Environmental Factors for Asthma Exacerbations at the Follow-up of Six Months: Korean Childhood Asthma Study (KAS).

초록

Background: Asthma exacerbations—acute or subacute episodes of progressively worsening symptoms and airflow obstruction—create a substantial burden to individuals and families and restrict individuals’ activities for a lifetime. We aimed to investigate the factors for aggravating asthma symptoms in the Korean Childhood Asthma Study (KAS). Methods: In KAS, we analyzed the data collected from 879 asthmatic children at the time of enrollment and 520 children at the follow‐up of six months. The analyzed data included lung function test, bronchial provocation test, fraction of exhaled nitric oxide, skin prick test, blood tests, and the questionnaires regarding the disease and the patients’environment. We investigated factors for the development of asthma symptoms at the follow‐up of six months. Results: At the follow‐up of six months, 233 children suffered from asthma symptoms during the previous six months. Using univariate analysis, we primarily explored the factors regarding the development of asthma symptoms during the previous six months. The multivariate logistic regression analysis finally determined the significant factors for asthma exacerbations: a history of asthma symptoms during the previous three months at the time of enrollment (odds ratio [OR] 1.98, 95% confidence interval [CI] 1.02–3.81), ownership of an air conditioner (OR 3.88, 95% CI 1.08–13.98), straight distance from home to the main road (OR 4.81, 95% CI 1.14–20.34), eosinophilia (OR 2.14,95% CI 1.14–4.02), the severity of concurrent allergic rhinitis (OR 31.93, 95% CI 3.50–291.66), omitting asthma medication (OR 2.09, 95% CI 1.04–4.20), mold exposure within 6 and/or 18 months (OR 2.04, 95% CI 1.05–3.96), and exposure to tobacco smoking within 6 and/or 18 months (OR 2.08, 95% CI 1.09–3.94). Conclusion: This study has identified many causes of asthma exacerbations in children. Recognizing and discriminating these factors individually may help educate asthmatic individuals and their families to reduce the risk of asthma exacerbations and prevent further worsening.