Issue link: https://hi.iaq.net/i/191637
Climate Change, the Indoor Environment, and Health INFECTIOUS AGENTS AND PESTS 169 Marder et al., 1992). Asthma mortality rates were consistently higher in the West and Midwest US Census regions than in the Northeast or South over the years 1980–1998 (Mannino, 2002). Akinbami (2006) notes that asthma prevalence rates among children 0–17 years of age are generally higher in the Northeast region than elsewhere but cautions: While it is tempting to attribute prevalence patterns to climate or air quality, many factors affect prevalence and may also vary by region. Some examples include the likelihood that symptomatic children are diagnosed accurately with asthma and population composition. For example, the Puerto Rican population, in which asthma prevalence is highest, tends to be concentrated in the Northeast region of the country. Exacerbations follow the seasonal patterns exhibited by asthma comorbidities, including rhinovirus and other respiratory viral infections, and triggers like pollen and mold (Johnston and Sears, 2006). Peak exacerbation occurs during the fall, although its magnitude varies depending on the age of the subject (younger asthmatics are more sensitive to seasonal changes). Studies suggest that climate change will take place over a long period, and "allergen avoidance" might not be as extreme as that in some study interventions. Boner et al. (2002) found that dust mite–sensitized children who had asthma and were moved temporarily to the Italian Alps had reduced morbidity, and this was attributed to the absence of dust mites. Morgan et al. (2004) found that a targeted allergen-avoidance strategy for children reduced their asthma symptoms and emergency-department visits over a period of two years. What is more likely is that with the changing pattern of dust mite–endemic areas and the change in allergic-sensitization patterns, people who have allergic asthma will mount immune responses to elements of their environment, such as cockroaches, cats, and mice (Gruchalla et al., 2005). In contrast, if the northern states experience milder winters and an increase in humidity, dust mites might become the dominant allergen and surpass cockroaches and pets as the allergen most associated with increased asthma morbidity (Chew et al., 2009). Other Pests Little information is available on the potential effects of climate change on indoor exposure to other pests. Research has noted that the presence of increased mammalian pests in the indoor environment can spread disease and exacerbate allergies (IOM, 2008b), and increased outdoor temperatures are thought to have brought rodents indoors and led, for example, to disease from exposure to hanta virus in mouse droppings (Gubler et al., 2001). It is plausible that climate change will engender other indoor expo- Copyright © National Academy of Sciences. All rights reserved.