By Tien-Shun Lee
Franklin Flores has heard many people complain of the same problems: chronic coughs, waking up in the middle of the night short of breath, wheezing. These people often live with their problems, which they consider annoyances, for years before finding out that they are asthmatic.
“People get confused. They think they've got a cold,” said Flores, who runs Elmhurst Hospital Center's asthma van. Working from the van, Flores gives out information about asthma every week in different locations around the borough.
“People generally don't know until they have a severe attack and end up in the emergency room that they're asthmatic,” said Flores' partner, Georges Leconte, who is the director of respiratory therapy at EHC.
If people are educated about their disease, they can avoid ending up in the hospital emergency room by taking anti-inflammatory medication on a regular basis and following an asthma action plan when they start to experience symptoms, where they promptly medicate themselves and distance themselves from asthma triggers, Leconte said.
Asthma triggers include dust mites, which frequently reside in bedding and curtains, mold, mildew, smoke, changes in temperature, certain foods and exercise.
“It's almost like going to battle. You have to figure out what's your enemy, what's your trigger,” Leconte said. “A lot of people take their medications and function perfectly normal. Jackie Joyner-Kersee is the perfect example. She's won the Olympic heptathelon and she's a very bad asthmatic. She has exercise-induced asthma.”
According to a report funded by KeySpan Energy that was publicized this month in a news conference organized by the National Resources Defense Council, an environmental advocacy organization, and the Astoria-based Community Helping Organize a Kleaner Environment, or CHOKE, the asthma hospitalization for children in Queens increased 57 percent from 1988 to 1997 and is almost three times higher than the state average.
The report cited air pollution as a factor for the increase in asthma, and stated that Queens is among the worst 10 percent of U.S. counties in terms of exposure to air pollution.
However, Patrick Kinney, an associate professor who researches asthma and air pollution at the Columbia School of Public Health in Manhattan, said there is no clear evidence that the upward trend in asthma has been due to air pollution.
“Although we know that air pollution can have an effect on asthma, it doesn't seem like that's enough to explain the increase,” Kinney said. “Some people have suggested indoor allergens. Some people have suggested a sedentary lifestyle, since obesity is related to asthma. Usually, air pollution is not a leading candidate, and studies show that air quality has generally improved over the last 20 years.”
Kinney and Leconte said asthma is correlated with poverty. People with low incomes tend to live in enclosed areas with more cockroaches and other asthma triggers, Leconte said. In addition, they are not as educated about the disease and often do not have access to health care.
“Asthma does not discriminate by race, but there are more cases of (asthma) attacks in people living in poverty,” Leconte said.
Hadi Jabbar, the director of the pediatric asthma center at New York Hospital Medical Center of Queens in Flushing, said about three out of five children living at the Carlton House homeless shelter next to Kennedy Airport are asthmatic.
“Nobody has looked into why the incidence is so high,” Jabbar said. “We're thinking of doing research into what the incidence is compared to outside.”
Jabbar hypothesized that besides coming from a low economic background, people in the shelters may suffer a high rate of asthma because they are under a lot of stress, which is a trigger for the disease.
Like Flores, Jabbar helps operate an asthma van. The 42-foot van is more advanced than EGH's asthma van, containing an examining room and treatment room, where patients can be diagnosed and treated for asthma. The van visits the Carlton House every Monday and Friday, and the Briarwood Family Shelter every Wednesday.
Approximately 140,000 children in New York City have asthma, including about 45,000 in Queens, Jabbar said. Neighborhoods in Queens with the highest incidences of asthma are Long Island City, Astoria and Jackson Heights, followed by Jamaica and St. Albans.
Though there is no cure for asthma, people with the disease can lead normal lives by taking their medication properly, usually by inhaling it with the use of a pump and spacer chamber, keeping their exposure to asthma triggers to a minimum and following an asthma action plan when they start to experience symptoms, Leconte said.
“This is your life you're talking about,” Leconte said. “If you can't breathe, you can't live.”
Reach reporter Tien-Shun Lee by e-mail at Timesledger@aol.com, or call 718-229-0300, ext. 155.
