Asthma
Asthma is the most common childhood chronic disease. The number of people with asthma roughly doubled between 1980 and 1995 in the U.S. (Tracey J. Woodruff , Daniel A. Axelrad DA, Amy D. Kyle, Onyemaechi Nweke, Gregory G. Miller, and Bradford J. Hurley, “Trends in Environmentally Related Childhood Illnesses,” Pediatrics, 113, no. 4 (April 2004): 1133-1140.) In 2008, more than 38 million people in the U.S. had experienced asthma at some point during their lives. Of these, ten million are children. (National Health Interview Survey, “Summary Health Statistics for U.S. Adults” Vital and Health Statistics, Series 10, no. 242 (2008).) (National Health Interview Survey, “Summary Health Statistics for U.S. Children” Vital and Health Statistics, Series 10, no. 244 (2008).) In 2008, almost one in 10 (9.4% or seven million) children in the U.S. had asthma. Non- Hispanic black children are more likely to have asthma (16%) than Hispanic children (7%) or non-Hispanic white children (9%). (Ibid.) The annual cost of asthma is estimated to be nearly $18 billion, with $10 billion of that total being direct medical costs and $8 billion in lost earnings due to illness or death. (Asthma and Allergy Foundation of America, “Asthma Facts and Figures,” http://www.aafa.org/display.cfm?id=8&sub=42 (accessed August 12, 2009).)
The link to chemical exposure
The doubling of asthma rates over the last two decades has prompted researchers to examine the role that chemicals and other environmental risk factors may play in this trend. Genetics cannot explain such dramatic increases in prevalence over such a short time. Extensive evidence from occupational studies and general population epidemiological and medical case reports documents that hundreds of chemicals can cause asthma in individuals previously free of the disease or can place asthma patients at greater risk for subsequent attacks. (Jean-Luc Malo and Mora Chan-Yeung, “Appendix: Agents Causing Occupational Asthma with Key References,” in
In his 2007 review, Mark J. Mendell surveyed the literature to find 21 studies that link indoor residential chemical emissions and respiratory health or allergy problems in infants or children. He identified formaldehyde or particleboard, phthalates or plastic materials, and recent painting as the most frequent risk factors. Elevated risks were also reported for renovation and cleaning activities, new furniture, and carpets or textile wallpaper. Table 3 provides an overview of the indoor sources identified in Mendell’s paper.
The 21 studies in the Mendell review include a 2004 Swedish study that compared 198 young children with asthma and allergies to 202 healthy control subjects. The home environment of every child was examined, with air and dust samples taken in the room where the child slept. The children whose bedrooms contained higher levels of the phthalate DEHP were more likely to have been diagnosed with asthma by a physician. (Carl-Gustaf Bornehag, et al., “The Association between Asthma and Allergic Symptoms in Children and Phthalates in House Dust: A Nested Case–Control Study,” Environmental Health Perspectives, 112, no. 14 (October 2004): 1393–1397.)
Asthma and TSCA
Consumers, retailers, and other downstream users of chemicals (including manufacturers of and distributers of toys and other products) have a problem in common: They cannot gain access to basic information about the chemicals used to make their products. Because TSCA does not ensure the right to know, we don’t have the information we need to identify all the sources of indoor air pollution that are causing and contributing to asthma.
How can an expectant mother determine if there is formaldehyde in the particleboard used to make cribs and other nursery furnishings? How does a new father decide which strollers may contain and release phthalates? Why should new parents even have to worry about whether dangerous chemicals are in the products they choose for their newborn children?
TSCA reform should require chemical manufacturers to disclose what they know about chemical uses, and for clearly hazardous substances, chemical manufacturers should also have to disclose the products in which they are used. (This entire section is informed by the article “Indoor Residential Chemical Emissions as Risk Factors for Respiratory and Allergic Effects in Children: A Review,” by Mark J. Mendell, Indoor Air, 17, no. 4 (2007): 259–77.)
