Abstract

Background: Environmental exposure is critical in sensitization to environmental allergens and pediatric asthma morbidity, especially in tropical climates where children are perennially exposed to bioaerosols, such as pollen and mold spores, and endotoxins. Objective: This cross-sectional study examines the association of allergies, associated allergic comorbidities, and the home environment separately and synergistically in pediatric asthma, including in asthma prevalence, severity of asthma, and undiagnosed asthma, in South Florida. Methods: An online survey was administered to the parents of children attending two of the University of Miami pediatric clinics from June to October 2016. Descriptive, factor, and multivariate regression analyses were used to analyze the data. Results: Of 163 children, 22% (36) children had physician-diagnosed asthma; 10% and 32% had allergic rhinitis diagnosis and rhinitis symptoms, respectively, in the past. The allergy diagnosis age was 2.3 years higher than the asthma diagnosis age (p < 0.01). Children with ≥ 2 allergies were 12.8 times more likely to have physician-diagnosed asthma than those without allergies (p < 0.01). Children with allergies and allergic rhinitis were 4.3 (p < 0.05) times more likely to have asthma, and those with asthma were 15 (p < 0.05) times more likely to have an asthma attack than those without known allergies and allergic rhinitis. Conclusion: Allergies and associated comorbidities are risk factors of asthma, asthma persistence, and multiple allergies exacerbate their effects. Early screening for allergies and treatment are warranted to manage asthma. Since the home environment plays an important role in sensitization to allergens, further research is needed to assess home-environment-mediated allergic conditions in the onset and persistence of asthma.

Highlights

  • Pediatric asthma remains one of the most common chronic diseases in the US, affecting6.2 million children and accounting for ~$50 billion/year in healthcare costs [1]

  • This paper aims to address this research gap by examining the age of diagnosis of asthma and allergies, and separate and synergistic effects of different allergies and associated allergic comorbidities on pediatric asthma, asthma severity and wheezing in South Florida

  • Three major findings emerged from this study: (a) allergies, eczema, and allergic rhinitis showed strong associations with asthma prevalence and asthma severity; (b) the coexistence of multiple allergic comorbidities and multiple allergies were associated with increased risks of asthma and worsening of asthma symptoms, and (c) the average age of environmental allergy testing was significantly higher than that of asthma diagnosis

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Summary

Introduction

Pediatric asthma remains one of the most common chronic diseases in the US, affecting6.2 million children and accounting for ~$50 billion/year in healthcare costs [1]. Mortality due to asthma has declined, there has been an increase in asthma morbidity, especially due to atopic asthma [3], which accounts for > 75% of asthma cases, is the most important phenotype in childhood, and often persists into adulthood [2,4]. Environmental exposure is critical in sensitization to environmental allergens and pediatric asthma morbidity, especially in tropical climates where children are perennially exposed to bioaerosols, such as pollen and mold spores, and endotoxins. Objective: This cross-sectional study examines the association of allergies, associated allergic comorbidities, and the home environment separately and synergistically in pediatric asthma, including in asthma prevalence, severity of asthma, and undiagnosed asthma, in South Florida. Since the home environment plays an important role in sensitization to allergens, further research is needed to assess home-environmentmediated allergic conditions in the onset and persistence of asthma

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