Finding “Ground Zero” of Asthma Causes

Asthma Researcher leader David van Sickle, a Robert Wood Johnson Foundation Health and Society Scholar and a former disease detective in the Epidemic Intelligence Service at the Centers for Disease Control and Prevention (CDC) in Atlanta, leads the drive to map asthma sources.

“For the millions of chronic asthma patients, knowing the ‘where’ indicates the ‘what,’ which provides important clues in individual and epidemic out breaks of asthma attacks. Sufferers are treated with a blanket of probable treatments with out indication of what exactly triggered the condition. Research is under way to develop a GPS inhaler that records the position or onslaught of an attack.” Van Sickle’s goal is to map where and when environmental exposures trigger asthma symptoms, prompting them to puff on their “rescue” inhalers, which deliver the medicine that keeps them breathing.

t’s easy to predict problems when an asthmatic visits a “cat lady” or runs through a field of ragweed. But van Sickle plans to use global positioning technology to find previously unknown causes of the lung disease and help doctors better monitor whether treatment is controlling symptoms and improving quality of life. A dramatic example includes an epidemic outbreak of asthma attacks in Barcelona that overwhelmed hospitals and emergency centers. “An epidemic of severe asthma struck Barcelona throughout the 1980s,” van Sickle said. “On more than 20 days, emergency rooms were overwhelmed with people having severe, and sometimes fatal, asthma attacks. Barcelona put together a group of scientists to look at the meteorology, climatology, and levels of standard air pollutants and pollens in the city, but there wasn’t anything exceptional about those days.”

Finally, they asked where the patients had been when they got sick: All reported that their symptoms started near the waterfront. Further investigation showed that the port had been unloading giant heaps of soybeans from container ships. “The victims were exposed to massive clouds of soybean dust because the appropriate filters weren’t installed in harbor silos,’’ he says. “It took the group nearly eight years to prove, but it was the first time soybean dust had been shown to be a potent allergen.”