollution nights."

Dr Epton says this shows air pollution does not cause serious immediate health problems for this age group, which is the good news, but this may not be the case for older adults with chronic respiratory conditions, such as bronchitis or asthma. These results cannot be generalised across all age groups he says. Neither does it measure the long term cumulative effects of air pollution in Christchurch.

Other findings indicate that exposure to wood smoke pollution can be directly measured in urine, with urine tests of the same group of students clearly showing an increase in 1-hydroxpyrene levels during high pollution days.

"This is the first time that this urine test has been used to detect exposure to wood-smoke pollution in New Zealand," Dr Epton said. There may be further opportunities to use this test as a biomarker for exposure to significant wood smoke as exists in Christchurch.

"Another important result which contradicts an urban myth is that you cannot escape the health effects of air pollution by going inside and slamming the door; indoors is just as polluted as outdoors," says Dr Epton. "Our tests show there is very little difference in the concentrations of PM10, PM2.5 and PM1 particulates between indoors and outdoors, contrary to many people's belief."

"Essentially pollution reaches people's lungs even if they stay inside on high pollution days; there is no escape from wood smoke pollution, particularly in older wooden houses during winter temperature inversions in Christchurch, or anywhere else."

The researchers are very grateful for all the hard work the boys and staff of Christ's College put in for this study. "They were really enthusiastic and supportive, which made the project much easier to co-ordinate".

Reference

Epton MJ, Dawson RD, Brooks WM et al. The effect of ambient air pollution on respiratory health of school children: a panel study. Environmental Health 2008; 7: 16.

Research Funding Opportunities

The National Asthma Council Australia would be pleased to list funding opportunities that may be available for asthma research. Submit brief details for consideration by email to nac@nationalasthma.org.au.

 

Conference Diary

Submit brief conference/meeting details to the National Asthma Council Australia for possible posting in our Conference Diary by email to nac@nationalasthma.org.au.

	WONCA 2008 Asia Pacific Regional Conference 1–5 October 2008. Melbourne, Australia http://www.wonca2008.com
	ERS Annual Congress 4-8 October 2008 Berlin, Germany http://www.ersnet.org/
	Advancing Asthma Where? Australian Asthma Conference 20 - 21 October 2008 Australian Technology Park Sydney, Australia http://www.asthmaconference2008.com/
	CHEST, Annual International Scientific Assembly of the American College of Chest Physicians 25-30 October 2008 Philadelphias United States http://www.chestnet.org/CHEST/
	American College of Allergy, Asthma & Immunology 7-12 November 2008 Seattle, United States http://www.acaai.org/
	ASCIA 19th Annual Scientific Meeting 12 - 14 November 2008 Park Hyatt Hotel, Melbourne, Australia http://www.ascia2008.com/
	13th APSR Congress 19-22 November 2008 Bangkok, Thailand http://www.apsr2008.org
	Annual Meeting of Taiwan Society of Pulmonary and Critical Care Medicine 6-7 December 2008 Taipei, Taiwan spccm@mars.seed.net.tw http://www.tspccm.org.tw/