Local Publications

The following publications used ISAAC data from the Seattle centre:

  • Maier WC, Arrighi HM, Morray B, Llewellyn C, Redding GJ. Indoor risk factors for asthma and wheezing among Seattle school children. Environ Health Perspec 1997; 105(2):208-14.
  • Debley JS, Carter ER, Redding GJ. Prevalence and impact of gastroesophageal reflux in adolescents with asthma: a population-based study. Pediatr Pulmonol.2006 May;41(5):475-81.
  • Carter E, Debley J, Redding G. Chronic productive cough in school children: prevalence and associations with asthma and environmental tobacco smoke exposure. Cough 2006, 2:11
  • Carter E, Debley J, Redding G. Changes in asthma prevalence and impact on health and function in Seattle middle-school children: 1995 versus 2003. Ann Allergy Asthma Immunol 2005; 94(6):634-639.

Seattle Centre

Phase OnePhase TwoPhase Three View Centre Details
Centre:Seattle, USA ( North America )
Principal Investigator:Professor Gregory J Redding
Age Groups:13-14Timeframe:
Sampling Frame:All middle schools within the Seattle Public School District
Phase OneView Centre DetailsPhase TwoPhase Three
Centre:Seattle, USA ( North America )
Principal Investigator:Professor Gregory J Redding
Age Groups:13-14Timeframe:June 2003 to June 2003
Sampling Frame:13-14yr: All middle schools in the Seattle School District. Same sampling frame as Phase One.


Professor Gregory J Redding

Professor Gregory J Redding

Seattle Children's Hospital & Regional Medical Center
Pulmonary Division 3D-4
4800 Sand Point Way NE
P O Box 5371/ 3D-4


  • Phase One Principal Investigator for Seattle
  • Phase Three Principal Investigator for Seattle

The ISAAC Experience

The United States joined the ISAAC network of centers late in the process, conducting school-based surveys with 2,330 students and through parental reports of 925 6-9 year old children in 1995. The former were added in the ISAAC database; the latter group was also asked about indoor allergens and irritants and published separately in 1997.

As part of an initial descriptive study about chronic respiratory symptoms among indigenous arctic populations, we amended the ISAAC survey to include a question on chronic productive cough. The survey among 365 Yupik Eskimo children in middle schools found that 40% had chronic respiratory symptoms, half with asthma and half with chronic productive cough or bronchitis. Asthma prevalences between Native Alaskan and American Indian children in Washington state were then compared using the ISAAC survey.

In a parallel effort, we used the ISAAC survey tool to evaluate the presence of asthma and asthma symptoms among 5495 5-11 year old Vietnamese children in Hanoi and identified environmental features associated with atopic and asthma symptoms.

During Phase III of the ISAAC project, we repeated the Phase I survey among 2,398 middle school children in Seattle but added to the survey questions regarding symptoms associated with gastro-esophageal reflux and also chronic productive cough. We found upon comparison with the Phase I data that diagnoses of asthma became more common but outcomes of asthma, once diagnosed, were no different. We also found that symptoms of gastro-esophageal reflux were more common among children with current asthma symptoms and that the frequency of symptoms of gastro-esophageal reflux correlated with medical care utilization among children with asthma. .

By adding a question regarding chronic productive cough among non-native children in Seattle, we could compare our previous data among Eskimo children to an urban mixed race cohort of the same age. The prevalence of chronic productive cough among Seattle middle school children in 2003 was 3% and was associated with tobacco smoke exposure, gastro-esophageal reflux, and a diagnosis of asthma.

Lessons Learned.

The information provided by the ISAAC surveys has been invaluable in raising the awareness of the policy makers in Washington about the persistence and impact of asthma among school children. Using additional questions in the survey has allowed up to sample large groups of children to assess the importance of self-reported chronic bronchitis and gastro-esophageal reflux among school children of different cultures in the Unites States. This has in turn led to additional research about these additional conditions.