John Makely / NBC News

Ken Court removes sheetrock and plywood damaged by the floodwaters of Hurricane Sandy from his home in Breezy Point.

From his perch on top of his father’s house in Breezy Point, N.Y., Ken Court can see an array of health disasters in the making.

“There are asbestos roofs that have collapsed near the ocean,” says Court, a 52-year-old roofer. “There is a lot of dust. You see people walking around with masks on. You use the hand cleaners all day long.”

Breezy Point sits at the tip of the peninsula jutting into the waters south of Brooklyn where Jamaica Bay, New York Bay and the Atlantic Ocean come together. Much of the close-knit, blue-collar neighborhood was destroyed when Superstorm Sandy hit three weeks ago – swamped in the storm surge, roofs ripped by flailing winds or burned to the ground in a six-alarm fire that took out block after block of homes.

Now it’s one of the last places left without power or clean water, with no ETA on when either will be restored. And as Court works day in and day out to clean up the mess, he sees long-term trouble wherever he looks.

"You should really wear masks. I remember that everyone in 9/11, when they went there to help, they got sick,” Court told NBCNews in a telephone interview.

Asbestos and other chemicals from the collapsed World Trade Centers created a pall of dust that persisted in lower Manhattan for months after the Sept. 11, 2001 attacks. Firefighters, police and other rescue workers are eligible for federal compensation for the illnesses they have developed since the cleanup – most recently 50 different types of cancer.

People who were in the area have higher death rates in general than similar populations, and were especially likely to develop respiratory diseases and asthma. Asbestos can cause a rare type of lung cancer called mesothelioma.

While the dust caused by the Sandy cleanup isn’t nearly as bad, Court isn't taking chances. Asbestos is only a problem if it is kicked up in dust and breathed in – but he’s seeing plenty of dust being generated as wrecking crews pile up and remove the debris. "Those corrugated roofs on the houses down by the ocean – they’re all asbestos,” he said.

The New York City Department of Health and Mental Hygiene advises on its website that "While Sandy has not caused problems with outdoor air quality, indoor dust, mold, fumes from temporary heating sources and the use of strong cleaning products can be irritating to the eyes, throat, and lungs. Dust can also be produced by repair and debris removal. In addition, debris removal and repair work can lead to injuries of various types.”

John Makely / NBC News

Breezy Point residents clean up after Hurricane Sandy
Kate Sisk. at her summer home at 21 Jamaica Walk in white jump suit trying to remove the fiberglass in the crawlspace before mold starts to grow.

What concerns Court most, however, is mold. His 79-year-old father, Rod, has emphysema  and needs supplemental oxygen. “We got a foot of water up into the first floor. We are just ripping everything out and starting fresh,” said Court, who grew up in Breezy Point and who now lives in Port Jefferson Station on Long Island.

“Right now I have men ripping out the tile. We can’t take a chance with mold with my dad,” Court added. “Now that we took up the tile floor, it’s all wet under there and it’s black.”

Health officials say Court’s doing the right thing. Anything that might turn moldy should be removed or cleaned with a bleach solution. Mold spores can cause allergic reactions or asthma in people who are sensitive to them.

The Centers for Disease Control and Prevention has done many studies on the health dangers that linger after hurricanes, but the CDC's parent agency, the Health and Human Services Department, is not making federal officials available to talk about Sandy's aftermath.

Still no clean water
Despite the flooding that swamped water treatment plants, poured into subway tunnels and flushed raw sewage into rivers, most of New York City’s tapwater supply remained clean. But Breezy Point’s water pipes were damaged so badly that the water still isn’t safe to drink, according to local authorities.

“Breezy Point Cooperative is in the process of re-establishing its internal drinking water system and the City will meet with the Breezy Point Cooperative to ensure that it can safely and reliably provide potable water to its residents," the New York health department said in a statement.

“DO NOT drink the water from the faucets. Do not use this water to cook, wash yourself or wash food, make ice, brush teeth or for any other activity involving consumption of water,” the Breezy Point Cooperative web site advises. It’s not even okay to boil it – meaning chemicals could be contaminating the water, also.

Andrew Juhl, an ecologist and oceanographer at Columbia University, has been testing the waters around New York City for years and knows well what could have seeped into the broken water pipes at Breezy Point.

“With the hurricane there was this enormous flood of water that came into the city and flooded sewage treatment plants and also damaged pipes,” Juhl told NBCNews. “It is possible that there was a lot of sewage released. We don’t really know. No one was out sampling at that time.”

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His tests the days after Sandy hit showed lots of bacteria in the water, however – enough to where people shouldn’t touch the water without washing afterwards.

