By Matt Leingang
The Cincinnati Enquirer

Richard Bronner, who was recently diagnosed with asthma, is a shipping supervisor at Roosevelt Paper in Richwood, Ky. Asthma costs taxpayers millions in Medicaid funds. The Cincinnati Enquirer/GARY LANDERS

FLORENCE - Four years ago, Richard Bronner was taking a shower when he suddenly bent over at the pain building up in his chest.

His breathing became so labored that it felt like "sucking air through a straw," said Bronner, now 51. The incident marked the beginning of the Florence man's battle with asthma.

Bronner is part of Kentucky's asthma epidemic.

According to a report released last month, Kentucky has the third-highest rate of asthma in the United States, affecting 9.5 percent of adults in the state. That's two percentage points higher than the national average.

Puerto Rico, at 11.5 percent, and Maine, with 10 percent of its adult population, topped the list of U.S. asthma rates. Many other states, including Ohio, were clustered around the national average of 7.5 percent.

Kentucky Health and Family Services Cabinet Secretary Dr. James Holsinger, who released the report, said asthma costs Kentucky taxpayers nearly $400 million a year in Medicaid funds. He called on the state to increase asthma education and outreach to the public, patients and health-care providers.

Asthma, a lung disease characterized by the narrowing of airways, affects more than 200,000 people in Kentucky. About one-third of the cases are in children.

The disease causes recurring attacks of wheezing, shortness of breath, chest tightness and cough. Asthma cannot be cured, but with proper treatment and management it can be controlled.

"I'm all for calling attention to this," Bronner said.

What caused the onset of Bronner's asthma remains unclear. He never smoked and rarely drank. But several sinus operations may have contributed to his asthmatic condition, he said.

Bronner takes the drug Prednisone twice a day to control his asthma attacks. But it has added 30 pounds to his 5-foot-9-inch frame, pushing his weight to 222. Fluid retention is one of the drug's side effects.

"This experience has been hard, and I really feel bad for people who've had asthma all their life," Bronner said.

Experts say Kentucky's adult smoking rate, which is the highest in the nation, contributes to the state's asthma problem. About 33 percent of adults in the state smoke.

Other risk factors:

• High rates of obesity.

• Exposure to air pollution.

• Secondhand smoke.

• Allergens.

"Basically, treating asthma is the bread and butter of my practice," said Dr. Manuel Villareal, an allergist and immunologist at the Fragge Allergy and Asthma Clinic, which has offices in Florence and Covington.

Several times a year, Villareal sets up a booth at area malls or community health fairs, offering people a chance to take a blowing test and to fill out a questionnaire, asking them if they have shortness of breath or chest pains when exercising or when carrying out daily activities.

The purpose is to catch people who may have asthma but don't know it. "I always get a few," Villareal said.

Kentucky health officials say the next step is to create a statewide asthma education program. The state has applied for a planning grant from the U.S. Centers for Disease Control and Prevention. The grant asks for $200,000 a year for three years.

An answer could come this summer, said Tricia McLendon, asthma program manager at the Kentucky Department for Public Health.

E-mail mleingang@enquirer.com