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New Paint: Another Asthma Trigger in Kids?

— Small study suggests big increase in exacerbation risk

MedpageToday

DALLAS – Children diagnosed with asthma exposed to freshly painted surfaces in the home were at increased risk for asthma exacerbation, especially when smokers lived in the home and the child was taking medication for asthma, researchers said here.

Fresh paint exposure at home was associated with a 4-fold greater risk of having an asthma exacerbation, but because of the low number of participants in the study, that did not rise to statistical significance (P=0.1), reported Nadia Saif, MD, of the University of Virginia, Charlottesville, who performed the study while at the University of Miami.

However, in her poster presentation at the , Saif said that if a child with asthma was exposed to fresh paint and was in a home where there was a smoker, and if the child used antihistamines for allergy and asthma management and also had other medication to control asthma and allergies, that child faced an 8-fold risk of having an asthma attack, and that was a statistically significant finding (P<0.05).

"Paint exposure is a significant risk factor of asthma attack while other environmental exposures including second-hand smoke further intensify this effect," she reported. "Airway remodeling is a potential mechanism which may explain the association between paint and asthma attack."

In commenting on the study, C. Turner Lewis III, MD, who is affiliated with Children's Medical Center Dallas, said, "We know there are a lot of different chemical irritants in the environment that can exacerbate asthma and we are always trying to look at the home environment for such things as mold levels, pollution levels outside the home, dust mite levels, pets, [and] smoking for sure."

"This is an interesting first go at this. I would like to see this replicated with a larger group of children," he said.

Chelsea Gatliffe, MD, of Rady Children's Hospital San Diego, told ľֱ, "We haven't had any specific complaints with paint, but anything that puts irritants in the air can cause asthma exacerbation."

Children and their parents or caretakers visiting general pediatric University of Miami clinics were surveyed on various topics including home environment. Of the 163 children in the survey, 36 children had been diagnosed with asthma, and 10 of these children had been exposed to paint. Overall, 44 children in the cohort had interior portions of their home painted within the past year.

Of the five boys and five girls who lived in homes that had been painted and were also diagnosed with asthma, two of the boys and four of the girls reported an asthma exacerbation, for an overall one-year exacerbation rate of 60%. Among the asthmatic children who were not exposed to paint, about 25% reported an exacerbation, Saif reported.

The mean age of the children in the study was 7. About 11% of the children had tested positive for allergens. Smokers were present in just 5% of households.

In her presentation, Saif suggested there may be ways to prevent or reduce the risk of asthma attacks even when the home needs a paint job. That included switching to a safer alternative paint "such as low- or zero-VOC [volatile organic compound] water-based paints which can reduce or eliminate VOC emission. Conventional oil-based paint emit high levels of VOCs and can result in chronic exposure to compounds," she noted.

"Many consumer products found in homes, including wood preservatives, aerosol sprays, cleaners and disinfectants, adhesives, air fresheners, printers, and furniture fabrics release VOCs. Additional measures should be implemented to avoid predicted exposure to paint in all pediatric patients in order to avoid unknown health consequences."

Disclosures

Saif disclosed no relevant relationships with industry.

Lewis and Gatliffe disclosed no relevant relationships with industry.

Primary Source

American Thoracic Society

Kumar N, et al "Pediatric Asthma Exacerbation and Home Paint Exposure" ATS 2019.