Background
Methods
Protocol and population
Questionnaire
Asthma definition and characterization
Studied co-factors
Statistical and epidemiological analyses
Results
Entire sample | Asthma | |||||
---|---|---|---|---|---|---|
All
|
Undiagnosed
|
Diagnosed
|
Diagnosed
| |||
N = 7,781
|
N = 903
|
N = 377
|
N = 526
|
Untreated N = 76
|
Treated N = 353
| |
N (%) | ||||||
Créteil | 1,420 | 175 | 73 | 102 | 13 | 66 |
(19.59) | (19.39) | (19.36) | (19.39) | (17.11) | (18.70) | |
Reims | 987 | 116 | 40 (10.61) | 76 | 14 | 50 |
(13.62) | (12.85) | (14.45) | (18.42) | (14.16) | ||
Marseille | 1,226 | 164 | 69 | 95 | 10 | 66 |
(16.92) | (18.16) | (13.12) | (18.06) | (13.16) | (18.70) | |
Strasbourg | 1,213 | 142 | 59 | 83 | 19 | 55 |
(16.74) | (15.73) | (15.65) | (15.78) | (25.00) | (15.58) | |
Clermont-Ferrand | 1,201 | 137 | 62 | 75 | 12 | 48 |
(16.57) | (15.17) | (16.45) | (14.26) | (15.79) | (13.60) | |
Bordeaux | 1,200 | 169 | 74 | 95 | 8 | 68 |
(16.56) | (18.72) | (19.63) | (18.06) | (10.53) | (19.26) |
Entire sample | Asthma | |||||
---|---|---|---|---|---|---|
All
(&)
|
Undiagnosed
|
Diagnosed
(^)
|
Diagnosed
| |||
N = 7,781
|
N = 903
|
N = 377
|
N = 526
|
Untreated N = 76
|
Treated
(
§)
N = 353
| |
Variable
| ||||||
Age (year, mean ± DS) | 10.40 ± 0.75 | 10.42 ± 0.74 | 10.40 ± 0.75 | 10.43 ± 0.74 | 10.43 ± 0.73 | 10.43 ± 0.71 |
Gender, N (%) | ||||||
Boys | 3,872 (49.77) | 545 (60.35)* | 222 (58.89) | 323 (61.41) | 45 (59.21) | 222 (62.89) |
Girls | 3,908 (50.23) | 358 (39.65) | 155 (41.11) | 203 (38.59) | 31 (40.79) | 131 (37.11) |
BMI, N (%) | ||||||
8 Kg/m2 | 4,751 (61.07) | 529 (58.58) | 224 (59.42) | 305 (57.98) | 45 (59.21) | 199 (56.37) |
18-25 Kg/m2 | 2,842 (36.53) | 347 (38.43) | 140 (37.14) | 207 (39.35) | 27 (35.53) | 145 (41.08) |
5 Kg/m2 | 187 (2.40) | 27 (2.99) | 13 (3.45) | 14 (2.66) | 4 (5.26) | 9 (2.55) |
Mother’s asthma, N (%) | 521 (7.27) | 151 (16.72)* | 62 (16.45) | 89 (16.92) | 10 (13.16) | 62 (17.56) |
Birth order, First, N (%) | 3,940 (55.01) | 517 (57.32) | 207 (55.05) | 310 (58.94) | 46 (60.53) | 218 (61.76) |
Ethnic origin of the parents, N (%) | ||||||
Metropolitan France | 4,272 (54.90) | 524 (78.80)* | 205 (75.65) | 319 (80.96) | 49 (84.48) | 215 (80.83) |
Overseas Departments | 98 (1.26) | 14 (2.11) | 4 (1.48) | 10 (2.54) | 2 (3.45) | 8 (3.01) |
South Europe | 142 (1.82) | 15 (1.78) | 8 (2.95) | 7 (1.78) | 0 | 5 (1.88) |
North Africa | 461 (5.92) | 57 (7.61) | 27 (9.96) | 30 (7.61) | 4 (6.90) | 21 (7.89) |
Asia | 169 (2.17) | 24 (2.79) | 13 (4.80) | 11 (2.79) | 1 (1.72) | 7 (2.63) |
Sub-Saharian Africa | 137 (1.76) | 11 (1.78) | 4 (1.48) | 7 (1.78) | 0 | 5 (1.88) |
Others | 190 (2.44) | 20 (2.54) | 10 (3.69) | 10 (2.54) | 2 (3.45) | 5 (1.88) |
Education, N (%) | ||||||
