LINDA WERTHEIMER, host:
Over the last several decades, asthma rates have increased steadily in the United States. And while scientists still don't know what causes the disease, they believe common irritants found in homes across the country can trigger an attack. One program in South Los Angeles aims to help parents of asthmatic children find these triggers and get rid of them.
From member station KQED, Sarah Varney has this report.
SARAH VARNEY: Mirabelle Larios(ph) walks down a driveway past a small stucco house in Compton, a working-class city south of downtown Los Angeles. Behind the house is a tiny apartment attached to a garage. Iron bars cover the windows and screen door.
Ms. MIRABELLE LARIOS: Buenos dias.
Ms. ERIKA MESA(ph): Buenos dias.
Ms. LARIOS: Como esta?
VARNEY: Mirabelle is the health worker from nearby St. John's Clinic, a community health center for low-income families. She's here to see if something in this tiny one-bedroom apartment is triggering asthma attacks for this family. All five children who live here have asthma. Mirabelle begins asking the children's mother, Erika Mesa, a litany of questions while a relative corrals Erika's three youngest kids onto the couch.
Ms. LARIOS: Does anyone smoke at home?
Ms. MESA: No.
Ms. LARIOS: Not even outside?
Ms. MESA: No.
Ms. LARIOS: Stuffed toys, they have?
Ms. MESA: No, they don't have.
Ms. LARIOS: They don't have?
VARNEY: The dizzying list of questions reveals what scientists know about the causes of asthma - not a whole lot. They do know that certain things can trigger an attack, like air pollution, cigarette smoke, mold, pets, dustmites and cockroaches.
Doctors at St. John's say asthmatic kids living in homes with these kinds of triggers need more than just medication. So along with several other clinics near L.A. and Long Beach, they've started this program to send health workers into the homes to find and reduce exposures, hoping to cut down on emergency room visits and missed school days.
Mirabelle scans the floors and ceilings for cockroaches. There are some small holes that the landlord has been promising to fix. Erika says the roaches come when it's hot, which means they'll be coming soon. Mirabelle reaches into a gray plastic bucket and pulls out a roach motel, then a rat trap.
Ms. LARIOS: We can give you the stuff to clean the (unintelligible).
Ms. MESA: (Unintelligible).
Ms. LARIOS: You don't have evidence of rats or…
Ms. MESA: No. No. No. Not yet.
VARNEY: These questions would be embarrassing for any mother proud of her clean home. Mirabelle says when families visit the clinic, they often tell their doctors they don't have cockroaches or dust mites because they don't want to be thought of as dirty. Erika says she's doing everything she can think of to help her children.
Ms. MESA: Yes, I try, but it's like they just get the attacks. And I say, whoa, I already - I clean. I change the blankets. I do everything I can and they just keep on getting them. So I say - I don't know, it's just really, really frustrating.
VARNEY: But she's still just trying to understand the disease. When her oldest son, now eight, first started having trouble breathing, she thought he had a cold. Then one morning his lips turned purple and Erika rushed him to the emergency room. That was the first of many trips to the ER, not just with that son but her other children as well.
Ms. MESA: I really would to know why - where did they get the problem or where does it come from. You know, because none of my family has, none of my brothers or cousins or - nobody, it's just me with my kids.
VARNEY: Erika walks to the kitchen and opened the cabinet next to the sink. Inside is a deep, two-foot long plastic bin full of blue tubing and packets of asthma medicines. Erika's four-year-old son Nikki(ph) sits compliantly on the couch, inhaling the vaporized medicines.
(Soundbite of nebulizer motor)
VARNEY: Erika says she'd like to work outside the home, but taking care of her five asthmatic children is a full-time job. And besides, says the children's grandmother Alicia(ph), it's tough to even find a babysitter.
ALICIA: (Spanish spoken)
Ms. LARIOS: When she's been trying to give the children to somebody to take care of them because she wants to work, they say they will charge more expensive because they are sick.
VARNEY: There are the public health costs of asthma like expensive emergency room visits. But then there are these kinds of costs as well, borne privately by families. St. John's and the other L.A. clinics will continue to visit some 700 children and their families over the next year.
For NPR News, I'm Sarah Varney.
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