“We measure Enterococcus,” he said. It’s found in the guts of warm-blooded animals, including people. “If you find it in the environment, you know it was recently in the body of a warm-blooded animal.” While enterococci are not themselves a big threat to health, if they’re in the water, so are other germs. These include anything that the people and animals in the area contribute to sewage, from hepatitis to parasites such as Cryptosporidium and Giardia lamblia that may cause diarrhea and stomach cramps.

One thing that people may fear is cholera, but cholera isn’t commonly found in New Yorkers, and so it’s very unlikely to be in the sewage or water.

“The most common illness that people get is gastrointestinal problems,” Juhl says. “They get nausea, diarrhea, cramping, skin rashes, eye infections -- that kind of thing.”

You don’t have to drink the water to get ill – people who touch the water can touch their eyes, mouths and noses and become infected. Juhl’s team sampled flooded basements in Queens and found the water was teeming with bacteria commonly found in sewage. They also found germs all over dried-out storm debris.

“The stuff we sampled up in Rockland County had been sitting around dry for a week and it still had really high (bacterial) counts. That actually surprised me,” Juhl said. “We haven’t done that kind of sampling before and we don’t have a context for it.  Maybe there are really high counts there all the time.”

Nonetheless, it could make people handling it sick. “They should wear gloves. They should wear face masks. They should make sure they clean themselves really well before they eat. We don’t know what the specific threat is. l would be prudent,” Juhl advises.

Court’s doing just that. “Most people are wearing protective equipment when they are working in the basements,” he said. “You wear boots.”

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If you’ve been feeling guilty because you can’t keep your house spotless, stop.

As it turns out, allowing the odd germ to flourish here or there just might be saving your kid from a lifetime of allergies, Dr. Nancy Snyderman explained on "NBC Nightly News with Brian Williams" Monday.

It seems counterintuitive, but that’s exactly what the so-called "hygiene hypothesis" suggests. You can actually be too clean for your own good.

Scientists came up with the hypothesis as a way to explain the explosion of allergies and asthma in America’s youth. And what they discovered was intriguing, if a little disconcerting: kids who grow up in less tidy environments end up with a lower risk of developing sensitivities to benign substances, like pollen and dog dander.

A study released in June added to the growing mound of evidence that the too-clean-for-health hypothesis might be on track. That study, published in the Journal of Allergy and Clinical Immunology, found that Amish children who were raised on farms were less likely to develop allergies and asthma than their peers.

Why would exposure to dirt and microbes make a kid less sensitive to pollen and the like?

For one thing, it’s exposure to pathogens that allows the immune system to become fine-tuned as it learns to differentiate between harmful and harmless irritants.

Beyond this, exposure to certain bacteria gives the immune system's dedicated "fighters" something to do.

“I believe that the immune system is like an army,” explains Dr. Samuel Friedlander, an allergist at University Hospitals Case Medical Center in Cleveland. “So, if the army doesn’t have something to fight like microbes, it’s going to fight things like allergens in many cases. People [who] live on farms are exposed to more microbes and as a result the immune system tries to fight those bugs and then, in turn, the body doesn’t have to fight allergens.”

Dr. Richard Gallo puts it a little differently. If you keep your environment too clean – by using too many bacterial soaps and hand sanitizers, for example – then your immune system becomes more sensitized to any irritant that comes its way.

“It’s a change in your allergic set point,” says Gallo, a professor and chief of dermatology at the University of California, San Diego. “So being too clean can lead you to have a high allergic set point that will overreact to the environment.”

Does that mean we can all throw out our mop buckets and soap? No, experts say. We still need to keep things clean, just not Bubble Boy antiseptic.

And there's an interesting side note: Some really intriguing animal studies have shown that you might be able to reset your immune system even after you’ve grown up by exposing yourself to certain types of bacteria.

“Some very recent studies that have been published in very excellent scientific journals have shown that with the introduction of specific bacteria in laboratory animals, you can completely reset their immune status and their capacity for certain allergic responses,” Gallo says.

And keep in mind, experts say, that some bacteria are fairly benign.

“So my advice is that some hygiene is good, too much is bad,” Gallo says. “In many cases you have to use common sense. You’re in a situation where you’re likely to be exposed to pathogens – germs that could cause disease – it’s a better idea to use sanitizers to remove them.

"But indiscriminate use - overusing hand sanitizers, anti-microbial soaps and so forth - is also going to be doing harm. So you have to balance the two.”

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New research suggests that asthma patients can skip daily doses and just use their inhalers as needed.

Just about everyone with asthma knows the drill. Take a daily snort of a prescription inhaler filled with a steroid that helps fight inflammation, to prevent trouble. Not everyone actually does this, but patients with mild, persistent asthma know they are supposed to.

A study published on Tuesday questions this common wisdom, and offers the potential for millions of adults to be freed of having to take daily medication, not to mention the savings to patients, their employers, health insurance companies and the government. Caveat: The findings don't apply to kids with asthma.

