Exposure to home and school environmental triggers and asthma morbidity in Chicago inner-city children.

BACKGROUND: In children, asthma hospitalization rates are highest among those aged 0-4 yr, indicating more acute and/or severe asthma exacerbations in younger children. We investigated the relationship between indoor exposures and three asthma morbidity measures in children of different age groups (0-4, 5-11, and 12 yr of age or older). Identifying the factors leading to asthma morbidity in specific subgroups may lead to a better understanding of the disease and contribute to the development of effective interventions tailored to subgroups.
METHODS: Children between 0 and 18 yr of age with asthma were enrolled in an asthma intervention program. At enrollment, hospitalizations, emergency room visits (ED), asthma night symptoms, and exposure to conditions in the child's home and school/daycare related to indoor allergens were collected using standardized questionnaires. Associations of exposure with the three asthma outcomes were estimated using logistic regression, stratified by age group.
RESULTS: Of 246 children enrolled, the youngest age group had more hospitalizations in the past year, more ED visits in the past year, and more night awakenings in the past month due to asthma than the oldest two age groups (p = 0.02; p < 0.0001; and p = 0.01, respectively). Overall, more associations of exposures to home triggers were found with hospitalization in children aged 0-11 yr, while classroom triggers were more likely to be associated with hospitalizations among the oldest two groups, 5-18 yr of age.
CONCLUSIONS: Examining the relationship of specific environmental exposures with asthma exacerbations and hospitalizations across age group and in different indoor environments warrants further study.