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Dastoorpoor M, Khodadadi N, Madadizadeh F, Raji H, Shahidizadeh E, Idani E, Shoushtari MH. Assessing the prevalence and severity of asthma, rhinitis, and eczema among schoolchildren (6-7 and 13-14 years old) in Khuzestan, Iran: a cross-sectional survey. BMC Pediatr 2022; 22:463. [PMID: 35918674 PMCID: PMC9344770 DOI: 10.1186/s12887-022-03520-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Accepted: 07/26/2022] [Indexed: 11/25/2022] Open
Abstract
Background Asthma and allergic complications are the most common chronic disorders in children and adolescents. This study aimed to determine the prevalence and severity of asthma, allergic rhinitis, eczema among schoolchildren, and some related risk factors. Methods The cross-sectional study was performed in 2019 and involved 4000 students aged 6–7 years and 4000 students aged 13–14 years (both girls and boys) from urban schools in Khuzestan Province, southwestern Iran. We used the multi-stage sampling method. Data were collected using the Persian version of the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. Results The prevalence of current wheeze, wheeze ever and asthma ever in the age group of 6–7 years was 3.8, 4.5, and 1.8%, respectively; in the age group of 13–14 years, it was 4.4, 5.9, and 3.4, respectively. In terms of gender, males (4.9, 6.0, and 2.7 percent, respectively) had substantially higher rates of current wheeze, wheeze ever, and asthma ever compared to the girls (2.8, 3.6, and 2.0 percent, respectively) (p < 0.001). The prevalence of rhinitis, Hay fever, and eczema among young people was 5.3%, 3.5%, and 1.0%, respectively. Current wheeze was more common in children with allergic rhinitis in the last 12 months (30.3% vs. 2.7%, p < 0.001), Hay fever (32.8% vs. 0.3%, p < 0.001) and eczema (27.8% vs 3.8%, p < 0.001), compared to children who did not. Conclusions The prevalence and severity of asthma symptoms were significantly associated with allergic rhinitis, eczema, and gender. Supplementary Information The online version contains supplementary material available at 10.1186/s12887-022-03520-x.
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Affiliation(s)
- Maryam Dastoorpoor
- Department of Biostatistics and Epidemiology, Air Pollution and Respiratory Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Narges Khodadadi
- Department of Biostatistics and Epidemiology, Air Pollution and Respiratory Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Farzan Madadizadeh
- Research Center of Prevention and Epidemiology of Non-Communicable Disease, Department of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Hanieh Raji
- Department of Internal Medicine, Air Pollution and Respiratory Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Elham Shahidizadeh
- Department of Environmental Health Engineering, Faculty of Medical Sciences, School of Health, Abadan, Iran
| | - Esmaeil Idani
- Department of Internal Medicine, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Maryam Haddadzadeh Shoushtari
- Department of Internal Medicine, Air Pollution and Respiratory Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Risk factors for current wheeze among school children (6–7 and 13–14 years old) in Khuzestan, Iran. PUBLIC HEALTH IN PRACTICE 2021; 2:100172. [PMID: 36101606 PMCID: PMC9461578 DOI: 10.1016/j.puhip.2021.100172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 07/12/2021] [Accepted: 07/26/2021] [Indexed: 11/20/2022] Open
Abstract
Objectives In recent years, there has been a clear trend of increasing allergic diseases especially in children, and developing countries are no exception. Thepresentstudy sought to determine the risk factors associated with wheezing among school children aged 6–7 and 13–14 years living in Khuzestan Province, Iran. Study design Cross-sectional. Methods Data for this cross-sectional study is the history of wheeze in the last 12 months. The participants included 6-7- and 13-14-year-old girls and boys studying in urban schools in Khuzestan Province in 2019. We collected the data using the multi stage sampling technique as suggested in the International Study of Asthma and Allergies in Childhood (ISAAC). The research reviewed the literature and consulted experts to collect the risk factors for demographic and clinical information, environmental exposure and lifestyle. Results Eight thousand questionnaires were handed out to both age groups, of which 7344 were completed. Two hundred ninety-nine (4.1 %) of the participants had current wheeze. Three-point four percent (124 individuals) in the 6–7 year age group and 4.8 % in the 13–14-year-old age group had current wheezing. The results of the logistic regression model suggest that the most significant risk factors associated with the chance of developing current wheeze in the both age groups are: being male (OR: 1.46, 95 % CI: 1.12–1.88), being from employed mother families (OR: 1.50, 95 %, CI:1.05–2.08), property ownership (OR:1.36, 95 %, CI:1.04–1.79) bugs in the property (OR: 1.29, 95 %, CI:0.99–1.70) mold in the property (OR: 1.75, 95 %, CI:1.12–2.76), pet(s) in the student's bedroom (OR: 1.75, 95 %, CI: 0.97–3.14), a family history of asthma and allergic diseases (OR: 2.20, 95 %, CI: 1.69–2.87), tobacco smoke exposures in the property (OR: 1.43, 95 %, CI:1.04–1.96), having allergic rhinitis (OR: 7.86, 95 % CI: 5.89–10.50) and eczema (OR: 3.85, 95 % CI: 2.10–7.08). Conclusions Families are suggested to adopt strategies to reduce exposure to outdoor air pollutants and contain indoor allergens. More studies are necessary to further explore the effects of modifying and changing these risk factors. 3.4 % in the 6–7 year age group and 4.8 % in the 13–14 year age group had current wheezing. In both age groups, current wheeze is more common in boys than girls. Mold in the home, pet in the bedroom and tobacco smoke exposures are the most important risk factors for current wheeze.