Elementary | 599 (9.10) | 58 (7.00) | 21 (6.03) | 37 (7.71) | 7 (10.14) | 19 (5.88) |
Secondary | 2745 (41.70) | 344 (41.55) | 150 (43.10) | 194 (40.42) | 22 (31.88) | 129 (39.94) |
High School, College | 3,103 (47.14) | 404 (48.79) | 165 (47.41) | 239 (49.79) | 38 (55.07) | 169 (52.32) |
Others | 135 (2.05) | 22 (2.66) | 12 (3.45) | 10 (2.08) | 2 (2.90) | 6 (1.86) |
Parental socio-economic status, N (%) | ||||||
Artisan, own activity | 339 (5.33) | 39 (4.88) | 15 (4.55) | 24 (5.11) | 2 (2.99) | 17 (5.36) |
Liberal profession | 1,525 (23.97) | 185 (23.13) | 75 (22.73) | 110 (23.40) | 14 (20.90) | 76 (23.97) |
Intermediate profession | 1,393 (21.89) | 195 (24.38) | 73 (22.12) | 122 (25.96) | 25 (37.31) | 83 (26.18) |
Employees | 1856 (29.17) | 228 (28.50) | 105 (31.82) | 123 (26.17) | 11 (16.42) | 79 (24.92) |
Blue collars | 871 (13.69) | 98 (12.25) | 38 (11.52) | 60 (12.77) | 12 (17.91) | 39 (12.30)* |
Farmer, retired, inactive | 379 (5.96) | 55 (6.88) | 24 (7.27) | 31 (6.60) | 3 (4.48) | 23 (7.26) |
Medical coverage, N (%) | ||||||
Social Security | 6,846 (87.99) | 864 (95.68) | 363 (96.29) | 501 (95.25) | 69 (90.79) | 341 (96.60)* |
Complementary insurance | 5,813 (74.71) | 733 (81.17)* | 305 (80.90) | 428 (81.37) | 63 (82.89) | 285 (80.74) |
Free medical care | 514 (6.61) | 74 (8.19) | 37 (9.81) | 37 (7.03) | 8 (10.53) | 24 (6.52) |
Personal insurance | 990 (12.72) | 106 (11.74) | 43 (11.41) | 63 (11.98) | 14 (18.42) | 37 (10.48) |
No protection | 12 (0.15) | 5 (0.55) | 1 (0.27) | 4 (0.76) | 0 | 2 (0.57) |
Type of family, N (%) | ||||||
Live with his/her 2 parents | 5,140 (72.24) | 584 (64.82)* | 236 (62.93) | 348 (66.16) | 51 (67.10) | 237 (67.14) |
Live with his/her mother only | 1,487 (20.90) | 234 (25.97)* | 101 (26.93) | 133 (25.29) | 17 (22.37) | 87 (24.65) |
Live with his/her father only | 179 (2.52) | 23 (2.55) | 12 (3.20) | 11 (2.09) | 1 (1.32) | 7 (1.98) |
Diagnosed vs. undiagnosed asthma
Asthma medication | Undiagnosed Asthma N = 377 | Diagnosed Asthma N = 526 | p-value |
---|---|---|---|
Antihistamines h1, N (%) | 11 (2.92) | 65 (12.36) | 0.01 |
Inhaled Corticosteroids, N (%) | 27 (7.16) | 209 (39.73) | 0.01 |
Bronchodilators, N (%) | 45 (11.94) | 312 (59.32) | 0.01 |
Other antihistamines, N (%) | 4 (1.06) | 42 (7.98) | 0.01 |
Nasal medications, N (%) | 0 | 9 (1.71) | NS |
Medication against eczema, N (%) | 0 | 3 (0.57) | NS |
Other medications, N (%) | 6 (1.59) | 12 (2.28) | NS |
Undiagnosed Asthma N = 377
|
Diagnosed Asthma (^) N = 526
|
Diagnosed Asthma
| ||
---|---|---|---|---|
Untreated N = 76
|
Treated(§) N = 353
| |||
Asthma severity according to GINA, N (%) | *** | *** | ||
level 1 | 340 (90.19) | 358 (68.06) | 70 (92.11) | 202 (57.22) |
level 2 | 15 (3.98) | 74 (14.07) | 2 (2.93) | 71 (20.11) |
