Asthma and the home environment of low-income urban children: Preliminary findings from the Seattle-King County healthy homes project

Objectives. Childhood asthma is a growing public health concern in low-inco me urban communities. Indoor exposure to asthma triggers has emerged as an important cause of asthma exacerbations. We describe indoor environmental c onditions related to asthma triggers among a low-income urban population in Seattle/King County, Washington, as well as caregiver knowledge and resour ces related to control of these triggers. Methods. Data are obtained from in-person, structured, closed-end interview s with the caretakers of children aged 4-12 pars with persistent asthma liv ing in households with incomes Less than 200% of poverty. Additional inform ation is collected during a home inspection. The children and their caregiv ers are participants in the ongoing Seattle-King County Healthy Homes Proje ct, a randomized controlled trial of an intervention to empower low-income families to reduce exposure to indoor asthma triggers. We report findings o n the conditions of the homes prior to this intervention among the first 11 2 enrolled households. Results. A smoker was present in 37.5% of homes. Mold was visible in 26.8% of homes, water damage was present in 18.6% of homes, and damp conditions o ccurred in 64.8% of households, while 39.6% of caregivers were aware that e xcessive moisture can increase exposures to allergens. Dust-trapping reserv oirs were common; 76.8% of children's bedrooms had carpeting. Cockroach inf estation in the past 3 months was reported by 23.4% of caregivers, while 57 .1% were unaware of the association of roaches and asthma. Only 19.8% of th e children had allergy-control mattress covers. Conclusions. Many low-income urban children with asthma in King County live in indoor environments that place them at substantial risk of ongoing expo sure to asthma triggers. Substandard housing and lack of resources often un derlie these exposures. Initiatives involving health educators, outreach wo rkers, medical providers, health care insurers, housing agencies, and elect ed officials are needed to reduce these exposures.