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Reiter J, Karakis I, Grotto I, Novack L, Haklai Z, Applbaum Y, Steiman A, Gordon ES, Riener E, Kerem E, Cohen-Cymberknoh M. Regional differences in pediatric asthma hospital admissions: National data from Israel 1996-2017. Pediatr Pulmonol 2021; 56:1434-1439. [PMID: 33788990 DOI: 10.1002/ppul.25300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 01/12/2021] [Accepted: 01/23/2021] [Indexed: 11/06/2022]
Abstract
BACKGROUND Asthma is a common chronic childhood illness and frequent cause of hospitalization. A decline in hospital admission rates was noted up to the 1990s, however, trends are not as clear since the turn of the century. This study aimed to assess the rates and regional differences of asthma admissions over more than two decades using the national Ministry of Health database, which registers data from all the hospitals. METHODS A retrospective cohort study, analysis of all pediatric asthma admissions, for Patients 1-14 years old, between 1996 and 2017 as recorded by the National Hospital Discharge Registry, was performed. Asthma admission rates were calculated per 1000 age adjusted residents, using the number of admission cases as the numerator, and age specific population size as the denominator. RESULTS The annual asthma hospitalization rate decreased in the entire pediatric population from 2.14 in 1996-0.89 in 2017. Children in the 1-4 year age group comprised most of the hospital admissions, and most of the decline was attributable to this age group. Significant differences in hospitalizations were found between different regions as well as differences in the rate of decline in asthma hospitalizations with the lowest admission rate in the Jerusalem district, highest in Haifa, northern and southern Israeli regions and the greatest rate of decline in the Tel-Aviv district. CONCLUSION This nationwide study, over more than two decades, shows clear regional differences in the rates of asthma admissions as well as regional differences in the rates of decline.
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Affiliation(s)
- Joel Reiter
- Faculty of Medicine, Hebrew University of Jerusalem, Israel.,Pediatric Pulmonary Unit, Department of Pediatrics, Hadassah Medical Center, Jerusalem, Israel
| | - Isabella Karakis
- Environmental Epidemiology Department, Public Health Services, Ministry of Health, Jerusalem, Israel
| | - Itamar Grotto
- Health Information Division, Ministry of Health, Jerusalem, Israel
| | - Lena Novack
- Clinical Research Center, Soroka University Medical Center, Beer Sheva, Israel
| | - Ziona Haklai
- Health Information Division, Ministry of Health, Jerusalem, Israel
| | - Yael Applbaum
- Health Information Division, Ministry of Health, Jerusalem, Israel
| | - Ada Steiman
- Health Information Division, Ministry of Health, Jerusalem, Israel
| | | | - Eva Riener
- Environmental Epidemiology Department, Public Health Services, Ministry of Health, Jerusalem, Israel
| | - Eitan Kerem
- Faculty of Medicine, Hebrew University of Jerusalem, Israel.,Pediatric Pulmonary Unit, Department of Pediatrics, Hadassah Medical Center, Jerusalem, Israel
| | - Malena Cohen-Cymberknoh
- Faculty of Medicine, Hebrew University of Jerusalem, Israel.,Pediatric Pulmonary Unit, Department of Pediatrics, Hadassah Medical Center, Jerusalem, Israel
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Zamanfar D, Gaffari J, Behzadnia S, Yazdani-Charati J, Tavakoli S. The Prevalence of Allergic Rhinitis, Eczema and Asthma in Students of Guidance Schools in Mazandaran Province, Iran. Open Access Maced J Med Sci 2016; 4:619-623. [PMID: 28028401 PMCID: PMC5175509 DOI: 10.3889/oamjms.2016.112] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Revised: 09/07/2016] [Accepted: 09/27/2016] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND: Eczema, allergic rhinitis and asthma are common chronic allergic disorders in childhood. AIM: The aim of this study was to determine the prevalence of common allergic disorders among Iranian guidance schools students in Mazandaran Province, northern