Felicia
Rabito, a clinical assistant professor in the Department of Biostatistics
and Epidemiology at the Tulane School of Public Health and Tropical
Medicine and a past Gambit Weekly 40 Under 40TM honoree,
recently received a three-year, $854,909 grant from the U.S. Department
of Housing and Urban Development to help lessen the number and
severity of asthma attacks and lead poisoning among inner-city
New Orleans children. Following are details of what she hopes
to accomplish.
Q: How prevalent is asthma in this
area?
A: There's no surveillance
system for asthma in New Orleans and Louisiana (but overall)
it's an epidemic and it's occurring frequently in inner-city
populations. What we're looking at is what is causing asthma
in children in New Orleans. I'm particularly looking at the
home environment in poor, inner-city kids.
Q: Why are allergies and asthma such
a problem?
A: Some people are saying
it's increasing because we build our houses more tightly and
consequently we've got more allergens floating around. That
doesn't make sense, however, for inner-city, minority populations.
People also talk about triggers. Our exposure matrix is somewhat
different from other parts of the country, with old buildings,
our climate -- it never freezes here so things don't die off.
Part of our research is to measure the environments of children
who have asthma. We're interested in indoor air in their homes.
Also because our children will be attending the allergy clinic,
we'll find out what they've been sensitized to.
Q: What do you hope to accomplish?
A: We're [trying to determine
if] there is anything we can do. We're looking at very basic
cleanup measures, things in the literature that have been shown
to help: hepa filter vacuum cleaners, mattress covers, cleaning.
Q: What are you looking for?
A: There's a lot of research
that shows cockroach droppings, among other things, trigger
asthma. What we'll do is use community health workers -- they're
research assistants but they are people who come from the community
-- and we'll talk to people about what those triggers are: dust
cockroaches, moisture, mold, mildew. Then we'll show them some
ways and explain why they should be cleaning up and give them
the tools to do it. Even if we do all that, we really don't
know if that will reduce the number of asthma attacks.
Q: Is there already evidence that
cleaning will help?
A: There have been other
studies looking at interventions ... but there's contradictory
information. What we're looking at is tried-and-true interventions.
But because we don't know what is causing the triggers, we don't
know if it will do that much good.
Q: Are you determining triggers for
allergies or asthma or are they the same?
A: We're not looking at
people with allergies; we're looking at people with asthma.
That's what brings children to the hospital emergency rooms.
The primary risk factor or trigger for asthma is reaction to
the allergens. Some people's trigger is respiratory infections;
others are different things, even stress.
Q: Is asthma a genetic or acquired
disease?
A: There is a genetic
component to it, but not in all cases is it genetic. That's
something we're going to look at, too. We're not really looking
at the development of the asthma but the triggers, regardless
of whether their asthma is due to genetic predisposition.
Q: Tell us about your work in clearing
homes of contaminants.
A: We're going to give
them (hepa filter) vacuum cleaners, cleaning supplies, containers
for food -- pastas, cereals, bread -- mattress covers, simple
things like trash cans with covers, integrative pest management,
getting rid of anything that collects dust. We'll give them
what has been shown to work.
Q: Do you recommend people have their
air-conditioning and heating ducts cleaned?
A: You have to be very
careful, because some suck it just at the surface, which doesn't
help, but to have it really cleaned is great. It gets the dust
and the mold and mildew.
