The environmental component
Parents express some frustration about the environmental component of asthma because sometimes they don’t have control over their environmental conditions. If they live in an apartment that they don’t own, for example, control of certain things is taken out of their hands. So they have a lot of questions about how the environmental things they cannot control will impact their child’s asthma, and about what can I do to try and change and/or improve their environments. There are some things that parents can do that can minimize environmental triggers for asthma, like not having standing water in places or a pile of damp clothes around the house. There are approaches they can take to advocate on behalf of themselves for their environment. They can speak with the landlord or go to the Inspectional Services Division; they can even get legal advocacy if necessary. I help direct parents though that process and let them know that there are some other options besides “My landlord won’t do anything about it so I’m stuck.”
Shari Nethersole, MD, Pediatrician
Concerns about environmental triggers
For parents who live in the city, their concerns are often about environmental triggers. They have mice and mites and mold and carpets and maybe neighbors who smoke, all of which make their child’s asthma worse. A big part of their concerns is that they don’t have control over altering their child’s environment, so they can’t help to make their child’s asthma better. Sometimes I write letters to landlords about the carpet or about the actual environment in the apartment and try to get them to change it. In addition to advocating for these families, we refer them to various asthma programs in the city, and some of the health insurers, like Neighborhood Health Plan, have staff who will go out and do homes visits with families. Our community asthma program, the Community Asthma Initiative, is an option for kids depending on where they live in the city.
Joanne Cox, MD, Associate Chief, Division of General Pediatrics
Do we have to get rid of our cat?
“Do we have to get rid of the family cat?” is another common question parents ask. Ideally, you don’t want a cat or any other feathered or fur bearing animal in the house if the child is allergic to them. But families often have very legitimate reasons for having cats in the home. There are many families with whom we work whose ability to control their home environments are limited; the buildings in which they live may have cockroach infestation or rodent problems which the family cat helps to control. It’s a negotiation point with parents– I encourage them to make the child’s bedroom a safe haven from any cat allergens, to make that space as allergy friendly and allergy safe as possible. If you have a cat in the house and you need that cat to help minimize the rodents in your house, or even if the cat is a beloved family pet that you can’t part with, I tell families to keep the cat out of the bedroom and keep the cat off of the child’s bed. If there is a safe haven for the child that’s as clean and allergen free as humanly possible, we know that he will have the best chance of breathing than he would anywhere else in the house.
Amy Burack, RN, MA, AE C, Former Community Asthma Programs Manager