Iran. METHODS: This analytical cross-sectional study was performed on 3000 children aged 11-14 years old during 2012-13 according to ISAAC study. Of 3000 recruited children 1576 (52.54%) were female and 1424 (47.46%) were male. Data gathered by ISAAC first phase questionnaire analysed by SPSS software 20. RESULTS: The prevalence of wheezing, allergic rhinitis symptoms (sneezing and pruritus) and atopic dermatitis symptoms (pruritus skin lesion) were 30.5%, 30% and 15% respectively. History of pets contact and smoking was positive 6.6% and 36 % respectively. About 52% was born with caesarian section. There was wheezing in 32.5% during sport. The diagnosis of asthma, allergic rhinitis and eczema were 12.2%, 28.5% and 15% respectively. Eczema, asthma and allergic rhinitis were significantly more common in boys students (p < 0.05). CONCLUSIONS: The results of this study showed that asthma, allergic rhinitis and eczema have a high prevalence and they are more common in boys.
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Affiliation(s)
- Daniel Zamanfar
- Infectious Disease Research Center with Focus on Nosocomial Infection, Department of Pediatrics, Mazandaran University of Medical Sciences, Sari, Iran
| | - Javad Gaffari
- Infectious Disease Research Center with Focus on Nosocomial Infection, Department of Pediatrics, Mazandaran University of Medical Sciences, Sari, Iran
| | - Salar Behzadnia
- Infectious Disease Research Center with Focus on Nosocomial Infection, Department of Pediatrics, Mazandaran University of Medical Sciences, Sari, Iran
| | - Jamshid Yazdani-Charati
- Biostatistics Department, Health Science Research Center, Faculty of Health, Mazandaran University of Medical Sciences, Sari, Iran
| | - Sahar Tavakoli
- Infectious Disease Research Center with Focus on Nosocomial Infection, Department of Pediatrics, Mazandaran University of Medical Sciences, Sari, Iran
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Mehal JM, Holman RC, Steiner CA, Bartholomew ML, Singleton RJ. Epidemiology of asthma hospitalizations among American Indian and Alaska Native people and the general United States population. Chest 2015; 146:624-632. [PMID: 24810971 DOI: 10.1378/chest.14-0183] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Asthma, a common chronic disease among adults and children in the United States, results in nearly one-half million hospitalizations annually. There has been no evaluation of asthma hospitalizations for American Indian and Alaska Native (AI/AN) people since a previous study using data for 1988-2002. In this study, we describe the epidemiology and trends for asthma hospitalizations among AI/AN people and the general US population for 2003-2011. METHODS Hospital discharge records with a first-listed diagnosis of asthma for 2003-2011 were examined for AI/AN people, using Indian Health Service (IHS) data, and for the general US population, using the Nationwide Inpatient Sample. Average annual crude and age-adjusted hospitalization rates were calculated. RESULTS The average annual asthma hospitalization rates for AI/AN people and the general US population decreased from 2003-2005 to 2009-2011 (32% and 11% [SE, 3%], respectively). The average annual age-adjusted rate for 2009-2011 was lower for AI/AN people (7.6 per 10,000 population) compared with the general US population (13.2 per 10,000; 95% CI, 12.8-13.6). Age-specific AI/AN rates were highest among infants and children 1 to 4 years of age. IHS regional rates declined in all regions except Alaska. CONCLUSIONS Asthma hospitalization rates are decreasing for AI/AN people and the general US population despite increasing prevalence rates. AI/AN people experienced a substantially lower age-adjusted asthma hospitalization rate compared with the general US population. Although the rates for AI/AN infants and children 1 to 4 years of age have declined substantially, they remain higher compared with other age groups. Improved disease management and awareness should help to further decrease asthma hospitalizations, particularly among young children.
