Asthma is becoming more prevalent in the United States, reports revealed. According to the CDC, the number of Americans diagnosed with the condition increased by almost 4.5 million between 2001 and 2009.
A few years after, the Asthma and Allergy Foundation of America (AAFA) shared that around 25 million have been diagnosed, of which 8 percent are adults and around 7 percent are children.
Although asthma is treatable and manageable, it doesn’t have a cure. In certain situations, it can be life-threatening. In 2019 alone, over 3,500 people died from it. It is also expensive. The annual cost could reach over $50 billion, a huge chunk of it going to hospitalization and medications.
But why is asthma becoming more common? Many experts weigh in their opinions:
Hygiene Hypothesis
One of the leading theories for the increased rates of asthma cases is the hygiene hypothesis, according to the AAFA. This principle suggests that keeping the environment squeaky clean may lower the exposure of children to germs that could train the immune system to know the difference between harmless and safe irritants.
This may also explain why kids who grew up in rural areas or farms are less likely to develop asthma and allergies. A 2015 research showed that an endotoxin could stimulate an immune response to the lung cells, turning them numb. This way, the farm dust won’t cause any inflammation or irritation that can lead to the mentioned conditions.
However, some studies say that the hygiene hypothesis is both incorrect and a misnomer. A 2016 research in Perspectives in Public Health said that there’s no strong evidence to suggest that hygiene could contribute to significant changes to the exposure to microbes.
Increased Pollutants
The number of pollutants or irritants has also increased over the years. In 2020, for the first time in world history, the UK attributed the death of a 9-year-old girl with asthma to outdoor pollution. The Environmental Protection Agency (EPA), meanwhile, shared that indoor air quality could be many times worse than in the outdoors.
Besides pet dander, dust, and debris, many products, from cleaning materials to personal care and paint, now emit volatile organic compounds (VOCs). These can further contaminate the air and trigger a bad respiratory response.
These pollutants, however, are just half of the equation. The other is the lack of maintenance in the home. Opting for a duct cleaning service, for example, can help remove the buildup of pollutants that have stuck on the system and have the chance to recirculate inside the home or building.
Treatment Noncompliance
There are different ways to treat asthma, including using inhalers or taking medications. However, for them to truly work and prevent symptoms, doctors strongly recommend that patients stick to the program until their next assessment. In other words, they cannot stop their therapy even when they feel fine without the doctor’s consent.
The problem is many patients are non-compliant. Non-adherence could range from 30 to 70 percent, according to UpToDate notes. Although the cost of medication is one of the reasons, the causes can also be multifactorial.
A 2016 study in the European Respiratory Journal revealed that other explanations could include being symptom-free, travel, social embarrassment from using inhalers, the difficulty of using inhalers, fear of side effects, forgetfulness, and religious practices.
Unfortunately, the consequences of stopping the medications without the doctor’s guidance could be more severe and expensive. These patients may develop worse outcomes, which would then increase the risk of hospitalization or even death. It could only increase the costs of treatment.
Obesity
Many studies already show an association between obesity and asthma. A 2018 study in the Journal of Allergy and Clinical Immunology pointed out that around 60 percent of adults diagnosed with severe asthma are also obese.
Moreover, because obese adults are more likely to develop severe asthma, they also increased their risk of hospitalization by as much as six times compared to lean individuals with the same condition. Currently, about 65 percent of US adults are either overweight or obese.
What causes the connection? The scientists are still looking into that, although they are considering different theories. First, obesity can have a direct effect on the development of the body’s immune system. It can also increase the risk of inflammation. Second, the excess weight could constrict the lungs and the diaphragm, making it harder to breathe and, thus, worsening asthma symptoms.
The world has made a lot of progress in treating and managing asthma that fewer people die annually. However, unless the potential causes are also controlled, the number of cases will only increase in the succeeding years.