CANADIAN CHILDREN WITH ASTHMA MAY BE SAD AND ON THE SIDELINES

(VANCOUVER, BC, CANADA, November 1, 2010)—Canadian children with asthma may feel a greater impact from the disease than children in other countries. New research, presented at CHEST 2010, the 76th meeting of the American College of Chest Physicians (ACCP), finds that Canadian children with asthma are more likely to feel sad and left out, less able to participate in sports, and more likely to feel different from their peers than children in other countries.

"There has been recent research showing that all children with chronic disease are at increased risk of bullying and social exclusion," said lead researcher William Carroll, MD, Derbyshire Children’s Hospital, United Kingdom. "Our study is important because it allows us insight into the lives of so many children with asthma from around the world."

Dr. Carroll and colleagues from Switzerland and The Netherlands conducted telephone interviews of 228 parents from Canada who have at least one child with physician-diagnosed asthma, aged 4 to 15 years. Telephone interviews also were conducted with the children, including 159 Canadian children with asthma, as well as some additional face-to-face interviews. Results were compared with child and parent interviews from Greece, Hungary, The Netherlands, the United Kingdom, and South Africa.

Compared with children from other countries, Canadian children were much more likely to consider asthma a barrier to sports (54.1 percent vs 35.2 percent), feel sad (18.2 percent vs 12.1 percent), and feel left out (13.2 percent vs 8.4 percent), and they were less likely to feel "no different" from their peers (31.5 percent vs 51.4 percent) because of their asthma.

"The data suggest that Canadian children with asthma may be missing out on being involved in sports because they feel excluded," said Dr. Carroll. "It’s also possible that sports involving cold air, such as ice hockey, which is popular in Canada, are more difficult for those with asthma."

The study also showed that complete asthma control in children was low in both Canada and other countries (11.8 percent vs 15.3 percent). The authors concluded that this was associated with concerns about the use of steroid medication in all countries studied.

"Our data show that, in Canada, and in other countries, there is a lack of complete asthma control in children, and steroid phobia among parents is common," said Dr. Carroll. "However, the impact that lack of control has on children’s lives seems to be greater in Canada."

Impact of Asthma on Parents in Other Countries
Further analysis revealed varying themes among South African and European parents of children with asthma, including the following:

• Dutch parents are the least concerned about steroid-based medications for children and use this treatment the most.
• Greek parents are the most likely to implement change in their household (eg, reducing allergens) in an effort to control or reduce risk to their children.
• South African parents have the highest level of concern for their children from diagnosis to the present time.
• Parents in the United Kingdom are the least likely to say their child’s asthma will limit their day-to-day activities.

Dr. Carroll was fascinated by the differences in country-specific themes relating to asthma, and noted that he and his team would be looking at data from subsets of families to further examine what might cause differences in the impact of asthma on children and parents. In the meantime, parents should be aware that there are far-reaching implications for children.

"Globally, one in 10 children with asthma believe they have been bullied as a result of their asthma," said Dr. Carroll. "Better social integration and sports participation can only be achieved by educating teachers, classmates, parents, and coaches."

"Asthma is a common, chronic disease affecting millions of children worldwide," said Robert Levy, MD, FCCP, Immediate Past President, Canadian Thoracic Society, and Co-Chair, CHEST 2010. "It is important that physicians have a complete picture of the barriers to asthma control and how deeply asthma affects the lives of children."

CHEST 2010 is the 76th annual meeting of the American College of Chest Physicians, held October 30 - November 4 in Vancouver, BC, Canada. The ACCP represents 18,000 members who provide patient care in the areas of pulmonary, critical care, and sleep medicine in the United States and throughout the world. The mission of the ACCP is to promote the prevention, diagnosis, and treatment of chest diseases through education, communication, and research. For more information about the ACCP, please visit the ACCP Web site at www.chestnet.org.