RATIONALE: Identifying high grass pollen days is important for asthma management programs that issue warnings to patients who are at an increased risk of an asthma attack due to grass pollen exposure. We sought to examine the association between increasing ambient concentrations of grass pollen and asthma Emergency Department (ED) presentations in children during the 2003 grass pollen season in Melbourne, Victoria; and whether there was any added influence from thunderstorms. METHODS: A short time series ecological study was conducted of ED presentations for asthma in children in Melbourne, Victoria and grass pollen, meteorological and air quality measurements recorded during the selected 2003 period. A semi-parametric Poisson regression model was used to examine the dose-response associations between daily grass pollen levels and mean daily ED attendances for asthma among children. RESULTS: A smoothed plot suggested a dose-response association -as ambient grass pollen increased to about 19 grains/m 3 the same day risk of childhood ED presentations also increased (p < 0.001). Grass pollen levels were also associated with an increased risk in asthma ED presentations on the following day (lag 1, p < 0.001). CONCLUSIONS: This is the first study to establish a clear relationship between increased risk of childhood asthma ED attendance and increasing levels of ambient grass pollen below 20 grains/m 3 , independent of thunderstorm-associated asthma. Lower levels of pollen may contribute to asthma symptoms, so the limits of the pollen season may need to be reviewed and this in turn could affect the timing of immunotherapy.
Objectives: The purpose of the study was to survey carers regarding their food allergic child's reactions, carer confidence to manage reactions, personal time impact of mitigating risk and personal psychological impacts.Methodology: A 6-month single centre prospective study surveyed all carers attending their child's first food allergen challenge admission for the period 1 July 2015 to 31 December 2015. The questionnaire captured carer and child characteristics and allergic reaction data. A Likert-type 5-point scale obtained carer rating of time and psychological impacts of mitigating risks and managing allergic reactions.Results: 55 (65%) of children had a mean of 3 (range 1-12) accidental food allergen exposures, triggering allergic reaction in 49 (89%) and requiring adrenaline in 8 (15%).For prior reactions, carer confidence to recognise severity was high for 47 (59%) and low for 8 (10%). Confidence to manage the reaction was high for 45 (57%) and low for 7 (8%). Where prescribed, confidence to use adrenaline auto-injectors was high for 14/27 (52%) and low for 8/27 (30%).65 children attended formal care settings. 17 (26%) had one or more allergic reactions in these settings. 21 (32%) carers had discussed safety concerns.Time impact of checking the safety of care settings and food preparation was high in 21 (25%) and 31 (37%) respectively and personal psychological impact was high for fear of a dangerous reaction in 35 (42%) and worry for the child's physical and emotional health in 18 (22%) and 13 (15%) respectively. 10 (12%) felt highly burdened and 8 (10%) highly exhausted.Conclusions: Accidental allergic reactions were common, including in formal care settings. A substantial minority of carers lacked confidence to recognise and manage allergic reactions including administering adrenaline. Carers experienced significant time and psychological impacts, exhaustion and sense of burden, relating to childhood food allergy. Objectives: The purpose of the study was to obtain the carer rating of the impact of their child's food allergy on their personal psychological wellbeing and to ascertain supports and services accessed, given carers' unremitting responsibility to manage their child's allergic reaction risks and chronic disease burden.Methodology: A 6-month single centre prospective study was conducted, surveying all carers attending their child's first food allergen challenge admission from 1 July 2015 to 31 December 2015. The questionnaire captured data regarding carer and child characteristics and supports accessed. A Likert-type 5-point scale, obtained the carer rating of personal psychological impacts and services accessed.Results: 85 carers completed questionnaires. Carer fear of their child experiencing a dangerous reaction was high in 35 (42%). Worry levels for their child's physical and emotional health were high in 18 (22%) and 13 (15%) respectively. Frustration levels regarding food allergy impacts on family relationships, friendships and employment were high in 5 (6%), 8 (10%) and 7(8%) respectively...
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