Air pollution and exacerbation of asthma in African-American children in Los Angeles.

Significant increases in asthma morbidity and mortality in the United States have occurred since the 1970s, particularly among African-Americans. Exposure to various environmental factors, including air pollutants and allergens, has been suggested as a partial explanation of these trends. To examine relations between several air pollutants and asthma exacerbation in African-Americans, we recruited a panel of 138 children in central Los Angeles. We recorded daily data on respiratory symptoms and medication use for 13 weeks and examined these data in conjunction with data on ozone (O3) nitrogen dioxide (NO2), particulate matter (PM10 and PM2.5), meteorological variables, pollens, and molds. Using generalized estimating equations, we found associations between respiratory symptom occurrence and several environmental factors. For example, new episodes of cough were associated with exposure to PM10 (OR = 1.25; 95% CI = 1.12-1.39; interquartile range [IQR] = 17 microg/m3, 24-hour average), PM2.5 (OR = 1.10; 95% CI = 1.03-1.18; IQR = 30 microg/m3, 12-hour average), NO2, and the molds Cladosporium and Alternaria, but not with exposure to O3 or pollen. The factors PM10 and O3 were associated with the use of extra asthma medication. For this population several bioaerosols and air pollutants had effects that may be clinically significant.

Targeting adult smokers through a multi-ethnic public school system.

In a unique approach to utilizing an existing intervention, "opportunistic" and targeted school-based strategies were used to enroll 446 adults into a tailored preventive health program featuring a health screening and smoking-cessation intervention. Implemented through a public school district serving a multi-ethnic low-to-middle income urban community, subjects in this randomized trial were interviewed at enrollment and at three-, six-, and 12-month follow-up, and rescreened at 12 months, to assess changes in smoking-related knowledge, attitudes, and practices. Using conservative assumptions, self-reported ever-quit rates and continuous abstinence rates of 57.5% and 2.6%, respectively, were achieved across groups; point-prevalence abstinence rates were 13.2%, 12.9%, and 10.3% at three, six, and 12 months. The study examines issues relevant to smoking status and stages of change in this population. The role of the school in increasing access to needed health programming in underserved communities is explored.