When shortness of breath means asthma
20-question test helps to pinpoint diagnosis
(CNN) - People who score high on the American College of Allergy, Asthma and Immunology's Life Quality test are more likely to have asthma, researchers say.
"Asthma is increasing significantly across the world," said Dr. John Winder, chair of the college's nationwide asthma screening program and lead author of the study, which appears in last month's issue of the Annals of Allergy, Asthma and Immunology. "Unfortunately, we don't know why."
The self-administered LQ test -- a series of yes-or-no questions on breathing quality -- can help to pinpoint an asthma diagnosis, said Winder.
"Undiagnosed asthma is a serious health problem," he added. "This is a while back, but in the 1984 Olympics in L.A. (Los Angeles, California), 15 percent of the athletes had exercise-induced asthma and didn't even know it."
Versions of the LQ test are available for young children, older kids and teen-agers and adults. "In another study, it was found that kids actually will answer questions differently than their parents would," said Winder, a board certified allergist in Toledo, Ohio.
Questions included on the tests are:
When I walk or do simple chores, I have trouble breathing or I cough
I have been unable to sleep through the night without coughing attacks or shortness of breath
Sometimes my chest feels tight
Colds make my child cough or wheeze
Sometimes my child has trouble taking a deep breath
My child stayed in the hospital overnight for asthma or trouble breathing this year
I don't like to run or play sports because I have trouble breathing or I cough
It's hard to breathe when people smoke or there are strong odors
Parents answer questions for children younger than 8, while those 8-14 use a modified test, explained the allergist. "We've screened over 30,000 people and used (the LQ test) as a key part of the program," he added. "We're in the fifth year of the screening."
For the study, Winder and his colleagues compared LQ scores on tests taken by patients during their first visit to an allergy or asthma clinic with those taken by a control group of dental patients. Each "yes" answer scored a point.
People who had asthma, they found, scored nearly four times higher than those who didn't have asthma, and nearly eight times above those in the control group.
By the numbers, dental patients had a mean score of 1.15. Those allergy patients who were not diagnosed with asthma came in at 2.39. And asthma patients scored 9.31. In screening, some 50 percent of patients were referred to a physician for further evaluation.
"People need to know that it's not normal to wake up at night coughing or become short of breath after exercising or walking up stairs," says Winder. "Treatment is available."
According to the Centers for Disease Control and Prevention, more than 17 million people in the United States have asthma. From 1980 to 1994, asthma prevalence increased by 75 percent. The condition - more common in children than adults -- is now the ninth leading cause of hospitalization.
Clues to causes
Scientists and physicians probing asthma causes have found possible links to air pollution - both outdoor and indoor -- and allergens such as animal dander, tobacco smoke and cockroach particles.
"There are avoidance measures you can take," says Winder. "If you know you're sensitive to a trigger, like dust mites, cigarette smoke or animals, you can use medication, or if someone is highly allergic, he or she might consider desensitization therapy."
Doctors now know that asthma can be related to chronic inflammation of bronchial passages in addition to episodic spasms, said Winder. "Generations ago, people thought it was a psychological problem," he continued. "Now those myths have been dispelled."
A growing body of research supports the idea of chronic inflammation, for example, and treatments continue to be refined.
"Two generations ago, all we had were oral steroids with a lot of side effects," said Winder. "But now, with inhaled steroids, there are still side effects, but nothing like they used to be."
It's not just a problem catching your breath. The disease remains a potential killer.
"In a classroom of 20 kids, there's one with asthma in any school," said Winder, pegging annual costs of asthma at $6 billion yearly in the United States.
"This disease has such a personal impact," he added.
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Allergy, Asthma and Immunology Online
Centers for Disease Control and Prevention: Asthma facts
European Federation of Asthma and Allergy Associations
American Lung Association
Allergy and Asthma Network/Mothers of Asthmatics Inc.
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