History Does Not Necessarily Predict Asthma Risk
a family history of asthma is associated with increased risk
of asthma in children, family history does not successfully predict
enough cases of childhood asthma to be a useful tool in guiding
widespread environmental prevention efforts, a new study concludes.
environmental efforts like housing improvements or hot-water
to all families with asthmatic children
-- regardless of family history -- "would probably target
a higher proportion of children likely to benefit from such interventions," according
to Wylie Burke, M.D., Ph.D., of the University of Washington
However, the asthma risk associated with family history might
motivate individual parents to take steps to prevent asthma complications
like removing rugs and using mattress covers, say the researchers.
"Knowledge of the risk associated with a family history
of asthma might also help healthcare providers and parents to
identify early signs of asthma and to be more proactive about
treatment," Burke and colleagues say.
Asthma affects 14 million to 15 million Americans and leads
to nearly 500,000 hospital visits and more than 5,000 deaths
each year. Rates of sickness and death are particularly high
among low-income minority children.
"These statistics suggest that strategies identifying children
at increased risk of asthma might have a public health benefit," the
To determine if family history might be such a strategy, Burke
and colleagues analyzed data from 33 previous studies of asthma
and family history in populations from 20 countries. The researchers
found that a family history of asthma, where first-degree relatives
such as a parent or sibling had asthma, was a consistent risk
factor for childhood asthma.
Yet in the
10 studies where Burke and colleagues could calculate the exact
of asthma cases predicted by family history,
the history factor was linked to fewer than half of the asthma
cases and "failed to identify the majority of children at
risk," they say.
The study was published in the February 2003 issue of the American
Journal of Preventive Medicine and supported by grants from the
Centers for Disease Control and Prevention, Association of Schools
of Public Health and the National Institute of Environmental
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