A Special Report on Asthma from the New York State Assembly

A Special Report on Asthma from the New York State Assembly
	Committee on State-Federal Relations
	Sheldon Silver, Speaker Jeffrey Klein, Chair, Committee on State-Federal Relations Richard N. Gottfried, Chair, Committee on Health Richard Brodsky, Chair, Committee on Environmental Conservation

Jeffrey Klein, Chair, Committee on State-Federal Relations

As an Assemblyman from the Bronx, I have always been very concerned with the devastating effects of asthma on our young people. In fact, I have dubbed certain sections of the Borough "Asthma Alley," because of the especially high prevalence of asthma there. Can you imagine - two of every dozen of our Bronx children suffer from asthma! These asthmatic children miss more school days due to illness and have a hospitalization rate that is 2-1/2 times the New York City average.

As chair of the State-Federal Relations Committee, I am increasingly uneasy with the effects of recent federal policies on the entire State of New York. When the American Lung Association gave a failing grade for air quality to not only the Bronx, but also to Chautauqua, Dutchess, Erie, Jefferson, Monroe, New York, Niagara, Orange, Putnam, Queens, Richmond, Saratoga, Suffolk, Wayne, and Westchester Counties, I became very apprehensive about the health of all New Yorkers, especially the most vulnerable, our children and grandparents.

Both the State and federal administrations do not always seem to understand that many of their policies — such as approving power plants without following necessary legal environmental procedures, cutting the Environmental Protection Agency’s budget, reneging on a presidential campaign promise to cut carbon dioxide emissions, and cutting the budget for asthma programs by 50% — adversely affect the safety of the air that we breathe. What can these "compassionate conservatives" be thinking?

My colleagues and I in the Assembly Majority are attacking New York’s growing asthma crisis on several fronts. I have funded a mobile asthma unit to screen and educate children and families all over the Bronx. In the Assembly, we are working to strengthen air pollution standards, cut pesticide use, increase medical research, and improve access to prescription drugs. We will continue our fight on behalf of our State’s most vulnerable residents until every New Yorker can breathe without fear.

JEFFREY KLEIN, CHAIR
COMMITTEE ON STATE-FEDERAL RELATIONS

An Epidemic in
our State...

Asthma

he American Lung Association recently handed out failing grades for air quality to 333 counties around the U.S., up 15% from last year. In all, more than half of the counties in the nation where there are ozone monitors received failing grades. In New York State, the counties that received a grade of "F" for air quality are: Bronx, Chautauqua, Dutchess, Erie, Jefferson, Monroe, New York, Niagara, Orange, Putnam, Queens, Richmond, Saratoga, Suffolk, Wayne, and Westchester.

ven in areas not monitored for ozone levels, the outlook is by no means rosy. According to Dr. Clement Y. Osei, a West Nyack pulmonologist, "In the 20 years that I’ve been practicing in Rockland [County], the incidence of lung disease has increased dramatically." Conditions such as asthma, emphysema, and chronic bronchitis — all linked to bad air — are becoming more prevalent every year in the patients Dr. Osei treats. "There is a definite decrease in air quality," he said (NY Journal News, 05/02/01).

ccording to the Centers for Disease Control, the U.S. prevalence rate for asthma rose by 75% during the 1980s and 1990s. Among children under age four, the rate increased by an astonishing 160%.

In Harlem, the percentage is twice that among adults and higher among children.
The highest asthma mortality rates of all are in New York City. The death rate from asthma increased 50% between 1980 and 1998.
While New York City as a whole reports high asthma incidences, the rate of hospitalization for asthma in Harlem and the Bronx is 21 times higher than that in the City’s more affluent neighborhoods.
In the South Bronx, 17% of all children — two of every dozen children — are asthmatic.
In the Bronx’s "Asthma Alley," children with asthma miss about 25% more school than their non-asthmatic peers, and the hospitalization rate is 2-1/2 times the City average.

