Since about 1980, asthma prevalence and asthma-related hospitalizations and deaths have increased substantially, especially among children. Of particular concern is the high mortality rate among African Americans with asthma.


Recent studies have suggested that indoor exposures—to dust mites, cockroaches, mold, pet dander, tobacco smoke, and other biological and chemical pollutants—may influence the disease course of asthma. To ensure an appropriate response, public health and education officials have sought a science-based assessment of asthma and its relationship to indoor air exposures.


Clearing the Air meets this need. This book examines how indoor pollutants contribute to asthma—its causation, prevalence, triggering, and severity. The committee discusses asthma among the general population and in sensitive subpopulations including children, low-income individuals, and urban residents. Based on the most current findings, the book also evaluates the scientific basis for mitigating the effects of indoor air pollutants implicated in asthma. The committee identifies priorities for public health policy, public education outreach, preventive intervention, and further research.

Table of Contents


Front Matter
Executive Summary
1 Major Issues in Understanding Asthma
2 Methodological Considerations in Evaluating the Evidence
3 Patterns of Asthma Morbidity and Mortality
4 Pathophysiological Basis of Asthma
5 Indoor Biologic Exposures
6 Indoor Chemical Exposures
7 Exposure to Environmental Tobacco Smoke
8 Indoor Dampness and Asthma
9 Asthma and Nonresidential Indoor Environments
10 Impact of Ventilation and Air Cleaning on Asthma
11 Summary of Research Recommendations and Overall Conclusions
Appendix A: Theoretical Considerations Relevant to the Influence of Ventilation and Air Cleaning on Exposures to Indoor-Generated Pollutants
Appendix B: Workshop Summaries
Appendix C: Committee and Staff Biographies
Index