Pollution and high obesity rates help to make Pittsburgh fourth highest in the nation for asthma rates, according to experts at an asthma summit on the North Side on Wednesday.

Speakers at “The Air We Breathe” summit highlighted links between asthma and obesity in children, as well as the role played by air pollution and viral infections.

West Virginia University School of Medicine Pediatrics Chair Dr. Giovanni Piedimonte mapped out a worst-case scenario for asthma: a child lives in a polluted area, which predisposes him for viral infections; an early infection inflames his airways for a lifetime basis; and his slow metabolism due to obesity prevents his body from responding well to the inflammation.

But Dr. Piedemonte noted that a child doesn’t necessarily have to be obese to have a poor metabolism. He said “thin-fat” children are those that were gestated and raised in poor nutritional environments, and now have slow metabolisms.

“So, children that don’t look fat, but they’re already having too much triglycerides and hyperinsulins in their blood,” said Piedemonte. “So, their metabolism already starts being abnormal, and simply that metabolic derangement predisposes them to asthma.”

Dr. Piedemonte said taking a mildly asthmatic child out of a polluted environment improved air flow within one week, according to one of his studies.

Allegheny General Hospital Director of Asthma Research Dr. Deborah Gentile said air pollution from particulate matter, ozone, benzene and other sources is a problem in Pittsburgh.

“We basically have coal-fired power plants that are still having some emission problems,” said Dr. Gentile. “We also have problems with exhaust fumes in diesel buses, and things like that. So, even though the air looks cleaner, and we are slowly getting it cleaned up, it still is polluted, and it is enough pollution to cause some problems.”

Dr. Gentile said some of Pittsburgh’s worst asthma rates are found in the inner city, where she said socioeconomic factors like poor nutrition and cigarette smoke combine with air pollution to create high asthma risk. She said about 50% of Pittsburgh children are overweight or obese.

“These are community issues, and we need to have all the players involved,” said Dr. Gentile. “We’re looking at models where we involve after-school programs, churches, even some of the schools are interested in it.”

She said the solution to lowering Pittsburgh’s asthma rate relies on citizens’ education regarding risk factors like obesity and smoking, as well as a regional effort to clean up the environment.