level 3 | 22 (5.85) | 94 (17.87) | 4 (5.26) | 80 (22.66) |
Number of attacks during the last 12 months, N (%) | ** | *** | ||
None | 53 (23.56) | 56 (15.14) | 17 (58.62) | 21 (6.95) |
1 to 3 times | 149 (66.22) | 204 (55.14) | 12 (41.38) | 177 (58.61) |
4 to 12 times | 18 (8.00) | 86 (23.24) | 0 | 81 (26.82) |
More than 12 times | 5 (2.22) | 24 (6.46) | 0 | 23 (7.62) |
Sleep disturbed due to wheezing, N (%) | * | |||
Never | 162 (72.70) | 200 (57.14) | 21 (80.77) | 157 (53.58) |
Less than a night per week | 38 (17.76) | 114 (32.57) | 3 (11.54) | 105 (35.84) |
One or more nights per week | 14 (6.54) | 36 (10.29) | 2 (7.69) | 31 (10.58) |
Asthma attacks, N (%) | *** | |||
1 or more crises per month | 13 (13.13) | 108 (25.71) | 1 (1.64) | 101 (31.08) |
Less than a crisis per month | 24 (24.24) | 107 (25.48) | 5 (8.20) | 100 (30.70) |
Less than a crisis by year | 27 (27.27) | 83 (19.76) | 11 (18.03) | 70 (21.54) |
Attacks have disappeared | 35 (35.35) | 122 (29.05) | 44 (72.13) | 54 (16.62) |
Wheezing ever been severe enough to limit your (child’s) speech in the last 12 months, N (%) | 9 (4.05) | 37 (10.14) | 1 (3.70) | 35 (11.59) |
Wheezing during or after effort in the last 12 months, N (%) | 106 (29.12) | 217 (42.27) | 6 (7.89) | 200 (58.48%)*** |
Hospitalization in the last 12 months, N (%) | 2 (2.06) | 32 (8.94) | 0 | 30 (10.68) |
Missed school days, N (%) | ** | |||
None | 69 (71.13) | 215 (60.91) | 49 (90.74) | 152 (53.71) |
1-5 days | 18 (18.56) | 87 (24.65) | 2 (3.70) | 83 (29.33) |
6-10 days | 6 (6.19) | 36 (10.20) | 3 (5.56) | 33 (11.66) |
More then 11 days | 4 (4.12) | 15 (4.25) | 0 | 15 (5.30) |
Entire sample N = 7,781 | Asthmatics N = 903 | Undiagnosed Asthma N = 377 | Diagnosed Asthma N = 526 | Diagnosed Asthma | p-value§ | ||
---|---|---|---|---|---|---|---|
Untreated N = 76
|
Treated N = 353
| ||||||
Lifetime eczema, N (%) | 1,715 (25.22) | 359 (41.65) | 121 (33.43) | 238 (47.60) | 27 (36.00) | 175 (52.24) | 0.0110 |
Lifetime allergic rhinitis, N (%) | 1,998 (29.28) | 537 (61.72) | 196 (54.44) | 341 (66.86) | 41(55.41) | 242 (70.76) | 0.0102 |
Severe health problem, N (%) | 287 (4.28) | 52 (6.30) | 17 (5.04) | 34 (7.16) | 5 (6.85) | 23 (7.12) | |
SPT + to indoor allergens, N (%) | 1,409 (20.95) | 342 (45.60) | 119 (37.07) | 223 (51.98) | 20 | 167 | <0.0001 |
(30.30) | (60.29) | ||||||
SPT + to outdoor allergens, N (%) | 824 (12.25) | 184 (24.53) | 56 (17.45) | 128 (29.84) | 12 | 95 | 0.0111 |
(18.18) | (34.30) | ||||||
SPT + to food allergens, N (%) | 138 (2.05) | 60 (4.00) | 6 (1.87) | 24 (5.59) | 2 (3.03) | ||
BRH10, N (%) | 610 (8.95) | 140 (17.95) | 55 (16.72) | 85 (18.85) | 6 (8.82) | 69 (23.31) | 0.0077 |
BRH15, N (%) | 227 (3.33) | 85 (10.90) | 28 (8.51) | 57 (12.64) | 2 (2.94) | 50 (16.89) | 0.0030 |
