DENVER —Researchers were able to identify more patients with asthma in specific communities by screening all children during routine wellness visits and asking about potential home environmental triggers, according to new research.
The authors of an abstract, "Screening for Asthma and Related Environmental Risks in a High-Risk Pediatric Populations: A Descriptive Analysis of Universal Screening," will present their findings during the American Academy of Pediatrics 2025 National Conference & Exhibition at the Colorado Convention Center Sept. 26-30.
Authors identified a community that already showed a high prevalence of asthma cases and started universally screening all pediatric patients.
"Although common in children and with significant morbidity, asthma is highly treatable if diagnosed early and approached with a holistic lens that includes identifying and addressing environmental triggers," said study author Karen Ganacias, MD, MPH, MedStar Health pediatrician and assistant professor of pediatrics at Georgetown University School of Medicine. "In populations with high asthma prevalence, routine screening for asthma symptoms and modifiable home environmental triggers can be an important first step to improving outcomes and decreasing disparities."
Asthma is often underdiagnosed, particularly in children, and ongoing research is being conducted to identify environmental triggers in the home, such as mold, rodents or roaches.
The MedStar Health Kids Medical Mobile Clinic (KMMC) designed and integrated an Asthma Risk and Control Screen (ARCS) that evaluated 650 children ages two and older who had at least one well child visit between January 2021 and December 2024. Of that, 35% of individuals with no previous diagnosis of asthma reported at least one asthma risk factor, and 24% of those individuals were subsequently diagnosed with asthma based on further clinical findings.
Those who screened as positive for asthma reported coughing or shortness of breath at night, previous use of an inhaler, or exercise intolerance due to difficulty with breathing.
The study also found a high prevalence of poor housing quality in children in this population, about 41%, even higher, at 52%, for those that screened positive on the asthma symptom screen. The clinic has since developed a partnership with a home visiting program to remediate environmental triggers for children with asthma, as well as a medical-legal partnership to help advocate for safe and healthy housing.
The authors observe that children with asthma are more likely to miss school days, participate less in activities and sports, and have irregular sleep.
"Asthma is often diagnosed late or not at all because parents may not think of certain symptoms such as night-time cough or needing to stop activity to catch your breath, as being related to asthma," said study author Janine A. Rethy, MD, MPH, division chief of Community Pediatrics at MedStar Health and associate professor at Georgetown University School of Medicine.
"There are also many environmental triggers in the home that may contribute to these symptoms and which a pediatrician should know about to help understand triggers and incorporate into a treatment plan. This study can open the conversation for screening for asthma and related environmental triggers for all children, especially when there is a high prevalence of asthma in the community."
The authors did not receive financial support for this research.
