Clinical deterioration in pediatric asthmatic patients after September 11, 2001.
BACKGROUND
New York City residents were exposed to a variety of inhaled substances after the collapse of the World Trade Center. Exposure to these substances might lead to an increase in asthma severity, with residential distance from Ground Zero predictive of the degree of change.


OBJECTIVE
We sought to assess the effect of the World Trade Center collapse on local pediatric asthmatic patients.


METHODS
We retrospectively reviewed the charts of 205 pediatric patients with established asthma from a clinic in lower Manhattan's Chinatown. Clinical data were obtained for the year before and the year after September 11, 2001. Measurements included numbers of visits, asthma medication prescriptions, oral corticosteroid prescriptions, weekly doses of rescue inhaler, and peak expiratory flow rates. Residential zip codes were used to compare the asthma severity of patients living within and beyond a 5-mile radius of Ground Zero.


RESULTS
After September 11, 2001, these children had more asthma-related clinic visits (P = .002) and received more prescriptions for asthma medications (P = .018). No significant differences in oral steroid or rescue inhaler use were noted. Those living within 5 miles had more clinic visits after September 11, 2001 (P = .013); the increase in clinic visits for patients living more than 5 miles from Ground Zero was not significant. Mean percent predicted peak expiratory flow rates decreased solely for those patients living within 5 miles of Ground Zero during the 3 months after September 11, 2001.


CONCLUSIONS
Asthma severity worsened after September 11, 2001, in pediatric asthmatic patients living near Ground Zero. Residential proximity to Ground Zero was predictive of the degree of decrease in asthma health.
Szema
Anthony M
AM
Department of Medicine, State University of New York at Stony Brook School of Medicine, Stony Brook, NY 11794-8161, USA.
Khedkar
Meera
M
Maloney
Patrick F
PF
Takach
Patricia A
PA
Nickels
Michael S
MS
Patel
Harshit
H
Modugno
Francesmary
F
Tso
Alan Y
AY
Lin
Deborah H
DH
D000293:Adolescent; D000393:Air Pollutants / Q000009:adverse effects*; D001213:Asian; D001249:Asthma / Q000209:etiology / Q000266:history / Q000503:physiopathology* / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D005260:Female; D049674:History, 21st Century; D006801:Humans; D008297:Male; D009519:New York City; D010366:Peak Expiratory Flow Rate; D023481:Terrorism / Q000266:history; D013997:Time Factors
D000393:Air Pollutants