"There’s not a day that goes by that a child doesn’t have an asthma attack."

Eliva Baron, Principal
P.S. 62, The Bronx

Pollution, Children and Breathing

The American Lung Association cites new studies that demonstrate that infants and children, particularly asthmatic children, are especially sensitive to the effects of fine particle pollution. "Asthma is the most common chronic illness in children and the cause of most school absences," stated Norris et al., in their study of children’s emergency department visits for asthma (Norris, G., et al. "An Association Between Fine Particles and Asthma Emergency Department Visits for Children in Seattle," Environmental Health Perspectives 107:489-493, 1999).

Power plants — one of the causes of air pollution — are responsible for 30,100 premature deaths each year in the United States, according to an Abt Associates analysis using EPA-approved emissions and air quality modeling techniques.

In addition, power plant emissions cause:

20,100 hospitalizations for respiratory and cardiovascular causes;
more than 7,000 asthma-related emergency room visits;
18,600 cases of chronic bronchitis;
600,000 asthma attacks;
over five million lost work days; and,
over 26 million minor restricted activity days (Abt Associates, Inc. with ICF Consulting, and E.H. Pechan Associates, Inc. prepared for Clean Air Task Force; "The Particulate-Related Health Benefits of Reducing Power Plant Emissions," Oct. 2000).

An award-winning series by the Daily News showed that a shortage of good primary care doctors and clinics in poor neighborhoods forces many asthma sufferers to use crowded hospital emergency rooms as their only medical provider. Those patients often are left with the wrong medicines and equipment, and inadequate training to treat their own or their children’s asthma.

"Asthma is a major public health problem that has been increasing over several decades. We have an urgent need to take action and begin to implement the best methods available based on sound research to control and prevent it."

Richard Jackson, MD
CDC’s National Center for Environmental Health

Asthma is the leading serious chronic illness among children.

Asthma accounts for one in six of all pediatric emergency visits in the U.S.

Over the past two decades, asthma deaths have risen both in numbers and rate.

The number of deaths attributed to asthma has increased by 109%.

Asthma accounts for an estimated three million lost work days annually for people over age 18.

Asthma accounts for 10 million lost school days annually for those ages 18 and under.

Sources:
National Center for Environmental Health and the American Lung Association

The President’s & Governor’s (Non) Response

hat is the "compassionate" response of the Bush Administration to this crisis that affects mostly children and the elderly?

Cut the budget of the Environmental Protection Agency (EPA) by 6.4%. Congressional Quarterly writes that "Bush is touting the use of market-based incentives to control pollution." The Bush budget seeks to sharply shift EPA responsibilities to state and local officials (CQ Weekly, March 3, 2001).
Renege on a presidential campaign promise to cut carbon dioxide pollution, when power plants and motor vehicles add to the spew of particulates in the air.

hat is the response of the governor’s Administration?

Cut funding for New York State’s asthma programs by 50%.
Build more power plants in heavily residential areas, skirting environmental regulations and ignoring concerns of local communities.
Give lip service to reducing nitrogen oxide and sulfur dioxide emissions, first by basing a Department of Environmental Conservation (DEC) directive on outdated health and ecological science, and then by failing to introduce any legislation or direct DEC to propose regulations to improve emissions, and finally by ignoring the threats to human health from carbon dioxide and mercury.

Action from the Assembly

n the other hand, the Assembly Majority already passed legislation (Assembly bill 5577-B; Brodsky) that would require power plants to reduce emissions of four major air pollutants: a 75% reduction in both sulfur dioxide and nitrogen oxide by 2007; a cap on carbon dioxide emissions by January 1, 2007; and, elimination of the threat of mercury in the environment.

Implementation of this bill would place New York on par with Massachusetts, which, to date, has the most stringent approach to power plant clean-up in the nation. The bill’s additional requirement to regulate the most prevalent greenhouse gas — carbon dioxide — will make New York State a leader in protecting the environment and public health.

