Asthma Prevelance in Native and Foriegn Born Children in a Predominanly Asian Community Setting

Abstract

P-085 Abstract: There is still inadequate understanding of the pathogenesis of asthma in children. Studies have suggested that asthma prevalence is lower in less developed countries and that some recent immigrant populations in the USA have lower asthma prevalence than the general population. On the other hand, inner city, urban children appear to have very high asthma prevalence. We surveyed parents of children at two pediatric clinics that serve large numbers of Asian, mostly Chinese, immigrants, in the low income urban Chinatown in Boston, Massachusetts, USA. Surveys were completed for 410 children, however, 30 surveys were disqualified for this analysis because we excluded children less than 1, persons with data missing for 5 questions or more and respondents who choose “other” for race. The final database (n=380; 64% Asian) was assessed for the relationship between asthma diagnosis (26% of the total sample) and native or foreign place of birth. The crude odds ratio for place of birth and asthma was 3.5 (CI: 1.6–7.5; p=0.001). Other factors considered were sex, race, age, language (Chinese v. English), SES (measured as parental occupation), smoking in the home, living near heavy motor vehicle traffic, having allergies, pest infestation in the home and family members with asthma. Of these, living near heavy motor vehicle traffic (p=0.02), having allergies (p=0.007), and family members with asthma (p<0.001) were statistically associated with diagnosis of asthma. A forward binary stepwise logistic regression that included all of the variables resulted in being born in the USA (p=0.02), living near heavy motor vehicle traffic (p=0.02) and family members with asthma (p<0.001) remaining statistically significant. Within the limits of self-reported survey data and the relatively small number of confounders that we were able to consider, the analysis is consistent with the hypothesis that early childhood has a substantial impact on development of asthma. It is interesting that none of the environmental factors other than motor vehicle traffic remained significant in the multivariate model. The interpretation of this analysis most consistent with our outcomes and the literature is that early childhood infections and genetic susceptibility may be important.