Childhood Asthma Advocates Call on EPA to Reconsider Transparency Rule

This week, as part of the Childhood Asthma Leadership Coalition (CALC), Families USA and other coalition members submitted comments to the Environmental Protection Agency (EPA) expressing concern with the proposed rule, “Strengthening Transparency in Regulatory Science,” which would limit the use of critical research in EPA decision-making. We believe this rule would have the effect of erecting barriers to science-based decisions in the regulatory process, and could remove consideration of public health studies that might otherwise improve health outcomes of children with asthma. Read our full comments here.

Approximately 6.13 million children under age 18 in the United States have asthma, with children from low-income families and children of color suffering a greater burden of the disease. Despite being widespread, childhood asthma is a treatable and manageable disease. Coordinated federal engagement on asthma-related research and policy has the potential to save lives and spur the creation of cost-effective policies.

EPA’s current, effective standard of using peer-reviewed research and regular reviews of science has saved lives and improved quality of life of children with asthma. It’s estimated that the 1990 amendments to the Clean Air Act prevented an estimated 1.7 million asthma exacerbations between 1990 and 2010.

The proposed rule, “Strengthening Transparency in Regulatory Science,” provides that pivotal studies would need to rely on data that are available “in a manner sufficient for independent validation.” Rather than strengthening the role of science in EPA’s rulemaking, we fear the proposed rule would actually limit the use of research that could improve the lives of children with asthma. Our comments outline how EPA’s proposal will undermine evidence-based regulation by blocking certain ground-breaking health studies and public health research, subjecting data to endless dredging that could slow or entirely forestall regulation, and granting the Administrator a gatekeeper-like power without clear checks and balances.

We urge EPA against moving forward with this proposed rule, and to pursue reasonable policymaking to protect and promote health and to improve the lives of children with asthma.

Childhood Asthma Research and News, July 9

Research

Nnoli, N.C., et al. The combined effect of ambient ozone exposure and toxic air releases on hospitalization for asthma among children in Harris County, Texas. International Journal of Environmental Health Research. July 2018: 1-21. DOI: 10.1080/09603123.2018.1479515. [Epub ahead of print]

Adami, A.J., et al. Early-life antibiotics attenuate regulatory T cell generation and increase the severity of murine house dust mite-induced asthma. Pediatric Research. July 2018. DOI: 10.1038/s41390-018-0031-y. [Epub ahead of print]

Bhagat, D., et al. Asthma Symptoms, Interactive Physical Play, and Socio-emotional and Academic Outcomes in Urban Children with Persistent Asthma. Journal of Asthma. July 2918: 1-28. DOI: 10.1080/02770903.2018.1488978. [Epub ahead of print]

Bernstein, J.A., and L. Mansfield. Step-up and step-down treatments for optimal asthma control in children and adolescents. Journal of Asthma. Jult 2018: 1-41. DOI: 10.1080/02770903.2018.1490752. [Epub ahead of print]

Horner, S.D., Timmerman, G.M., and C.B. McWilliams. Feasibility study of a combined lifestyle behaviors and asthma self-management intervention for school-aged children. Journal for Specialists in Pediatric Nursing. July 2018; e12224. DOI: 10.1111/jspn.12224

Agnihotri, N., et al. Predictors of prior asthma specialist care among pediatric patients seen in the emergency department for asthma. Journal of Asthma. July 2014: 1-22. DOI: 10.1080/02770903.2018.1493600 [e-pub ahead of print].

Assessment of genetic factor and depression interactions for asthma symptom severity in cohorts of childhood and elderly asthmatics. Experimental & Molecular Medicine. July 2018.; 50(7): 77. DOI: 10.1038/s12276-018-0110-5.

Sharma, A., et al. Pharmacokinetics of tiotropium in asthmatic children aged 6-11 years support its safety profile. Pediatric Allergy and Immunology. July 2018. DOI: 10.1111/pai.12952. [Epub ahead of print]

Beydon, N., et al. Interrupter resistance to measure dose-response to salbutamol in wheezy preschool children. Pediatric Pulmonology. July 2018. DOI: 10.1002/ppul.24116 [Epub ahead of print]

Streisand, Randi, et al. Wellness coaches in intervention delivery: pediatric asthma as an example. Translational Behavioral Medicine. June 2018. DOI: 10.1093/tbm/iby071

Bernstein, D. I., et al. Genetic Variants with Gene Regulatory Effects are Associated with Diisocyanate Asthma. Journal of Asthma and Clinical Immunology. June 2018. DOI: 10.1016/j.jaci.2018.06.022. [Epub ahead of print]

Soffer, N., et al. Alternaria is associated with asthma symptoms and exhaled NO among NYC children. Journal of Allergy and Clinical Immunology. June 2018. DOI: 10.1016/j.jaci.2018.04.043. [Epub ahead of print]

Holtz, B.E., Murray, K., and T. Park. Serious Games for Children with Chronic Diseases: A Systematic Review. Games for Health Journal.