In addition, the Assembly Majority wants to:

provide $12 million to the State Department of Environmental Conservation from interest expected to accrue in the Environmental Protection Fund account, including $2.4 million to continue support for asthma programs;
accept the $219,600 Bond Act allocation proposed by the Governor, but add an additional $6 million under the clean-fuel bus category, releasing $10 million for the purchase of cleaner non-diesel buses that use alternative fuel;
require all State departments, agencies, and public authorities to phase out the use of pesticides over the next three years, helping to reduce health problems linked to pesticide use; and,
develop statewide cancer incidence maps utilizing analysis units that are specific enough to locate potential cancer clusters. These maps would depict sources of environmental, occupational, and geographical risks.

Assemblyman Klein:
Action & Legislation

Assemblyman Jeff Klein views asthma as a silent epidemic sweeping New York City, and particularly the Bronx. He has been a leader in bringing this issue to the forefront, and in securing dollars to diagnose and treat asthma in the City.

Assemblyman Jeff Klein visits with children who participate in the Breathing Easy Mobile Asthma Screening and Testing Program.

In 1999, Assemblyman Klein purchased a mobile van and invited St. Barnabas Hospital and the pharmaceutical giant Glaxo Wellcome to join him in establishing the first Bronx mobile asthma initiative, the Breathing Easy Mobile Asthma Screening and Testing Program. As the van toured the Borough’s elementary schools, a respiratory specialist from St. Barnabas administered free asthma screenings, and Glaxo Wellcome provided free asthma devices. "We can test if a child is not breathing properly and should be referred for a complete examination," said Dora Jaime, one of the respiratory specialists performing screenings in 1999. "We will also show parents how to take care of their children better at home so they don’t end up in the hospital."

The success of Assemblyman Klein’s mobile unit helped secure a $250,000 State grant for the St. Barnabas Asthma Initiative, a program that tracks children who have visited emergency rooms as a result of asthma attacks, and provides asthma education and preventive care in order to avoid or minimize future attacks. The centerpiece of this new initiative is the Family Asthma Center, unveiled in April 2001, that travels to schools, community centers, and events to provide asthma screenings and education. Participating children will receive free medical devices from Glaxo Wellcome.

Assemblyman Klein recognizes that more research needs to be done regarding asthma, including identifying the communities most affected, and also advocates educating children, families, and school personnel about the symptoms of asthma and steps to take that will save lives and unnecessary trips to the hospital.

To this end, Assemblyman Klein is sponsoring two bills to help families and communities deal with asthma:

Assembly bill 7562 would create the Asthma Disease Management and Control Program. This program would include services, such as disease and case management for patients and their families; asthma outreach and screening; and, promotion of awareness of the causes of asthma, as well as education on prevention strategies, disease management practices, and available treatment. Grants would be provided to pay for these services in communities throughout the State.
In addition, the State Health Department would study the incidence and prevalence of asthma and current disease management practices, collecting data from: the Statewide Planning and Research Cooperative System; HMOs; other insurers; Medicaid; health facilities; health care practitioners and patients; and, the Department of Environmental Conservation.
The bill would also create the Asthma Disease Advisory Panel, which would monitor the implementation of programs, studies, and reports. This panel would submit an annual report regarding the status and accomplishments of the Asthma Disease Management and Control Program, and provide recommendations to improve it.
Assembly bill 2265 would require that all teachers be trained to identify and respond to asthma emergencies. Starting in school year 2004, all teachers in both public and private schools would need to complete a course, developed by the Departments of Education and Health, on how to recognize the symptoms of an asthma attack and how to respond as effectively as possible.

To request a copy of this
publication printed in Spanish or
Chinese, please contact:

The Assembly Committee on
State-Federal Relations
(518) 455-5844

New York State Assembly
[ Welcome Page ] [ Legislative Reports ]