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.