"Daily treatment with an inhaled corticosteroid has long been believed to be the best treatment for mild persistent asthma, but it is not followed by the majority of patients,'' said Dr. Homer Boushey of the University of California San Francisco, who worked on the study. Boushey also helped the National Institutes of Health set guidelines for managing asthma.

"People don't seem to like taking this type of treatment every day -- just a third of the inhaler prescriptions are renewed even once,'' Boushey said. "So we wondered what would happen if people with mild asthma already well controlled by daily treatment with an inhaled corticosteroid instead took a puff only when they used their rescue medication -- usually albuterol -- for relief of symptoms.''

The researchers at 10 different universities studied 342 adults with moderate, persistent asthma. It was a small number of patients but an intense study, because the researchers assigned the volunteers to one of three different treatments: Being checked by a doctor and having the inhaler adjusted as needed every six weeks; getting checked and having the inhaler dose adjusted based on a measurement of exhaled nitric oxide, which tells doctors how much inflammation there is in the airways; or allowing patients to adjust their own inhaler use based on symptoms and taking one puff of their inhaled corticosteroid for every puff of albuterol.

In this case, the patients all got beclomethasone, a corticosteroid sold under a variety of brand names such as Qvar, Beconase, Beclovent or Vanceril. Other drugs in this category include fluticasone, sold under the brand name Flovent; budesonide, sold under the Pulmicort brand; mometasone or Asmanex and ciclesonide or Alvesco.

These drugs control the inflammation that can swell up airways, making it harder to breathe.

None of the groups fared any better or worse than the others. On average, they had the same number of flare-ups and symptoms, the researchers report in this week’s issue of the Journal of the American Medical Association.

“Asking patients to take their inhaled steroids only when they had symptoms was just as effective as having them take it every day and just as effective as having them take it using very sophisticated monitoring of inflammatory mediators in the airway,” Dr. William Calhoun of the University of Texas Medical Branch, who also worked on the study, said in a video commentary.  “So the simple question ‘how are you doing and are you having symptoms’ is just as good as sophisticated methods of adjusting corticosteroids.”

"This approach allows personalization of treatment and is easy for patients. Also, it could hypothetically result in saving $2 billion a year in medication costs,'' Boushey added.

About 25 million Americans, or 8 percent of the population, have asthma, according to the U.S. Centers for Disease Control and Prevention. It’s more than an annoyance. CDC says asthma killed 3,447 people in 2007. It costs the country about $3,300 per patient, for a total bill of $50 billion in 2007.

More than half of children and a third of adults who had an asthma attack missed school or work because of it in 2008.

In a commentary, Dr. George O'Connor of Boston University and Dr. Joan Reibman of New York University said it would save a lot of patients the inconvenience of having to take a drug daily if the results bear out in more study. But they said it's too early to change the guidelines just yet. "There is no compelling rationale to alter the current approach to inhaled corticosteroid dosing for mild or mild to moderate persistent asthma," they wrote.

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An inhaled drug commonly used to treat children with asthma cuts about half an inch off their height permanently, researchers reported on Monday.

But the good news is that the stunting effect doesn’t get worse over time, the researchers report in the New England Journal of Medicine. They said doctors can work with parents to reduce the dose of the drug as much as possible to minimize the effects.

The drug is called budesonide and is marketed under several brand names, including Rhinocort and Pulmicort. It is very effective at controlling serious asthma, which affects an estimated 6 million U.S. children and millions more adults. So the researchers don't recommend taking kids off the drug if they need it.

A big study done more than a decade ago showed the drug was safe and very effective but doctors noted at the time that the kids in the study were about half an inch shorter if they got budesonide instead of other asthma treatments. The new study, presented at the European Respiratory Society Annual Congress in Vienna, Austria, shows the effect may be permanent.

“This was surprising because in previous studies, we found that the slower growth would be temporary, not affecting adult height,” said Dr. Robert Strunk of Washington University in St. Louis, who worked on the study.

“It clarifies that they do not eventually catch up as they age or fall further behind their peers,” added Dr. Gary Gibbons, director of the National Heart, Lung and Blood Institute.

The original study included more than 1,000 children aged 5 to 12 who got either budesonide, a non-steroid drug called nedocromil, or a placebo or sham treatment. William Kelly of the University of New Mexico and colleagues tracked down 943 of the original children, now adults. The children who got budesonide were still, on average, just about half an inch shorter.

In the original study, kids got a dose of 400 micrograms. Studies since have shown doctors can cut this dose in half and still control asthma, although kids who get even this lower dose are still just under half an inch shorter than children getting different treatments.

“This suggests that finding the minimum dose required to control each child’s asthma could help mitigate any potential effects on height,” Kelly said in a statement.

