OFFICES CLOSED MONDAY SEPTEMBER 1
Labor Day Holiday

BUILDING TOLERANCE TO EGG ALLERGY
A recent study suggests that gradual exposure to heat-treated egg could help children outgrow the allergy.
Read summary article at: aaaai.org/media/jaci

OLYMPIC ATHLETES: TROUBLE BREATHING IN BEJING?
MILWAUKEE – When the world’s top athletes convene next month for the Beijing 2008 Olympic Games, some will face a challenge that tests more than their athletic abilities. Heavy pollution in the Chinese capital could pose problems for competitors, especially those with asthma, according to the American Academy of Allergy, Asthma & Immunology (AAAAI). The ozone, sulfur dioxide, nitric oxide and other pollutants in Beijing’s hazy air are asthmagenic – meaning exposure can inflame the airways of sensitive people and even cause an asthma attack. Similar problem were witnessed in past Olympic host cities of Atlanta, Athens and Seoul, but Beijing’s place among the world’s worst in air quality has experts concerned. “Not only will athletes have irritated eyes, but a good portion may have decreased potential to be competitive,” said Timothy Craig, DO, FAAAAI, and chair of the AAAAI Sports Medicine Committee. “Exercise can enhance the adverse effects air pollutants have on health. Rigorous exercise combined with pollutants can sometimes stimulate an asthma attack.”
Research points to EIA origins New research to be presented next month in the Journal of Allergy and Clinical Immunology (JACI), the official scientific journal of the AAAAI,investigates the origins of exercise-induced asthma. Sandra D. Anderson, PhD, DSc, and colleagues report that exercise-induced asthma results from injuries to the airway caused by breathing poorly conditioned air – particularly cold, dry air – over long periods of time. The researchers concluded that cold-weather athletes and swimmers, who train in irritant environments, may be at risk of airway injury leading to increased airway sensitivity. In a European study of adolescent elite swimmers, Lars Pedersen, MD, and colleagues found that young competition swimmers had the same healthy airways as their non-swimming peers after two years in the sport. However, previous studies have shown a higher prevalence of respiratory symptoms among adult endurance athletes, suggesting that these sensitivities develop over time and repeated exposure to the pool environment.
EIA common among athletes Exercise-induced asthma (EIA) affects an estimated 20 percent of top athletes and an estimated 1 in 6 of all Olympic athletes, according to the AAAAI. EIA frequently affects individuals who do not suffer from chronic asthma. Typically, athletes with EIA experience difficulty breathing 5-10 minutes after exercise. Other symptoms include: • Wheezing • Chest tightness • Coughing • Chest pain • Prolonged or unexpected shortness of breath Prescription asthma medications, including controller and rescue medication, can be used to control and treat EIA. Due to anti-doping regulations, which restrict the use of many asthma medications at the Olympic Games, athletes must obtain official approval for many medications. Tactics that can help mitigate EIA include warming up before exercise and keeping hydrated.
Spectators should also prepare In addition to athletes, high pollution levels threaten to take a toll on spectators with a history of allergies or asthma. “Spectators may develop the same symptoms as the athletes and need to be prepared to treat their asthma and other allergic diseases if they develop or worsen,” Craig said. “Remember to take your asthma medication as prescribed and carry albuterol and hydrating eye drops at all times to treat symptoms. Think ‘avoidance’ and be willing to stay indoors on a very poor air quality day so the rest of your trip is completed in health.” The AAAAI represents allergists, asthma specialists, clinical immunologists, allied health professionals and others with a special interest in the research and treatment of allergic disease. Established in 1943, the AAAAI has more than 6,500 members in the United States, Canada and 60 other countries. Visit www.aaaai.org for more information.

SINGULAIR UPDATE
The FDA informed healthcare professionals and patients of the Agency's investigation of the possible association between the use of Singulair and behavior/mood changes, suicidality (suicidal thinking and behavior) and suicide. Singulair is a leukotriene receptor antagonist used to treat asthma and the symptoms of allergic rhinitis, and to prevent exercise-induced asthma. Patients should not stop taking Singulair before talking to their doctor if they have questions about the new information. Healthcare professionals and caregivers should monitor patients taking Singulair for suicidality (suicidal thinking and behavior) and changes in behavior and mood.
This early communication is in keeping with FDA’s commitment to inform the public about its ongoing safety reviews of drugs. Due to the complexity of the analyses, FDA anticipates that it may take up to 9 months to complete the ongoing evaluations. As soon as this review is complete, FDA will communicate the conclusions and recommendations to the public.
Read the complete 2008 MedWatch Safety Summary, including a link to the FDA Early Communication about an Ongoing Safety Review regarding this issue at:
http://www.fda.gov/medwatch/safety/2008/safety08.htm#Singulair

DR. DAVID NAIMI JOINED PRACTICE IN MARCH
Dr. Naimi will be seeing patients primarily in our Everett and Mount Vernon offices beginning March 1st.
He received his Fellowship in Asthma and Immunology from The Children's Hospital of Philadelphia. He did his Residency at the Rainbow Babies and Children's Hospital in Cleveland.
Dr. Naimi is a native of Mukilteo, WA

EVERETT OFFICE HAS MOVED
We have moved to a new, expanded space to better serve our patients and to have room for our newest physician, Dr. David Naimi.
The new space is located about 3 blocks south of the current office--it is in the Silverlake Pavillion, directly across the street from Costco.
The address is 10333 19th Ave. SE, Suite 105.

QUESTIONS ABOUT YOUR BILL?
You will be able to have quick access to our Patient Accounts staff via the internet. They will contact you within 48 hours.
ptaccounts@nwasthma.com