Asthma survey items as predictors of respiratory problems in children 2 yrs later: a longitudinal study

Abstract

The study compared the ability of characteristics defined by an asthma survey (wheeze versus cough and asthma diagnosis versus no diagnosis) to predict later respiratory problems in a cohort of 108 schoolchildren who had reported either recent wheeze or recurrent cough in a 1987 asthma survey. The children recorded daily respiratory symptoms and peak flow from April 1989 until May 1990. The frequency and severity of lower respiratory symptom episodes and peak flow dips were compared in the wheeze and cough groups and in the diagnosed versus nondiagnosed children. The independent effects of initial wheeze, atopy, diagnosis and bronchial hyperresponsiveness (BHR) on the longitudinal outcome measures were assessed using multiple linear regression. Children with initial wheeze had more chronic symptoms and peak flow variability than those with cough alone, but wheeze had only a weak effect on frequency and severity of acute lower respiratory episodes. Children with both wheeze and atopy had more acute symptomatic episodes and more chronic symptoms than did the other children. Children with diagnosed asthma (versus no diagnosis) had significantly more frequent and severe lower respiratory exacerbations, more days symptomatic and greater peak flow variability. The predictive effects of diagnosis were independent of (and stronger than the effects of) wheeze, atopy and BHR, or combinations of these variables. The results suggest that among children who report respiratory symptoms, survey‐reported wheeze on its own is a weaker marker of significant respiratory disease than is a doctor′s diagnosis of asthma.

Associations between markers of respiratory morbidity in European children

“…Only children with both asthmatic symptoms during the past 12 months and doctor-diagnosed asthma reported cough more often than children with cough alone. In contrast to the study by PATTEMORE et al [2], recent asthmatic symptoms were a better predictor of acute symptoms than a doctor9s diagnosis of asthma. However, children with both the diagnosis and asthmatic symptoms experienced acute respiratory symptoms most often.…”

“…In the subject selection phase of the study, one-half of the children asked, agreed to participate. This is a little less than in the follow-up study of PATTEMORE et al [2] in which the response was 62%. It is possible that children, who had had more respiratory symptoms, would have been more likely to participate in the study.…”

“…However, few studies have examined the longitudinal relationship between host factors, such as atopy and lung function, and respiratory morbidity in children. Among these are the studies carried out in Southampton, UK [1,2]. In these studies, children with either wheeze or cough were followed-up over a year, by daily diaries.…”

Neutrophil airway inflammation in childhood asthma

“…6 It has been estimated that occupational factors may be responsible for 15% of all cases of adult onset asthma. 7 The financial costs of occupational asthma in the US alone were estimated at between $1.1 and $2.1 billion in 1996. 8 Although occupational causes are relatively uncommon, they are important because, unlike most other forms of asthma, occupational asthma is eminently preventable.…”