Do inner city children get more asthma than suburban and country kids? Or do they suffer instead from roundworm infestations that give asthma-like symptoms? Dr. Peter Hotez, a tropical disease specialist at George Washington University, says that up to 23 percent of urban black children may be infested with Toxocara roundworms--a "neglected tropical disease" that dogs and cats can pass to people through their feces. The roundworms cause a lung disease that resembles asthma, as well as liver and brain diseases.
"Urban playgrounds in the United States have recently been shown to be a particularly rich source of Toxocara eggs and inner-city children are at high risk of acquiring the infection," Dr. Hotez writes, in the journal Neglected Tropical Diseases. He notes that children are far more likely than adults to "play in the dirt" and sometimes even to swallow some of it. Obviously, sandboxes and feral cats are a prime source of infection.
"I believe there has been a lack of political will to study the problem," says Dr. Hotez.
One reason for the lack of such political will on asthma factors may be that anti-pesticide activists have long claimed the high asthma rates in the inner cities were due to the heavy use of pesticides to control cockroaches, rats and other vermin. Dr. Philip Landrigan of the Mount Sinai Center for Children's Health and the Environment, has published often in this vein.
Organizations such as Beyond Pesticides have made poorly founded claims of children being harmed by safety-tested pesticides. Beyond Pesticides says farmers are more likely than non-farmers to suffer from asthma, implicating pesticides as a factor. However, the Medical College of Wisconsin says farm kids are only half as likely to have asthma as kids who live in non-farm rural areas—implying no pesticide connection.
The Environmental Protection Agency says roaches themselves can cause asthma attacks. EPA says the roaches' urine, feces, and shed casings contain allergens that can trigger asthma in allergic individuals.
The National Institute of Allergy and Infectious Diseases says it has "conclusively demonstrated that the combination of cockroach allergy and exposure to the insects is an important cause of asthma-related illness and hospitalizations among children in the U.S. inner city." The Institute's skin tests showed 37 percent of inner city children tested were allergic to cockroaches—and the allergic children exposed to high roach allergen levels were more than 3 times as likely to be hospitalized with asthma.
Now, Dr. Hotez adds the roundworm factor—infestations that are transmitted by the frequent, uncontrolled wanderings of cats and dogs around inner city playgrounds and sandboxes. One solution to the problem, of course, is to urge owners to de-worm pets regularly and to enforce the use of "Pooper Scoopers" The second solution is to treat afflicted children with anti-parasitic drugs; blood tests can reveal any infestation.
And, mandatory spraying for cockroaches in apartment houses should be welcomed. The pests we control with pesticides are more infinitely more dangerous than the safety-tested chemicals available to protect inner city children from lung disease.