Abstract
BackgroundThe prevalence of asthma among Shanghai children has increased over time. This increase might be associated with changes in environmental exposures. Investigation of the time-trend of asthma and current prevalences is essential to understanding the causes.ObjectiveTo estimate the current prevalences of asthma, allergies and other respiratory symptoms among Shanghai preschool children, and to investigate the time-trend of childhood asthma prevalence of from 1990 to 2011.MethodsFrom April 2011 to April 2012, the CCHH (China, Children, Homes, Health) cross-sectional study was conducted in Shanghai. Questionnaires were distributed to 17,898 parents or guardians of preschool children from 72 kindergartens in 5 districts. Previous similar studies were also summarized by a systematic literature review.ResultsFrom a total of 14,884 questionnaires for 3–7 year old children, prevalences of the following diseases and symptoms were calculated: asthma 10.2%, wheeze (ever) 28.1%, pneumonia (ever) 33.5%, otitis media 11.0%, rhinitis (ever) 54.1%, hay fever 12.2%, eczema (ever) 22.7%, and food allergy 15.7%. Urban children had higher prevalences of most symptoms than suburban children. The prevalence of asthma has increased significantly, almost five-fold, from 2.1% in 1990 to 10.2% in the present study. The prevalence of asthma in boys was higher than in girls in the present study and in all reviewed studies.ConclusionsAsthma, allergy and airway symptoms are common among preschool children in Shanghai. The prevalence of childhood asthma in Shanghai has increased rapidly from 1990 to 2011.
Highlights
During the period 1990–2011, Shanghai, one of the largest cities of China, rapidly modernized (Fig 1)
Allergy and airway symptoms are common among preschool children in Shanghai
Compared to prevalences in other Chinese cities, where similar surveys have been conducted in recent years, 3–7 year old children in Shanghai had the highest prevalence of asthma (10.2%) [10, 12, 27, 34]
Summary
During the period 1990–2011, Shanghai, one of the largest cities of China, rapidly modernized (Fig 1). More and more new-fashioned personal products, household appliances, building materials and furnishing materials have been used in residences [1, 2], changing indoor environmental exposures in Shanghai residences over the past 20 years [2, 3]. During the same time period in developed countries (Germany [4], Italy [5], Australia [6], and Switzerland [7]), where similar exposures to modern chemicals began many years ago and have plateaued, prevalences of asthma, allergies and airway symptoms among children seem to have reached a high plateau or even decreased. In developing countries where home environments have recently and rapidly changed, prevalences of these diseases and symptoms among children appear to have been increasing [8, 9, 10, 11, 12]. The prevalence of asthma among Shanghai children has increased over time This increase might be associated with changes in environmental exposures. Investigation of the timetrend of asthma and current prevalences is essential to understanding the causes.
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