Monday, 23 November 2015

Are bedrooms a risk factor for childhood asthma presentations in hospitals?

SPHPM’s Professor Michael Abramson has co-authored a paper with researchers from La Trobe University, the University of Melbourne, the Murdoch’s Children Research Institute and the Royal Children’s Hospital on the impacts of indoor environmental and lifestyle factors and child asthma readmission.

Asthma is the most commonly occurring medical condition affecting Australian children, as well as being the number one cause for childhood hospital admissions.

Statistics indicate that between 2010 and 2011, children aged 0 to 14 had higher rates of hospitalisation for asthma than the rest of the population over the age of 15. Furthermore, asthma related expenditure came to $655 million between 2008 and 2009 alone.

Identifying the triggers or risk factors leading to asthma related admissions are vital, significantly indoor environmental factors, as children have been found to spend up to 90 per cent of time inside. The cost of childhood asthma readmissions also represents a vast amount of resources allocated for the overall treatment of asthma within the health system.

Despite these statistics, there remains a gap in the data examining the impact of indoor environmental factors on the number of child asthma hospital readmissions. The purpose of this study was to investigate the associations between indoor environmental and lifestyle factors and hospital admissions for children with asthma. Past evidence has suggested that exposure to allergens such as house dust mite or indoor mould could influence asthma within children, and that there can be a higher exposure to such within schools. In cases that lead to hospitalisation, factors such as viral infections and allergen exposure can act together, creating a greater risk for affected children. A better grasp of these factors can assist medical professionals in identifying children at greater risk of severe asthma as well assisting in how to tackle any modifiable environmental risk factors.

The authors conducted a case control study, based within a hospital, as part of the Melbourne Air Pollen Children and Adolescent Health Study. A total of 44 children were recruited as part of the study, with 22 children being readmitted to hospital for asthma and 22 children as part of the control group.

Logistical regression modelling was utilised to explore any associations between aeroallergens, fungi within bedrooms and indoor lifestyle factors for hospital rehospitalisation. In order to identify the best set of predictors within a numerous number of risk factors, the authors employed random forests techniques.

The results indicated that bedrooms with higher rates of airborne Cladosporium and yeast posed a greater risk of hospital readmission for the child. Bedrooms with carpeted floors or synthetic doonas were also linked to a greater number of asthma readmissions, as did homes that had frequent vacuuming with bagged cleaners.

The authors concluded that the various factors in a child’s bedroom have a critical role in the risk of asthma hospital readmission. The conclusions drawn from this study have strong clinical implications and can be utilised to lessen the burden of modifiable risk factors.

You can read the paper here.

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