2004 -- Researchers ranked the top 100 metropolitan areas in the U.S. based on 15 prevalence, risk, and medical factors related to asthma, including:

• Prevalence of asthma
• Asthma-related deaths
• Outdoor air quality
• Annual pollen measurements
• Smoking laws
• Number of asthma prescriptions filled per patient
• Number of asthma specialists

Knoxville, Tenn., Little Rock, Ark., and St. Louis topped the list as the three worst cities for asthma sufferers. Conditions were found to be much more favorable for people with asthma in the San Francisco Bay area, Miami, and Daytona Beach, Fla., which ranked at the bottom of the list of asthma capitals.
 
The metro area with a total score of 100 points did not necessarily have the "most severe" score for every factor, but rather, it achieved the highest composite score.
 
"The asthma capitals list gives us evidence of how prevalent asthma is across the country -- a disease that has increased twofold in the last two decades," says Derek Johnson, MD, of Temple University Children's Medical Center, in a news release. "Despite the rising incidence, we are seeing an alarming amount of uncontrolled asthma, which points to the need for better education."
 

2004 Ranking	Metropolitan Area	Total Score
1	Knoxville, Tenn.	100.00
2	Little Rock, Ark.	87.02
3	St. Louis	86.37
4	Madison, Wis.	83.32
5	Louisville, Ky.	82.32
6	Memphis, Tenn.	82.13
7	Toledo, Ohio	82.08
8	Kansas City, Mo.	81.96
9	Nashville, Tenn.	81.69
10	Hartford, Conn.	81.67
11	Buffalo-Niagara Falls, N.Y.	81.53
12	Johnson City, Tenn.	81.51
13	Allentown-Bethlehem-Easton, Pa.	81.51
14	Springfield, Mass.	80.99
15	Pittsburgh	80.97
16	Milwaukee-Waukesha, Wis.	80.68
17	Chattanooga, Tenn.	80.39
18	Detroit	80.23
19	Dayton-Springfield, Ohio	80.04
20	Indianapolis	79.71
21	Columbus, Ohio	79.70
22	Fresno, Calif.	79.60
23	Wichita, Kan.	79.42
24	Harrisburg-Lebanon-Carlisle, Pa.	78.96
25	Lexington, Ky.	78.95
26	Albany-Schenedtady-Troy, N.Y.	78.95
27	Philadelphia	78.45
28	Greensboro-Winston Salem-High Point, N.C.	78.26
29	Oklahoma City	78.12
30	Syracuse, N.Y.	78.03

 
Surprisingly, several big cities were ranked in the bottom 50 (the best cities for asthma sufferers) including: Atlanta ranked at No. 47, Washington at 50, Chicago at 56, and Los Angeles at 85
.
Recognizing Asthma Triggers
Researchers say more than 20 million Americans suffer from asthma. About half of those suffer from the most common form, allergic asthma, but many may not know it.
 
In people with allergic asthma, the coughing and wheezing of an asthma attack is triggered by exposure to allergens, such as dust, pet dander, or mold spores rather than irritants, weather changes, viral or sinus infections, or exercise.
 
"We need to help people with asthma know more about their disease, including recognizing whether or not they have allergic asthma, knowing their triggers and being more aggressive about seeking help from a physician specially trained to treat their disease," says Stanley Goldstein, MD, director of Allergy and Asthma Care of Long Island, in a news release.
 
Researchers say that a better understanding of the role of IgE antibodies in allergic asthma now makes it easier for people with the condition to get effective treatment. IgE antibodies are produced by the body in response to exposure to allergens and may cause the release of histamines and other chemicals that can lead to inflammation of the airways and an asthma attack.
 
SOURCE: News release, Asthma and Allergy Foundation of America. 

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