Asthma

Asthma in Baltimore

The City of Baltimore is burdened by asthma. According to the Maryland Department of Health, 13.7% of Baltimore City adults currently have asthma, compared to 9.0% statewide1 and 9.0% nationally.2 Baltimore City youth also have asthma at rates higher than elsewhere in the State. Among our high school students, 33.3% have been told by a doctor or nurse that they had asthma, compared to 25.9% statewide.(3) Baltimore City’s rate of emergency department visits due to asthma is the highest in Maryland.(4)

Asthma continues to have a large impact on school and work. Nationally, one study estimated that almost 11 million school days and 14 million workdays were missed due to asthma in 2008.5  The overall economic burden of asthma was estimated at $81.9 billion in 2013 in the US.6

What is Asthma?

Asthma is a chronic disease of the airways – the tubes that bring air in and out of your lungs – that can make it hard to breathe. People with asthma have airways that are sensitive to things called triggers. Triggers cause the airways to swell and fill up with mucus, and make the muscles around the airways tighten. This can cause coughing, wheezing, chest tightness, and trouble breathing. Everyone's asthma triggers are different, so it is important to know what your triggers are. Asthma cannot be cured, but it can be controlled! Seeing your doctor, taking your medication, and avoiding triggers are all ways you can manage your asthma.

When asthma is under control a person can be active, feel good, and sleep through the night. When your asthma is controlled you:

  • Have few asthma symptoms even after exercise and at night
  • Have few asthma attacks
  • Do not miss school or work
  • Can exercise without symptoms
  • Have no emergency room visits or hospital stays
  • Use quick-relief medicine (albuterol) fewer than twice per week during the day or twice per month at night

Asthma that is not well controlled can lead to many school or work absences, emergency room visits, and hospitalizations.

What Can You Do?

There are things you can do to manage asthma:

  1. Know the early signs of worsening asthma so you can take your medicine or contact your doctor and prevent a serious attack
  2. Keep your Asthma Action Plan available
  3. Know how to respond to an asthma episode
  4. Use your medicine as prescribed by your doctor
  5. Use a spacer when using a Metered Dose Inhaler
  6. Keep your rescue medicine in the school health suite
  7. Know your asthma triggers and avoid them
  8. See your doctor regularly

How to Respond to an Asthma Episode

If despite doing everything you can to manage asthma, your child still has an asthma episode, you should do the following:

  1. Stop all activity, and help to sit up
  2. Follow the steps outlined in the Asthma Action Plan
  3. Help the child use his/her inhaled quick-relief medication:
    • 1 spray, wait one minute, repeat
  4. Get emergency help if a child fails to improve within a few minutes.
  5. Call 911 if a child is hunched over; struggling to breathe, talk, or stay awake; or has blue lips/fingernails

Recognizing Signs and Symptoms

It is important to know your asthma signs and symptoms. Relief medication works best when it is taken as soon as symptoms appear. Common signs include:

  • Shortness of breath
  • Wheezing
  • Coughing
  • Chest tightness

Other signs can include:

  • Feeling sweaty / getting sudden chills
  • Feeling edgy for no reason
  • Funny feeling in the chest or throat
  • Feeling tired even after sleeping
  • Itchy chin or neck
  • Chronic cough

Asthma Medications

It is important to work with your doctor to find the right medicines that will control asthma symptoms. There are two kinds of asthma medicines:

  1. Controller (daily) medication that:
    • Reduces airway swelling
    • Prevents symptoms
    • Should be taken daily, even if feeling ok
    • Can take up to two weeks to work
  2. Relief (or rescue) medication that:
    • Relaxes airway muscles and opens the airway
    • Relieves symptoms
    • Is taken when symptoms first develop or before encountering a trigger

Asthma Triggers

An asthma trigger is anything that makes your asthma worse.  It is important to know what triggers your asthma and take steps to reduce those triggers. Since asthma can be triggered by the things you are allergic to, you may want to talk to you doctor about testing for allergies.

Some common triggers are:

  • Tobacco and other smoke
  • Dust mites
  • Pets with fur or feathers
  • Bleach (or other cleaners with strong smells)
  • Air fresheners
  • Perfumes
  • Chalkdust
  • Pollution
  • Mold
  • Pollen 
  • Pests such as cockroaches and mice
  • Cold, dry weather
  • Warm, damp weather
  • Colds & flu
  • Strong emotions or stressful situations

Asthma Action Plan

Your doctor can help you remember what to do by filling out an Asthma Action Plan. The Asthma Action Plan is a form that explains what medicine to take for asthma and when to take it. You should give a copy of the Asthma Action Plan to everyone who cares for your child. 

Baltimore City Public Schools have their own School Health Asthma Action Plans. These forms can be obtained in the school s Health Suite and should be completed and signed by your health care provider, and a copy given to the school nurse or health aide. These forms let the school know what and how much medicine to give your child in the event of an asthma attack.

What Services Does BCHD Provide?

Home Visiting Services

The Community Asthma Program (CAP) is enrolling Baltimore City children ages 1 to 18 who have trouble managing their asthma. Home visits from trained community health workers help families improve asthma control by: 

  • Going over medications prescribed by your doctor
  • Showing proper medication technique
  • Helping obtain an Asthma Action Plan from your doctor
  • Showing you where asthma triggers are in your home
  • Giving supplies to reduce asthma triggers in the home
  • Connecting you to other services that might help

Home visiting services can be requested by calling 410-396-3848, or by faxing the referral form to 410-244-1366.

Community Education

CAP also provides interactive asthma education to community groups, parent groups, children, and care providers.  Education is tailored to group needs.  To request asthma education for a group, please call 410-396-3896, or fax the referral form to 410-244-1366.

Program Office Location and Contact Information

Community Asthma Program (CAP)
7 E. Redwood Street, 2nd Floor
Baltimore, Maryland 21202

8:30 a.m.-4:30 p.m., Monday-Friday
Phone:   410-396-3848 / Fax:  410-244-1366

References:  

  1. 2019 Maryland Behavioral Risk Factor Surveillance System (BRFSS),  can be accessed on 9/30/2021.
  2. Table C1, Adult Self-Reported Current Asthma Prevalence, and Number by State or Territory: BRFSS 2019, can be accessed on 9/30/2021.
  3. Maryland Youth Risk Behavior Survey, 2018-2019, High School Data, Detailed Tables, can be accessed on 10/1/2021.
  4. Maryland State Health Improvement Process (SHIP) Emergency Department Visit Rate Due To Asthma 2008-2017, can be accessed on 10/1/2021.
  5. Akinbami LJ, Moorman JE, Liu X. Asthma prevalence, health care use, and mortality: the United States, 2005-2009. Natl Health Stat Report. 2011 Jan 12;(32):1-14. PMID: 21355352.
  6. Nurmagambetov T, Kuwahara R, Garbe P. The economic burden of asthma in the United States, 2008–2013. Ann Am Thorac Soc 2018;15:348–56.
 

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