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Affiliation(s)
- Jason M Mehal
- Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), Centers for Disease Control and Prevention (CDC), Department of Health and Human Services (DHHS), Atlanta, GA.
| | - Robert C Holman
- Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), Centers for Disease Control and Prevention (CDC), Department of Health and Human Services (DHHS), Atlanta, GA
| | - Claudia A Steiner
- Healthcare Cost and Utilization Project, Center for Delivery, Organizations, and Markets, Agency for Healthcare Research and Quality, DHHS, Rockville, MD
| | | | - Rosalyn J Singleton
- Alaska Native Tribal Health Consortium, Arctic Investigations Program, Division of Preparedness and Emerging Infections, NCEZID, CDC, DHHS, Anchorage, AK
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Noonan CW, Brown BD, Bentley B, Conway K, Corcoran M, FourStar K, Freide P, Hemlock B, Wagner S, Wilson T. Variability in childhood asthma and body mass index across Northern Plains American Indian communities. J Asthma 2010; 47:496-500. [PMID: 20560824 DOI: 10.3109/02770901003759436] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE There are sparse data on the variability in childhood asthma across different Native American communities and the corresponding associations with known risk factors such as high body mass index and family history. The purpose of this study is to evaluate cross-sectional data on childhood asthma prevalence, body mass index, and other descriptive variables among Native Americans in five rural Northern Plains Indian reservation communities. METHODS A school-based screening program was conducted on four Northern Plains Indian Reservations. The 1852 children (96% Native American, 4th through 12th grades) were screened for asthma status, body mass index (BMI), and family history. RESULTS Approximately 9.5% of students reported current asthma. Current asthma varied significantly across the four reservation sites, ranging from 5.7% to 12.6%. Current asthma was also positively associated with BMI and family history of asthma. CONCLUSIONS The intertribal differences in asthma prevalence noted here emphasize the need for further understanding the intertribal environmental, social, and behavioral factors that are associated with childhood asthma and obesity. Such knowledge can help inform disease prevention or disease management strategies that encompass the unique characteristics of tribal communities and culture.
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Affiliation(s)
- Curtis W Noonan
- Center for Environmental Health Sciences, The University of Montana, Missoula, MT 59812, USA.
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Anandan C, Nurmatov U, van Schayck OCP, Sheikh A. Is the prevalence of asthma declining? Systematic review of epidemiological studies. Allergy 2010; 65:152-67. [PMID: 19912154 DOI: 10.1111/j.1398-9995.2009.02244.x] [Citation(s) in RCA: 354] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Asthma prevalence has increased very considerably in recent decades such that it is now one of the commonest chronic disorders in the world. Recent evidence from epidemiological studies, however, suggests that the prevalence of asthma may now be declining in many parts of the world, which, if true is important for health service planning and also because this offers the possibility of generating and testing new aetiological hypotheses. Our objective was to determine whether the prevalence of asthma is declining worldwide. We undertook a systematic search of EMBASE, Medline, Web of Science and Google Scholar, for high quality reports of cohort studies, repeat cross-sectional studies and analyses of routine healthcare datasets to examine international trends in asthma prevalence in children and adults for the period 1990-2008. There were 48 full reports of studies that satisfied our inclusion criteria. The large volume of data identified clearly indicate that there are, at present, no overall signs of a declining trend in asthma prevalence; on the contrary, asthma prevalence is in many parts of the world still increasing. The reductions in emergency healthcare utilization being reported in some economically developed countries most probably reflect improvements in quality of care. There remain major gaps in the literature on asthma trends in relation to Africa and parts of Asia. There is no overall global downward trend in the prevalence of asthma. Healthcare planners will for the foreseeable future, therefore, need to continue with high levels of anticipated expenditure in relation to provision of asthma care.