Undiagnosed Asthma N = 377 | Diagnosed Asthma N = 526 | Diagnosed Asthma | p-value§ | ||
---|---|---|---|---|---|
Untreated N = 76
|
Treated N = 353
| ||||
Medication compliance, N (%) | |||||
All treatment | 34 (73.91) | 262 (72.58) | 6 (50.00) | 243 (73.41) | <0.0001 |
Most of the treatment | 6 (13.04) | 66 (18.28) | 1 (8.33) | 62 (18.73) | |
A part of the treatment | 6 (13.04) | 21 (5.82) | 0 | 20 (6.04) | |
None | 0 (0.00) | 8 (2.22) | 4 (33.33) | 3 (0.91) | |
Attacks prevention, N (%) | 33 (31.43) | 281 (62.86) | 31 (45.59) | 223 (67.58) | 0.0006 |
Medication during asthma attacks, N (%) | 68 (64.15) | 423 (91.36) | 59 (84.29) | 325 (94.20) | 0.0040 |
Management of asthma by the child, N (%) | 21 (23.08) | 300 (66.52) | 23 (32.39) | 258 (77.48) | <0.0001 |
Peak flow-meter use, N (%) | 0 (0.00) | 29 (6.25) | 2 (2.99) | 25 (7.20) | 0.2003 |
Entire sample N = 7,781 | Asthmatics N = 903 | Undiagnosed Asthma N = 377 | Diagnosed Asthma N = 526 | Diagnosed Asthma | p-value§ | ||
---|---|---|---|---|---|---|---|
Untreated N = 76
|
Treated N = 353
| ||||||
Paternal smoking, N (%) | 1,958 (27.31) | 251 (27.80) | 113 (29.97) | 138 (26.24) | 17 (22.37) | 97 (27.48) | NS |
Maternal smoking, N (%) | 2,060 (28.73) | 294 (32.56) | 136 (36.07) | 158 (30.04) | 20 (26.32) | 110 (31.16)( | NS |
Living in, N (%) | NS | ||||||
Town | 4,625 (67.48) | 593 (68.79) | 258 (71.67) | 335 (66.73) | 47 (68.12) | 225 (66.37) | |
Suburb of a town | 1,633 (23.83) | 199 (23.09) | 76 (21.11) | 123 (24.50) | 14 (20.29) | 90 (26.55) | |
Village | 369 (5.38) | 39 (4.52) | 15 (4.17) | 24 (4.78) | 4 (5.80) | 13 (3.83) | |
Isolated house, farm | 227 (3.33) | 31 (3.60) | 11 (3.06) | 20 (3.98) | 4 (5.80) | 11 (3.24) | |
House built, N (%) | |||||||
Before 1945 | 1,444 (21.44) | 202 (23.71) | 92 (26.44) | 110 (21.83) | 12 (17.14) | 77 (22.65) | NS |
Between 1945-1960 | 832 (12.35) | 86 (10.09) | 32 (9.20) | 54 (10.71) | 9 (12.86) | 33 (9.71) | |
After 1960 | 3,150 (46.76) | 387 (45.42) | 144 (41.38) | 243 (48.21) | 35 (50.00) | 164 (48.24) | |
Don’t know | 1,310 (19.45) | 177 (20.77) | 80 (22.99) | 97 (19.25) | 14 (20.00) | 66 (19.41) | |
Living near bus stops ,N (%) | 2,781 (41.07) | 358 (41.68) | 167 (47.18) | 191 (37.82) | 17 (23.94) | 137 (40.41) | 0,0092 |
Gas cooking, heater with evacuation, N (%) | 3,340 (49.10) | 424 (49.19) | 167 (47.04) | 257 (50.69) | 35 (48.61) | 167 (49.26) | NS |
Conditioned air, N (%) | 400 (5.84) | 56 (6.50) | 23 (6.44) | 33 (6.53) | 4 (5.41) | 18 (5.31) | NS |
Cracked painting at home, N (%) | 790 (11.45) | 119 (13.63) | 48 (13.26) | 71 (13.89) | 10 (13.51) | 45 (13.12) | NS |
Condensation, N (%) | 1,225 (18.10) | 172 (20.02) | 75 (20.89) | 97 (19.40) | 13 (18.60) | 69 (20.60) | NS |
