Risk factors for asthma symptoms in Kawerau children

To study risk factors for asthma prevalence in Kawerau children aged 8-13 years.

Questionnaires on asthma symptoms and risk factors were completed in 1992 by parents of 708 Kawerau schoolchildren aged 8-13 years, a response rate of 82.0%; for a subgroup of children, stored serum samples from a 1984 survey were also analysed.

The overall prevalence of current wheeze (21.3%) was similar to that observed in other New Zealand surveys. The prevalence of current wheeze was elevated in males (odds ratio (OR) = 1.7, 95% CI 1.2-2.5), in those who had been passively exposed to cigarette smoke from the primary caregiver (OR = 1.4, 95% CI 1.0-2.1), in those who had had pets in the home at age 0-5 years (OR = 1.9, 95% CI 1.2-2.9) and in those with one or more birth parents with asthma (OR = 2.1, 95% CI 1.4-3.1); current wheeze was less common in those with older children living in the same household (for 2 or more older children in the same household, OR = 0.5, 95% CI 0.2-1.0). In a small nested case-control study it was found that current wheeze was more common in those with high levels of IgE (OR = 6.4, 95% CI 1.3-36.4) or low levels of selenium (OR = 3.1, 95% CI 0.9-11.8) in stored serum collected 8 years previously. There was no difference in the proportions with current wheeze, or with diagnosed asthma between Maori and European children, but Maori children were more likely to have current frequent nocturnal wheeze (OR = 2.2, 95% CI 1.0-5.1), current severe wheeze (OR = 1.8, 95% CI 0.8-3.7) or to have been admitted to hospital with asthma (OR = 2.4, 95% CI 1.2-4.8). Passive exposure to tobacco smoke was more common among Maori children, but this only partially accounted for the greater asthma severity in Maori children, and the lower prescribing of prophylactic medications in this group may also have contributed.

Multiple factors were associated with asthma symptoms in children in this age-group, including a family history of asthma, male gender, environmental tobacco smoke, environmental allergen exposure, atopy, and low selenium status. Further studies are required to assess the relative contributions of these factors to the prevalence of asthma in New Zealand.