The aetiology of childhood asthma

Biological basis of child health 5: development of the respiratory system and elements of respiratory assessment

This article is the fifth in a series on the biological basis of child health. It describes the development of the respiratory system, which starts relatively late in the embryo and continues after birth until the age of seven to eight years. It explains what the developing anatomy of the respiratory system in infants and children means in terms of the conditions that may occur and the precautions required when assessing them. The article provides an overview of the elements of respiratory assessment in infants and children and describes some respiratory conditions seen in these patient groups. It also discusses some of the changes in the care of children with respiratory conditions, which has increasingly moved from hospital into the community and become nurse-led, multidisciplinary and holistic.

Health effects of ozone focusing on childhood asthma: what is now known--a review from an epidemiological point of view

Protecting the health of children and the environment is an essential objective for the health policies of any modern society, being also crucial for a sustainable development, according to the World Health Organization. Evaluating the risk of developing childhood asthma is one of the four priority issues identified by the European Commission, according to the European Union Environment and Health Action Plan. Accordingly, this review aimed to update information concerning the effects of exposure to ozone on childhood asthma, thus helping in the development of strategies for further research. Studies have been demonstrating strong associations between the exposure to ozone and asthma. However, the complexity of exposure patterns, the changes in the vulnerability of children at various stages of development, and the practical limitations of research, lead to a still incomplete understanding of the ozone impact on the health of children. Difficulties on the interpretation of epidemiological studies to evaluate chronic effects are mainly due to an absence of studies designed specifically to address this question and to inherent limitations in characterizing exposure. The more rigorous studies provided new evidences for chronic effects of ozone on small airway function and possibly on asthma, but substantial uncertainties remain.