Patricia Marín still remembers the day nine years ago when her daughter Azul started coughing and couldn't stop. Her breathing was ragged.
At the time, Azul was just 18 months old. Marín brought her to the emergency room.
"The hospital got her symptoms under control," Marín says, "but, a week later, she stopped being able to breathe again and I had to take her back."
It was a cycle. By the time her little girl was 5, Marín says, "Azul lived in the emergency room."
Marín and her husband, Javier, are originally from Mexico, but they’ve worked picking fruit and pruning trees for decades in the orchards of central Washington’s Yakima Valley.
Most people think of asthma as a city kid problem — but it turns out rural kids are just as likely to have asthma. And the children of the people who grow our food are especially vulnerable.
Researchers at the University of Washington and the Yakima Valley Farm Workers’ Clinic are working on a new approach to solving the problem.
“When there’s like a lot of dust around me,” Azul says, “that’s when I feel like coughing, when I can’t, like, really cough right. I feel like my air goes away sometimes.”
Azul missed a lot of school because of her asthma, and her mom missed a lot of work.
“I had to stop working because of the dust and all the chemicals I brought home on my clothes,” which would trigger Azul’s asthma, Patricia Marín explains. “I couldn’t come home like that and hug my daughter.”
It was hard for the family of five to live on just her husband’s paycheck of less than $500 a week.
Uncontrolled asthma often has to do with poverty and poor housing conditions. And farm worker families are exposed to a lot of pollutants that can trigger asthma: dust, pesticides, smoke from wildfires and agricultural burning, and ammonia from dairy farms.
As a result, “hospitalization rates for asthma are higher in Yakima County than other places in the state. Morbidity is higher,” says University of Washington pediatrician and asthma expert Dr. Catherine Karr. “We were interested in understanding asthma in this context — in a rural agricultural community, which has not been a focus of most asthma studies, which take place in cities and in highly industrialized settings with lots of traffic.”
That’s why Karr is working with the Yakima Valley Farm Workers’ Clinic to try to figure out how best to address the problem of uncontrolled asthma in farm worker communities. They decided to test whether or not air purifiers placed in the child's bedroom and the home's living area could help decrease asthma symptoms.
Adriana Pérez is a community health worker at the Farm Workers’ Clinic. She visits families to teach them how to keep asthma under control and to monitor how their kids are doing. Half the families in the study also get air filters to reduce the pollutants in their homes.
“If it does work, in the future, providers could do a prescription for air purifiers,” Pérez explains. That way, insurance would pay for them.
Today, Pérez is visiting Marín and Azul, getting Azul to breathe into a machine that tests her lung capacity.
Azul is 10 now. She says, no matter how bad her asthma gets, she hates going to the emergency room.
“I would always be scared,” she says, “’cause they would always poke me in the nose right here with the I don’t know what it was called.” (When people are having a severe asthma attack, doctors sometimes put an oxygen tube in their nose or throat.)
“And that’s why I would never like going no more,” she concludes.
Azul’s asthma is much better these days. She is hoping that someday she'll be able to breathe well enough to join an organized soccer team.
Her biggest problem now is that she doesn’t like taking her medicine. Her mom asked Pérez, with the Farm Workers Clinic, to talk to Azul about it.
“You need to be taking this one every day, so use the spacer, OK? That’s the only way the medication gets in your lungs,” Pérez admonished. “I’m going to come back in two weeks to check if you’re using it. Is that OK?”
Since the clinic started helping, Marín’s been able to go back to work, but she still worries.
“I was left with the trauma of having seen my daughter unable to breathe,” Marín says. “When she coughs or gets up at night — or sometimes when she doesn’t move at all — I go check on her, thinking that, at any moment, she could stop breathing.”
NWPB/EarthFix reporter Courtney Flatt contributed to this report.