References

Myers, T. R., & Tomasio, L. (2011). Asthma: 2015 and Beyond... 47th Respiratory Care Journal Conference, “Neonatal and Pediatric Respiratory Care: What Does the Future Hold?” November 2010, Arizona... includes discussion. Respiratory Care, 56(9), 1389-1410. doi:10.4187/respcare.01334

* Asthma is a multifactorial, chronic inflammatory disease of the airways. The knowledge that asthma is an inflammatory disorder has become a core fundamental in the definition of asthma. (coughing, wheezing, and shortness of breath.)

* The prevalence of asthma among children changes with increasing age. As an example, boys have higher current asthma prevalence, compared with girls throughout most of childhood.

* From 1980 through the mid-1990s, the asthma hospitalization rate steadily increased in children under 17 years of age.

* Trend analysis identified an annual 2.9% increase from 1980 through 1991, but there has been no statistically significant trend after 1991.

* Overall non asthma hospitalizations for children has decreased over that period, whereas the asthma hospitalization rate remained level.

* In 2006 there were 21 asthma-related hospitalizations per 10,000 children, for a total of 155,000 hospitalizations; this represented approximately 5.6% of all hospitalizations among children in 2006.

* Trend analysis found that, while asthma related mortality increased 3.2% per year from 1980 through 1996, a reversal thereafter led to an average decrease of 3.9% per year from 1996 through 2005.

* In 2005 there were 2.3 asthma-related deaths per million children, for a total of 167 deaths.

* Asthma creates a substantial burden for the estimated 9.6 million children, their families, caretakers, schools, families’ employers, and the healthcare system. The epidemiology of the increasing prevalence of asthma is still poorly understood.

* Living in certain environments or neighborhoods is definitely associated with higher risk of developing asthma and with worse outcomes.
* Tobacco smoke, air pollution, and other environmental variables, and respiratory infections and diet are associated with higher asthma risk.

* Tobacco exposure is probably the strongest known environmental modifier of the natural history of asthma. Children exposed to tobacco smoke have more asthma exacerbations and other problems, including lower- respiratory infections and middle-ear infections.

* Preschool children are more likely to be exposed to environmental tobacco smoke in their homes than in public places.

* “Smoking outside” or “not in the presence of the child” is not enough to limit harm to children from tobacco smoke. Smoke settles on clothes hair, car upholstery, and furniture.

* A recent clinical trial on limiting children’s exposure to secondhand smoke found no statistically or clinically important effect in decreasing secondhand exposure.

* Children with asthma who live in high-poverty and low opportunity communities have disproportionately high adverse asthma outcomes. (Sociocultural factors)

* In a study funded by the Health Resources and Services Administration, Kogan et al determined that, in 2007, 11 million children were without health insurance for all or part of the year, and 22.7% of children with continuous insurance coverage (14.1 million children.)

* The majority of children with asthma experience their first asthma symptoms before 6 years of age.