“If a child is not growing as they should, we may reduce their steroid dose,” agreed Strunk. “But we think that the half-inch of lowered adult height must be balanced against the well-established benefit of inhaled corticosteroids in controlling persistent asthma. We will use the lowest effective dose to control symptoms to minimize concerns about effects on adult height.”

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Workplace environments continue to be blamed for causing or worsening cases of asthma, according to the latest survey of U.S. workers by the Centers for Disease Control and Prevention.

About 9 percent of adults who have asthma reported having work-related asthma, the CDC found from its telephone survey, which was conducted in 2006-09 and included information from 38 states and the District of Columbia. This would mean that 1.4 million people in the U.S. have work-related asthma.  

Florida had the highest proportion of adults with work-related asthma (14.1 percent), and Arizona the lowest (4.8 percent), according to the CDC, which will publish the results tomorrow (May 25) in its Morbidity and Mortality Weekly Report.

Black workers were found to be disproportionately affected, with 12.5 percent saying their asthma was work -related, compared with 8.2 percent of white workers. People ages 45 to 64 were the most likely to report suffering from the condition.

Work-related asthma is a preventable but often undiagnosed condition, the CDC says. It calls for an expanded effort to collect information on the condition so researchers can learn more about its triggers and how to prevent it. For instance, in years past, reducing the amount of powder in latex gloves led to a reduction of work-related asthma in the health care industry, the CDC says.

The report is based on a telephone survey of about 38,300 adults who have asthma. Because not all states were included in the survey, and because only landlines were used, the estimates may not be representative of the U.S. population as a whole, the CDC said.

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Asthma rates in the United States increased over the past decade to their highest level ever, according to a new government report. 

The portion of people in the U.S. with asthma rose from 7.3 percent in 2001 to 8.4 percent in 2010, according to the report from the Centers for Disease Control and Prevention.

That means 25.7 million people had asthma in 2010, including 7 million who were younger than 18.

Over the same period, death rates from the condition dropped 33 percent. For every 10,000 people with asthma, there were 1.4 deaths in 2010, compared with 2.1 deaths in 2001.

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The disorder has been linked with poverty, and the new findings showed that 11.2 percent of people living below the poverty level had asthma. However, asthma was also reported by 7.3 percent of those who earn at least twice the poverty level.

The findings also showed 9.2 percent of females had asthma in 2010, whereas the rate among males was 7 percent.

Asthma is a chronic airway disorder that can be triggered by exercise, infections, certain chemicals, airborne irritants such as tobacco smoke, or allergens such as pollen. During an asthma attack, the airway becomes obstructed because of inflammation and constriction of the surrounding muscles. It is not clear how to prevent asthma from developing, and there is no known cure, the CDC says.

The new findings are based on data gathered during the National Health Interview Survey, in which CDC researchers conducted household interviews with a nationally representative sample of participants.

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People who live in apartment buildings, especially those with children, breathe in tobacco smoke even if no one in their own household smokes, a new study shows.

Researchers found that about one third of study participants living in apartment buildings, condominiums and other multi-unit housing reported smelling smoke in their buildings, and about half of those residents reported smelling smoke in their own units. People were only eligible to participate in the study if no members of their household smoked in the home.

The findings also showed that 41 percent of people with children reported smelling smoke in their building, whereas 26 percent of people with no children said the same.

That may be because people with children, on average, are poorer than people without children, so they tend to live in buildings with larger numbers of other people who are smoking, said study researcher Dr. Jonathan Winickoff, an associate professor in pediatrics at MassGeneral Hospital for Children in Boston. There is a general association between being poorer and smoking, he said.

But taken together with another recent study, the findings mean that half of parents whose children are exposed to tobacco smoke don't know it, Winickoff said. In that earlier study, Winickoff and his colleagues found that nine out of 10 children living in apartments had a chemical called cotinine in their blood. Cotinine is an indicator that a person has breathed in tobacco smoke.

"We know that if you smell it, you child will have evidence of tobacco smoke exposure in their blood. But just because you don't smell it, doesn't mean you're not exposed," Winickoff said.

Exposure to secondhand tobacco smoke has been linked with higher rates of asthma, pneumonia and ear infections in children, even when researchers take into account other factors linked to these conditions, such as poverty and race, he said.

Some policy makers are making efforts that could improve the health of children living in apartment buildings, Winickoff said. Public housing authorities in Maine and in Boston, for example, will soon implement mandates that buildings become smoke-free, and in New York City, Mayor Michael Bloomberg is advocating for disclosure rules, which would require all multi-unit buildings to clearly state whether smoking is permitted in the building.

"People will have a choice to live in a building that has clean air, and I think we want people to have choices," Winickoff said.

The next step in his research, Winickoff said, is to look at how best to raise awareness among people living in multi-unit housing of the impact of allowing smoking in buildings.

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