California's children missed 1.9 million days of school and the state's adult workers missed 2 million days of work due to asthma, according to new research from the UCLA Center for Health Policy Research.
Asthma, a chronic inflammation of the air passageways in the body, is also to blame for a half million - and possibly more - visits to emergency department or urgent care center over the course of one year, researchers found.
As many as 475,000 children and adults in California reported that they went at least once to the emergency room or urgent care center because of asthma. The number is likely to be much higher due to repeat visits.
The research adds to a growing body of knowledge about the debilitating personal and economic effects of asthma, a condition linked to pollution, lack of insurance and medical care as well as to risk factors such as smoking.
In the new policy brief, "Uncontrolled Asthma Means Missed Work and School, Emergency Department Visits for Many Californians," researchers measured the overall toll that asthma takes on the attendance at work and at school of California's adults and children and examined how the burden worsens for those Californians suffering from frequent asthma symptoms.
The brief's authors found that one out of three California school-age children with daily or weekly asthma symptoms missed at least one week of school and about 12% of adults with daily or weekly symptoms missed one week of work in California in 2005.
The year represents the latest date for which comprehensive health statistics are available from the California Health Interview Survey, the nation's largest state health survey.
Frequent (daily or weekly) asthma symptoms are a sign of possible poor management of the disease, according to the brief's authors.
"Having asthma attacks every day or week suggests that the patient is not getting adequate preventative care," said Ying-Ying Meng, lead author of the report. "It puts them much more at risk for a serious asthma attack and a visit to the emergency room."
Meng said that a third of children and one-fifth of adults with frequent asthma symptoms reported one or more asthma-related emergency room or urgent care visits in the previous year.
Californians with poorly controlled asthma are also more likely to miss school and work.
Lack of insurance and little or no medical care - essential for asthma control - were factors in the findings.
One-fifth of adults and one-tenth of children with frequent asthma symptoms - 116,000 Californians in all - had fewer than the minimum recommended two scheduled doctor visits per year.
One-fifth of children and non-elderly adults with daily or weekly asthma symptoms (20% or 108,000) were uninsured for all or part of 2005.
"Lack of health insurance is related to frequent asthma attacks and visits to the emergency room," said Sue Babey, a co-author of the policy brief. "Without insurance and quality medical care, children and adults with asthma suffer far more than they should."
Experts noted that some asthma sufferers could take positive steps to improve their own health.
"By reducing asthma triggers - environmental irritants and toxins that exacerbate asthma - we can reduce the number and severity of asthma attacks," said Robert K. Ross, M.D., president and CEO of The California Endowment which funded the policy brief. "In turn more children will go to school and more workers to work. Good asthma control has a direct impact on our productivity as a society."
Of those adults experiencing daily or weekly asthma symptoms, 15% described themselves as current smokers. In addition, 8% of children and non-smoking adults with daily or weekly symptoms - 41,000 in all - are exposed to second-hand smoke at home.
Such internal irritants, along with allergens such as dust mites, animal dander, cockroaches and molds, should be controlled, the brief's authors recommended.
Local, county and state government should also play a role, the brief's authors argued. Although tobacco smoke has been identified as a Toxic Air Contaminant by the state legislature, "further research and action plans are needed to determine how to help Californians curtail their individual indoor triggers," the brief's authors note. "People spend much of their time indoors; however, indoor triggers have only recently appeared on the policy agenda." Meng noted that some cities and towns have banned smoking in outdoor places and inside condos and apartment buildings in recent years.
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