Incidence rates of childhood asthma with recurrent exacerbations in the US Environmental influences on Child Health Outcomes (ECHO) program

Rachel L Miller; Holly Schuh; Aruna Chandran; Izzuddin M Aris; Casper Bendixsen; Jeffrey Blossom; Carrie Breton; Carlos A Camargo Jr; Glorisa Canino; Kecia N Carroll; Sarah Commodore; José F Cordero; Dana M Dabelea; Assiamira Ferrara; Rebecca C Fry; Jody M Ganiban; James E Gern; Frank D Gilliland; Diane R Gold; Rima Habre; Marion E Hare; Robyn N Harte; Tina Hartert; Kohei Hasegawa; Gurjit K Khurana Hershey; Daniel J Jackson; Christine Joseph; Jean M Kerver; Haejin Kim; Augusto A Litonjua; Carmen J Marsit; Cindy McEvoy; Eneida A Mendonça; Paul E Moore; Flory L Nkoy; Thomas G O'Connor; Emily Oken; Dennis Ownby; Matthew Perzanowski; Katherine Rivera-Spoljaric; Patrick H Ryan; Anne Marie Singh; Joseph B Stanford; Rosalind J Wright; Robert O Wright; Antonella Zanobetti; Edward Zoratti; Christine C Johnson; of program collaborators for Environmental influences on Child Health Outcomes

doi:10.1016/j.jaci.2023.03.016

Incidence rates of childhood asthma with recurrent exacerbations in the US Environmental influences on Child Health Outcomes (ECHO) program

J Allergy Clin Immunol. 2023 Jul;152(1):84-93. doi: 10.1016/j.jaci.2023.03.016. Epub 2023 Mar 25.

Authors

Rachel L Miller¹, Holly Schuh², Aruna Chandran², Izzuddin M Aris³, Casper Bendixsen⁴, Jeffrey Blossom⁵, Carrie Breton⁶, Carlos A Camargo Jr⁷, Glorisa Canino⁸, Kecia N Carroll⁹, Sarah Commodore¹⁰, José F Cordero¹¹, Dana M Dabelea¹², Assiamira Ferrara¹³, Rebecca C Fry¹⁴, Jody M Ganiban¹⁵, James E Gern¹⁶, Frank D Gilliland⁶, Diane R Gold¹⁷, Rima Habre⁶, Marion E Hare¹⁸, Robyn N Harte¹⁹, Tina Hartert²⁰, Kohei Hasegawa²¹, Gurjit K Khurana Hershey²², Daniel J Jackson¹⁶, Christine Joseph²³, Jean M Kerver²⁴, Haejin Kim²³, Augusto A Litonjua²⁵, Carmen J Marsit²⁶, Cindy McEvoy²⁷, Eneida A Mendonça²², Paul E Moore²⁰, Flory L Nkoy²⁸, Thomas G O'Connor²⁹, Emily Oken³, Dennis Ownby²³, Matthew Perzanowski³⁰, Katherine Rivera-Spoljaric³¹, Patrick H Ryan²², Anne Marie Singh¹⁶, Joseph B Stanford²⁸, Rosalind J Wright⁹, Robert O Wright⁹, Antonella Zanobetti³², Edward Zoratti²³, Christine C Johnson²³; of program collaborators for Environmental influences on Child Health Outcomes

Collaborators

of program collaborators for Environmental influences on Child Health Outcomes:
P B Smith, K L Newby, L P Jacobson, D J Catellier, R Gershon, D Cella, A Alshawabkeh, J Aschner, S Merhar, C Ren, A Reynolds, R Keller, G Pryhuber, A Duncan, A Lampland, R Wadhawan, C Wagner, M Hudak, D Mayock, L Walshburn, S L Teitelbaum, A Stroustrup, L Trasande, C Blair, L Gatzke-Kopp, M Swingler, J Mansbach, J Spergel, H Puls, M Stevenson, C Bauer, S Deoni, C Duarte, A Dunlop, A Elliott, L Croen, L Bacharier, G O'Connor, L Bacharier, M Kattan, R Wood, G Hershey, D Ownby, I Hertz-Picciotto, A Hipwell, M Karagas, C Karr, A Mason, S Sathyanarayana, B Lester, B Carter, C Neal, L Smith, J Helderman, L Leve, J Ganiban, J Neiderhiser, S Weiss, R Zeiger, R Tepper, K Lyall, R Landa, S Ozonoff, R Schmidt, S Dager, R Schultz, J Piven, H Volk, R Vaidya, R Obeid, C Rollins, K Bear, S Pastyrnak, M Lenski, M Msall, J Frazier, L Washburn, A Montgomery, C Barone, P McKane, N Paneth, M Elliott, J Herbstman, S Schantz, C Porucznik, R Silver, E Conradt, M Bosquet-Enlow, K Huddleston, N Bush, R Nguyen, T O'Connor, M Samuels-Kalow