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Affiliation(s)
- C Anandan
- Centre for Population Health Sciences, University of Edinburgh, UK
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Loveland KM, Kessler AC, Helgerson SD, Harwell TS. Is there a disparity in the prevalence of asthma between American Indian and white adults? J Asthma 2008; 45:557-60. [PMID: 18773326 DOI: 10.1080/02770900801999108] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Though racial disparities in asthma prevalence are well documented, little is known about the burden of asthma in American Indians compared to whites in the United States. OBJECTIVES To compare the prevalence of asthma among American Indian and white adults 18 years of age and older in Montana. METHODS We used Behavioral Risk Factor Surveillance System (BRFSS) data representative of the Montana population from 2001 to 2006. RESULTS Using multiple logistic regression analysis, American Indian race was not independently associated with increased asthma prevalence (OR 1.05, 95% CI 0.83-1.33). Obesity, lower household income and lower educational attainment, factors disproportionately affecting American Indians in Montana, were independently associated with increased asthma prevalence. CONCLUSIONS Regional and national surveillance is needed to comprehensively document asthma prevalence in American Indians and other underrepresented minorities in the United States.
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Affiliation(s)
- Katie M Loveland
- Asthma Control Program, Chronic Disease Prevention and Health Promotion Bureau, Montana Department of Public Health and Human Services, Helena, Montana 59620, USA.
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Gessner BD. Lack of piped water and sewage services is associated with pediatric lower respiratory tract infection in Alaska. J Pediatr 2008; 152:666-70. [PMID: 18410771 DOI: 10.1016/j.jpeds.2007.10.049] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2007] [Revised: 10/03/2007] [Accepted: 10/25/2007] [Indexed: 01/05/2023]
Abstract
OBJECTIVES To determine the association between the high incidence of lower respiratory tract infection (LRI) documented among young Alaskan children and the absence of modern water service (in-home piped water/septic system or water delivered by closed haul truck) found commonly in rural Alaskan communities. STUDY DESIGN A community-level analysis was performed of all 108 Alaskan communities with at least 15 children <2 years of age enrolled in Medicaid during 1998-2003. Community LRI incidence rates were determined from a Medicaid database with standard LRI billing codes. Potentially confounding community-level demographic variables were obtained, as was availability of water service. RESULTS During linear regression analysis, the percentage of households with modern water service in a community predicted community-level outpatient (beta = -0.53; P < .001) and inpatient (beta = -0.15; P = .088) LRI incidence rates when controlling for the degree of household crowding, unemployment, adult education, tobacco cigarette use, wood stove use, and poverty. Modest improvements in water service delivery were not shown to be associated with changes in LRI burden. CONCLUSIONS Lack of modern water service in Alaska is associated with high pediatric LRI incidence. These communities should receive modern water service, but this intervention alone may not dramatically reduce LRI burden.
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Affiliation(s)
- Bradford D Gessner
- Maternal-Child Health Epidemiology Unit, Alaska Division of Public Health, Anchorage, AK 99524, USA.
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Dixon AE, Yeh F, Welty TK, Rhoades ER, Lee ET, Howard BV, Enright PL. Asthma in American Indian adults: the Strong Heart Study. Chest 2007; 131:1323-30. [PMID: 17400687 DOI: 10.1378/chest.06-1968] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Despite growing recognition that asthma is an important cause of morbidity among American Indians, there has been no systematic study of this disease in older adults who are likely to be at high risk of complications related to asthma. Characterization of the impact of asthma among American Indian adults is necessary in order to design appropriate clinical and preventive measures. METHODS A sample of participants in the third examination of the Strong Heart Study, a multicenter, population-based, prospective study of cardiovascular disease in American Indians, completed a standardized respiratory questionnaire, performed spirometry, and underwent allergen skin testing. Participants were > or = 50 years old. RESULTS Of 3,197 participants in the third examination, 6.3% had physician-diagnosed asthma and 4.3% had probable asthma. Women had a higher prevalence of physician-diagnosed asthma than men (8.2% vs 3.2%). Of the 435 participants reported in the asthma substudy, morbidity related to asthma was high: among those with physician-diagnosed asthma: 97% reported trouble breathing and 52% had severe persistent disease. The mean FEV(1) in those with physician-diagnosed asthma was 61.3% of predicted, and 67.2% reported a history of emergency department visits and/or hospitalizations in the last year, yet only 3% were receiving regular inhaled corticosteroids. CONCLUSIONS The prevalence of asthma among older American Indians residing in three separate geographic areas of the United States was similar to rates in other ethnic groups. Asthma was associated with low lung function, significant morbidity and health-care utilization, yet medications for pulmonary disease were underutilized by this population.
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Affiliation(s)
- Anne E Dixon
- University of Vermont College of Medicine, 111 Colchester Ave, Burlington, VT 05401, USA.
