Book Review- Clearing the Air: Asthma and Indoor Air Exposure

Abstract

Clearing the Air: Asthma and Indoor Air Exposure is a report from the Committee on the Assessment of Asthma and Indoor Air from the Division of Health Promotion and Disease Prevention of the Institute of Medicine. A distinguished committee prepared this report, an excellent description of the patterns of the disease and an encyclopedic discussion of indoor air triggers of asthma attacks. The Committee chose to present their review on the basis of making the judgment of whether the evidence for various agents acting as triggerswas sufficient to conclude a causal relationship, an association, was only suggestive of a causal relation or association, was inadequate to determine whether or notthere was an association, or was suggestive of no association. There are superb chapters detailing how the animal antigens, chemicals, environmental tobacco smoke, molds, and dampness promote asthmatic reactions in sensitive individuals. They conclude that there is sufficient evidence of a causal relationship between exposure to cat, cockroach, and dust mite allergens and to environmental tobacco smoke and exacerbation of asthma, but that the evidence for fungi, molds, and nitric oxides is only sufficient to conclude an association. There is even a very long chapter on ventilation and air cleaning systems and how they impact asthma, although this chapter would be more appropriate for a book on sick-building syndrome than asthma.