Affiliations

¹ Icahn School of Medicine at Mount Sinai, New York, NY. Electronic address: Rachel.miller2@mssm.edu.
² Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Md.
³ Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Inc, Boston, Mass.
⁴ Marshfield Clinic Research Institute, Marshfield, Wis.
⁵ Harvard University Center for Geographic Analysis, Cambridge, Mass.
⁶ Keck School of Medicine of University of Southern California, Los Angeles, Calif.
⁷ Department of Epidemiology, Massachusetts General Hospital, Harvard Medical School, Boston, Mass; Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Mass.
⁸ University of Puerto Rico Behavioral Sciences Research Institute, San Juan, Puerto Rico.
⁹ Icahn School of Medicine at Mount Sinai, New York, NY.
¹⁰ Medical University of South Carolina, Charleston, SC.
¹¹ University of Georgia College of Public Health, Athens, Ga.
¹² University of Colorado Anschutz Medical Campus, Aurora, Colo.
¹³ Division of Research, Kaiser Permanente Northern California, Oakland, Calif.
¹⁴ Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC.
¹⁵ George Washington University, Washington, DC.
¹⁶ University of Wisconsin School of Medicine and Public Heath, Madison, Wis.
¹⁷ Brigham and Women's Hospital, Harvard Medical School, Boston, Mass; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Mass.
¹⁸ University of Tennessee Health Science Center, Memphis, Tenn.
¹⁹ Colorado School of Public Health, Aurora, Colo.
²⁰ Vanderbilt University School of Medicine, Nashville, Tenn.
²¹ Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Mass.
²² University of Cincinnati, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
²³ Henry Ford Health, Detroit, Mich.
²⁴ Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, Mich.
²⁵ Division of Pediatric Pulmonary Medicine, Department of Pediatrics, Golisano Children's Hospital, University of Rochester Medical Center, Rochester, NY.
²⁶ Rollins School of Public Health, Emory University, Atlanta, Ga.
²⁷ Oregon Health and Science University, Portland, Ore.
²⁸ University of Utah Health, Salt Lake City, Utah.
²⁹ School of Medicine and Dentistry, University of Rochester Medical Center, Rochester, NY.
³⁰ Columbia University Mailman School of Public Health, New York, NY.
³¹ St Louis Children's Hospital, Washington University, St Louis, Mo.
³² Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Mass.

Abstract

Background: Descriptive epidemiological data on incidence rates (IRs) of asthma with recurrent exacerbations (ARE) are sparse.

Objectives: This study hypothesized that IRs for ARE would vary by time, geography, age, and race and ethnicity, irrespective of parental asthma history.

Methods: The investigators leveraged data from 17,246 children born after 1990 enrolled in 59 US with 1 Puerto Rican cohort in the Environmental Influences on Child Health Outcomes (ECHO) consortium to estimate IRs for ARE.

Results: The overall crude IR for ARE was 6.07 per 1000 person-years (95% CI: 5.63-6.51) and was highest for children aged 2-4 years, for Hispanic Black and non-Hispanic Black children, and for those with a parental history of asthma. ARE IRs were higher for 2- to 4-year-olds in each race and ethnicity category and for both sexes. Multivariable analysis confirmed higher adjusted ARE IRs (aIRRs) for children born 2000-2009 compared with those born 1990-1999 and 2010-2017, 2-4 versus 10-19 years old (aIRR = 15.36; 95% CI: 12.09-19.52), and for males versus females (aIRR = 1.34; 95% CI 1.16-1.55). Black children (non-Hispanic and Hispanic) had higher rates than non-Hispanic White children (aIRR = 2.51; 95% CI 2.10-2.99; and aIRR = 2.04; 95% CI: 1.22-3.39, respectively). Children born in the Midwest, Northeast and South had higher rates than those born in the West (P < .01 for each comparison). Children with a parental history of asthma had rates nearly 3 times higher than those without such history (aIRR = 2.90; 95% CI: 2.43-3.46).

Conclusions: Factors associated with time, geography, age, race and ethnicity, sex, and parental history appear to influence the inception of ARE among children and adolescents.

Keywords: Asthma; environmental and social determinants of asthma; incidence rates; recurrent exacerbations.

Publication types

Research Support, N.I.H., Extramural

MeSH terms

Adolescent
Adult
Asthma* / etiology
Child
Child, Preschool
Ethnicity
Female
Humans
Incidence
Male
Outcome Assessment, Health Care
Prevalence
Young Adult

Abstract

Publication types

MeSH terms

Grants and funding