Allergy Asthma Immunol Res.  2020 Jan;12(1):86-98. 10.4168/aair.2020.12.1.86.

Associated Factors for Asthma Severity in Korean Children: A Korean Childhood Asthma Study

Affiliations
  • 1Department of Pediatrics, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea.
  • 2Department of Pediatrics, Korea University College of Medicine, Seoul, Korea.
  • 3Department of Pediatrics, Inje University Seoul Paik Hospital, Seoul, Korea.
  • 4Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea.
  • 5Department of Pediatrics, Hallym University Kangdong Sacred Heart Hospital, Seoul, Korea.
  • 6Department of Pediatrics, Soonchunhyang University School of Medicine, Bucheon, Korea.
  • 7Department of Pediatrics, Korea University Anam Hospital, Seoul, Korea.
  • 8Department of Pediatrics, School of Medicine, The Catholic University of Korea, Uijeongbu St. Mary's Hospital, Uijeongbu, Korea.
  • 9Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea.
  • 10Department of Pediatrics, National Health Insurance Service Ilsan Hospital, Goyang, Korea.
  • 11Department of Pediatrics, School of Medicine, Inha University, Incheon, Korea.
  • 12Department of Pediatrics, Pediatric Allergy and Respiratory Center, Soonchunhyang University College of Medicine, Seoul, Korea.
  • 13Department of Pediatrics, School of Medicine, The Catholic University of Korea, Bucheon St. Mary's Hospital, Bucheon, Korea.
  • 14Department of Pediatrics, Dankook University Hospital, Dankook University College of Medicine, Cheonan, Korea.
  • 15Department of Pediatrics, College of Medicine, Chungbuk National University, Cheongju, Korea.
  • 16Department of Pediatrics, Pusan National University Yangsan Hospital, Yangsan, Korea.
  • 17Department of Pediatrics, Gangnam CHA Medical Center CHA University School of Medicine, Seoul, Korea.
  • 18Department of Pediatrics, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea.
  • 19Department of Pediatrics, Mediplex Sejong Hospital, Incheon, Korea.
  • 20Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
  • 21Asan Institute for Life Sciences, University of Ulsan College of Medicine, Seoul, Korea.
  • 22Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. jyu3922@gmail.com

Abstract

PURPOSE
Childhood asthma has a considerable social impact and economic burden, especially in severe asthma. This study aimed to identify the proportion of childhood asthma severity and to evaluate associated factors for greater asthma severity.
METHODS
This study was performed on 667 children aged 5-15 years with asthma from the nationwide 19 hospitals in the Korean childhood Asthma Study (KAS). Asthma was classified as mild intermittent, mild persistent, and moderate/severe persistent groups according to the National Asthma Education and Prevention Program recommendations. Multinomial logistic regression models were used to identify the associated factors for greater asthma severity.
RESULTS
Mild persistent asthma was most prevalent (39.0%), followed by mild intermittent (37.6%), moderate persistent (22.8%), and severe persistent asthma (0.6%). Onset later than 6 years of age (adjusted odds ratio [aOR], 1.69 for mild persistent asthma; aOR, 1.92 for moderate/severe persistent asthma) tended to increase asthma severity. Exposure to environmental tobacco smoke (aOR, 1.53 for mild persistent asthma; aOR, 1.85 for moderate/severe persistent asthma), and current dog ownership with sensitization to dog dander (aOR, 5.86 for mild persistent asthma; aOR, 6.90 for moderate/severe persistent asthma) showed increasing trends with greater asthma severity. Lower maternal education levels (aOR, 2.32) and no usage of an air purifier in exposure to high levels of outdoor air pollution (aOR, 1.76) were associated with moderate/severe persistent asthma.
CONCLUSIONS
Modification of identified environmental factors associated with greater asthma severity might help better control childhood asthma, thereby reducing the disease burden due to childhood asthma.

Keyword

Child; asthma; severity; risk factor; environmental exposure; smoke; dogs; education status; air pollution

MeSH Terms

Air Filters
Air Pollution
Animals
Asthma*
Child*
Dander
Dogs
Education
Environmental Exposure
Humans
Logistic Models
Odds Ratio
Ownership
Risk Factors
Smoke
Social Change
Tobacco
Smoke
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