Water leaks, N (%) | 551 (7.97) | 74 (8.47) | 30 (8.26) | 44 (8.61) | 3 (4.05) | 30 (8.72) | NS |
Moulds, N (%) | 1,176 (17.02) | 166 (19.10) | 71 (19.72) | 95 (18.66) | 17 (22.97) | 63 (18.48) | NS |
Pets, N (%) | 3,643 (50.81) | 406 (44.96) | 169 (41.63) | 237 (58.37) | 32 (42.11) | 160 (45.33) | NS |
Entire sample N = 7,781 | Asthmatics N = 903 | Undiagnosed Asthma N = 377 | Diagnosed Asthma N = 526 | Diagnosed Asthma | p-value§ | ||
---|---|---|---|---|---|---|---|
Untreated N = 76
|
Treated N = 353
| ||||||
Birth weight, N (%) | NS | ||||||
<2.5 kg | 402 (6.16) | 61 (7.61) | 29 (8.81) | 32 (6.77) | 2 (2.90) | 22 (6.94) | |
2.5 kg −3.5 kg | 4,191 (64.25) | 512 (63.84) | 224 (68.09) | 288 (60.89) | 44 (63.77) | 192 (60.57) | |
3.5 kg< | 1,930 (29.59) | 229 (28.55) | 76 (23.10) | 153 (32.35) | 23 (33.33) | 103 (32.49) | |
Pre-term birth, N (%) | 4,829 (25.88) | 264 (32.51) | 117 (35.35) | 147 (30.56) | 24 (31.58) | 93 (26.35) | NS |
Breast-fed child, N (%) | 3,709 (54.36) | 460 (53.74) | 197 (56.29) | 263 (51.98) | 33 (45.21) | 186 (55.36) | 0.1150 |
Treated vs. untreated asthma
Odds Ratio | Confidence interval 95% | p-value | |
---|---|---|---|
Centres
| |||
Bordeaux vs. Strasbourg | 2.816 | 1.121–7.075 | 0.0436 |
Asthma severity
| |||
Level 2 vs. Level 1 | 11.619 | 2.738–49.311 | 0.0009 |
Level 3 vs. Level 1 | 6.680 | 2.330–19.065 | 0.0004 |
Number of attacks
| |||
1 to 3 attacks vs. no crisis | 10.202 | 3.843–27.084 | <0.0001 |
Night awakening
| |||
Less than one crisis/week vs. never | 4.029 | 1.139–14.253 | <0.0307 |
Asthma attacks
| |||
Less than one attack per year vs. crises have disappeared | 4.428 | 2.017–9.722 | 0.0002 |
Less than one attack per month vs. crises have disappeared | 16.652 | 5.948–46.616 | <0.0001 |
1 or more attacks per month vs. crises have disappeared | 70.728 | 9.414–531.388 | <0.0001 |
Wheezing after an exercise
| 17.384 | 7.165–42.178 | <0.0001 |
Missed school days
| |||
One day and more vs. none | 11.480 | 2.650–49.734 | 0.0011 |
Lifetime eczema
| 2.206 | 1.269–3.835 | 0.0050 |
Lifetime allergic rhinitis
| 3.055 | 1.310–7.122 | 0.0097 |
SPT Positivity to indoor allergens
| 3.691 | 2.024–6.734 | <0.0001 |
SPT Positivity to outdoor allergens
| 2.458 | 1.215–4.970 | 0.0123 |
HBR10
| 2.854 | 1.157–7.040 | 0.0228 |
HBR15
| 5.950 | 1.389–25.482 | 0.0163 |
Medication compliance
| |||
Most of the treatment vs. nothing | 37.648 | 1.742–813.854 | 0.0207 |
All treatment vs. nothing | 36.005 | 3.169–409.117 | 0.0039 |
Attacks prevention
| 2.311 | 1.317–4.054 | 0.0035 |
Medication during asthma attacks
| 2.857 | 1.222–6.680 | 0.0154 |
Management of asthma by the child
| 6.697 | 3.702–12.113 | <0.0001 |
Living near a bus stop
| 2.423 | 1.298–4.522 | 0.0055 |