Wednesday, March 26, 2003

Big Island study finds
asthma in high numbers

By Rod Thompson

HILO >> A University of Hawaii study of Big Island fourth- and fifth-graders has found more than twice as many cases of asthma as expected.

University of Hawaii More than one in five of the children participating in the study say a doctor has told them they have asthma, said researcher Dr. Elizabeth Tam of the University of Hawaii's John A. Burns School of Medicine.

Hilo lung doctor Benjamin Ono said part of the unexpectedly large number may be due to a change in the definition of asthma to include more illnesses.

One thing the university study hasn't found, despite it being the reason for the $1.1 million federally funded study, is a link between asthma and volcanic fumes called vog.

Tam and others noted that the study data are very preliminary, and much more needs to be done before any conclusions can be drawn.

Tam said the data were obtained last fall, the second year of the five-year study.

The data include responses to 130 questions from about 1,700 students at 29 schools in all areas of the Big Island. About 200 other students and their families chose not to participate. Only the answers to the first 10 questions have been tabulated, Tam said.

They showed 22 percent of the students had been told they have asthma, Tam said.

John Hunter at the American Lung Association in Honolulu, not connected with the study, called the numbers "startling."

Using state Department of Health figures, Hunter calculated the incidence of asthma in people of all ages statewide at 9 percent.

But there are pockets of higher numbers. For Hawaiians of all ages the number is 14.3 percent and for Hawaiians from Nanakuli on Oahu, the number reaches 18 percent, he said.

Lung specialist Ono said doctors now diagnose as asthma conditions that in the past were often called a cold, a cough, emphysema, bronchitis, or "we thought the person was just out of shape."

The asthma numbers were fairly uniform for the entire island.

The uniformity would seem to rule out a connection to vog, which is abundant in Kona, sporadic in Hilo, and low or nonexistent in North Kohala.

Part of Tam's study is to measure vog levels in the various areas over a four-year period and compare them to asthma rates, but no vog numbers are available yet.

A 1996 study of hospital emergency room visits for asthma in the 1980s, done by researcher David Mannino, found more emergency visits in Kona than in Hilo. But Mannino had no air-quality data to clearly link the visits to vog.

Dr. Fred Holschuh, who helped Mannino with the study, said people are often concerned about vog, over which they have no control.

"Tobacco has got to be a way bigger factor (in asthma attacks)," he said.

UH John A. Burns School of Medicine

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