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Chimonas MAR, Gessner BD. Airborne particulate matter from primarily geologic, non-industrial sources at levels below National Ambient Air Quality Standards is associated with outpatient visits for asthma and quick-relief medication prescriptions among children less than 20 years old enrolled in Medicaid in Anchorage, Alaska. ENVIRONMENTAL RESEARCH 2007; 103:397-404. [PMID: 17049511 DOI: 10.1016/j.envres.2006.08.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2006] [Revised: 08/25/2006] [Accepted: 08/29/2006] [Indexed: 05/12/2023]
Abstract
In Anchorage, Alaska, particulates with aerodynamic diameter < or = 10 micro m (PM(10)) arise primarily from natural, geologic sources, and particulates with aerodynamic diameter < or = 2.5 micro m (PM(2.5)) arise primarily from automobile emissions. The current study used a population-based time-series analysis design to evaluate the effects of daily and weekly PM(10) and PM(2.5) on respiratory health outcomes among children <20 years of age residing in Anchorage enrolled in Medicaid. All generated estimating equations models were adjusted for season, year, weekends, temperature, wind speed, and precipitation. Relative to the days with PM(10) mass concentration < or = 13 micro g/m(3), a significant 9.3% increase (RR: 1.093, 95% CI: 1.004-1.191) in the rate of outpatient visits for asthma occurred during days with PM(10) of 20-33 micro g/m(3). No further dose-response occurred for days with PM(10) > or = 34 micro g/m(3). A significant 18.1% increase (RR: 1.181, 95% CI: 1.010-1.381) in the rate of quick-relief medication prescriptions occurred during days with PM(10) of 34-60 micro g/m(3), and a 28.8% increase (RR: 1.288, 95% CI: 1.026-1.619) occurred during days with PM(10) > or = 61 micro g/m(3). Similar results for outpatient asthma visits and quick-relief medication occurred in weekly models. There were no significant associations with PM(2.5) in either daily or weekly models. These subtle but statistically significant associations suggest that non-industrial, geologic sources of PM(10) may have measurable health effects at levels below current national standards.
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Affiliation(s)
- Marc-Andre R Chimonas
- Division of Occupational and Environmental Medicine, Duke University Medical Center, Durham, NC 27710, USA.
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Gessner BD, Chimonas MAR. Asthma is associated with preterm birth but not with small for gestational age status among a population-based cohort of Medicaid-enrolled children <10 years of age. Thorax 2006; 62:231-6. [PMID: 17040936 PMCID: PMC2117147 DOI: 10.1136/thx.2005.053363] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Few population-based studies have evaluated the association between birth weight or gestation and subsequent clinically significant asthma. METHODS Birth records of 37 349 Alaska residents <10 years of age who were enrolled in Medicaid for at least 365 days during 1999-2002 were linked to a Medicaid billing file. The occurrence of asthma and lower respiratory infections during the study period was categorised on the basis of standard International Classification of Diseases 9th Revision codes. The association between gestational age or small for gestational age status and asthma outcomes was adjusted for recent history of lower respiratory infection, years of Medicaid enrolment, age at enrolment and a variety of birth-related factors. RESULTS Among children <5 years of age, the adjusted odds ratio (OR) for developing asthma decreased by 5.5% (95% confidence interval (CI) -0.2 to 10.9) and 7.9% (95% CI 5.2 to 10.4) per additional week of gestational age for children without and with any lower respiratory tract infection, respectively. For children > or =5 years of age, the adjusted OR for developing asthma decreased by 3.4% (95% CI -2.8 to 9.8) and 3.7% (95% CI -2.0 to 9.2) per additional week of gestation for those without and with lower respiratory tract infection, respectively. Among all children with asthma, the adjusted OR for hospitalisation due to asthma decreased by 6.9% (95% CI 2.1 to 11.5) for each additional week of gestational age. Small for gestational age status was not significantly associated with asthma outcomes. CONCLUSIONS Preterm birth but not small for gestational age status predicted subsequent asthma outcomes. Adverse effects of preterm birth on asthma outcomes persist beyond age 5 years.
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Affiliation(s)
- Bradford D Gessner
- Alaska Division of Public Health, Section of Epidemiology, 3601 C Street, Suite 540, PO Box 240249, Anchorage, Alaska 99524, USA.
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