Busse, W.W., et al. Combined Analysis of Asthma Safety Trials of Long-Acting β2-Agonists. New England Journal of Medicine. June 2018; 378(26): 2497-2505. DOI: 10.1056/NEJMoa1716868.

Hatoun, J., Trudell, E.K., and L. Vernacchio. Identifying children at risk of asthma exacerbations: beyond HEDIS. American Journal of Managed Care. June 2018; 24(6): e170-e174.

Andrews, A.L., et al. A longitudinal examination of the asthma medication ratio in children. American Journal of Managed Care. June 2018; 24(6): 294-300.

Willis, M.D., et al. Unconventional natural gas development and pediatric asthma hospitalizations in Pennsylvania. Environmental Research. June 2018; 166: 402-408. DOI: 10.1016/j.envres.2018.06.022. [Epub ahead of print]

Scherzer, R. and M.H. Grayson. Heterogeneity and the origins of asthma. Annals of Allergy and Asthma Immunology. June 2018; pii: S1081-1206(18)30481-2. DOI: 10.1016/j.anai.2018.06.009. [Epub ahead of print]

Everhart, R.S., et al. Primary and Secondary Caregiver Reports of Quality of Life in Pediatric Asthma: Are They Comparable? Applied Research in Quality of Life. June 2018; 13(2): 371-383.

Kelly, R.S., et al. An Integrative Transcriptomic and Metabolomic Study of Lung Function in Children With Asthma. Chest. June 2018. DOI: 10.1016/j.chest.2018.05.038. [Epub ahead of print]

News

Ann & Robert H. Lurie Children's Hospital Of Chicago. Lifetime sentence: Incarcerated parents impact youth behavior. EurekAlert! July 9, 2018.

Steele, Kelli. Div. of Public Health seeks comment on statewide health assessment. Delaware Public Media. July 8, 2018.

Laville, Sandra. Child's asthma death linked to illegal levels of air pollution. The Guardian. July 4, 2018.

Rodriguez, Alison. Study Finds Association Between Childhood Asthma and Low Neighborhood Walkability. AJMC Newsroom. July 1, 2018.

Saker, Anne. Parent survey shows Cincy kids have more asthma. Cincinnati Enquirer. June 25, 2018.

Vickers, Allen. AC Units Help Family with Child Struggling with Asthma. WNEP 16. June 20, 2018.

Rearden, Sunshine A. Strategies for Success: Improving Influenza Vaccination Rates for Asthma within Pediatric Primary Care. Nursing. June 19, 2018.

Beavers, Suzanne. Managing Childhood Asthma: The Approach that Works. Medscape. June 18, 2018.

Rodriguez, Alison. Studies Assess Costs and Accessibility for Asthma Medications. AJMC Newsroom. June 18, 2018.

Childhood Asthma Research and News, June 18

Research

Zhang, Xiao, et al. Decreasing trend in passive tobacco smoke exposure and association with asthma in U.S. children. Environmental Research. Oct 2018; 166: 35-41. [e-pub ahead of print]

Lintzenich Andrews, Annie, et al. A Longitudinal Examination of the Asthma Medication Ratio in Children. American Journal of Managed Care. June 2018; 24(6): 294-300.

Chorniy, A., Currie, J., and L. Sonchak. Exploding asthma and ADHD caseloads: The role of Medicaid managed care. Journal of Health Economics. July 2018; 60: 1-15. [e-pub ahead of print]

Lê-Scherban, Félice, et al. Intergenerational Associations of Parent Adverse Childhood Experiences and Child Health Outcomes. Pediatrics. June 2018; 141(6).

Huo, N. and J. Quian. Associations of Herbs and Nonvitamin Dietary Supplements Use with Clinical Outcomes Among Adult and Pediatric Patients with Asthma in the United States. Journal of Allergy and Clinical Immunology. May-June 2018; 6(3): 936-943.

Gray, W N., et al. Medication adherence in pediatric asthma: A systematic review of the literature. Pediatric Pulmonology. May 2018; 53(5): 668-684.

Hales, C.M., et al. Trends in prescription medication use among children and adolescents-United States, 1999-2014. JAMA. May 2018; 319(19): 2009-2020.

Rice, J L., et al. Allergen-specific immunotherapy in the treatment of pediatric asthma: A systematic review. Pediatrics. May 2018; 141(5).

Carillo, G., et al. Asthma prevalence and school-related hazardous air pollutants in the US-México border area. Environmental Research. April 2018; 162: 41-48.

News

Preidt, Robert. Walkable Neighborhoods May Lower Kids' Asthma Risk. WebMD

Marusic, Kristina. Breathless: Pittsburgh's asthma epidemic and the fight to stop it. Environmental Health News [series]

Abate, Carolyn. Why Removing Your Child's Tonsils May Do More Harm Than Good. Healthline