Association between electronic screen time and childhood asthma: a cross-sectional study using NHANES 1999-2014 data

Childhood asthma prevalence has risen globally, paralleling increased electronic screen exposure. This study investigated the association between electronic screen time (TV, computer, and total device use) and asthma risk in U.S. children.

A cross-sectional analysis of 15,526 children (aged < 20 years) from NHANES (1999-2014) was conducted. Screen time (hours/day) was assessed via questionnaires. Asthma status was self-reported. Multivariable logistic regression, restricted cubic splines, and mediation analyses adjusted for demographics, obesity, income, and environmental factors.

Total screen time was positively associated with asthma risk (adjusted OR = 1.48 per hour increase, 95% CI:1.26-1.75, p < 0.001). Computer use ≥ 5 h/day conferred 30% higher asthma odds (OR = 1.30, 95% CI:1.06-1.60). Dose-response analysis showed elevated risk even at ≤ 2 h/day (OR = 1.18, 95% CI:1.04-1.34). Subgroup analyses (age, gender, body Mass Index) confirmed consistency (p < 0.05). No mediation by physical activity was observed.

Prolonged electronic screen time independently increased childhood asthma risk, emphasizing its role as a modifiable factor. Clinicians should integrate screen behavior assessments into asthma management. Future research should explore causal pathways, including circadian disruption and indoor pollutant interactions.