Perth Centre

Personnel

• Professor Louis Landau
• Dr Lyle J Palmer
• Professor Peter Sly

Perth Centre.

Perth was very pleased to participate in ISAAC. There are a number of internationally recognized experts in asthma and allergy working in Perth, ranging from research in the basic sciences to clinical care and long term cohort studies. It was appreciated that participation in a world wide study of the relationships between asthma/allergy and environmental factors would be complementary and add value to the work being done.

ISAAC Experience.

Apart from the contribution of data to the world wide analyses and reports, 2 separate studies of the Perth data have been published. One study aimed to investigate the relationship between socio-economic factors and symptoms of asthma and atopy in the 6-7 year old ISAAC cohort in Western Australia. Parental questionnaire responses were obtained in 2,193 children in 34 randomly selected primary schools in the Perth metropolitan area. Children born in Australia had a significantly increased risk of current asthma (OR 2.37, p=0.001). Having a mother born in Australia was the only factor independently associated with an increased risk of current hay fever (OR 1.56, p=0.005). Increasing numbers of people living in the home were significantly associated with a multiplicative decrease in risk of current asthma (OR 0.88,p=0.02)and eczema (OR0.82, p=0.01). Houses made of fibrocement (OR2.40,p=0.02) and the presence of mats on less than half the floor area in the main bedroom (relative to wall to wall carpet) were associated with an increased risk of current eczema (OR3.50,p=0.003). All reported associations were independent of socioeconomic status, age and sex. This study suggested that household and country specific environmental factors are associated with asthma, hay fever and eczema risk in 6-7 year old children, and may have contributed to the increased prevalence of these diseases in Australia.

Another study investigated whether regular check-ups and preventive drug use reduced asthma symptoms in 2,193 primary school children in 34 primary schools aged 6-7 years and 3,650 secondary school children aged 13-14 years in 9 secondary schools, selected at random by cluster sampling. Asthma severity in the past 12 months was measured by the number of attacks of wheezing, visits to a doctor for care of an exacerbation of symptoms, visits to a hospital emergency department and admissions to hospital for wheezing or asthma. Analysis by multivariate ordinal logistic regression indicated that regular general practitioner check ups were associated with reduced asthma severity. Regular use of prophylactic and bronchodilator medications were associated with reduced symptoms. Asthma action plans and peak flow meter usage were associated with reduced hospital admissions. If these associations prove to be causal, then regular GP check-ups are particularly effective in reducing the health consequences of asthma in children.

References.

Palmer LJ, Valinsky L, Pikora T, Zubrick SR, Landau LI. The association of environmental factors with asthma and allergy in a population based sample of school children from Western Australia. Eur Resp J 1999;14:351-7.
Palmer LJ, Valinsky L, Pikora T, Landau LI. Do regular check-ups and preventive drug use reduce asthma severity in school children? Aust Fam Phys 2004; 33:573-6.

Acknowlegements.

National Health and Medical Research Council.
School of Paediatrics and Child Health, The University of Western Australia.
Telethon Institute for child Health Research.
Princess Margaret Hospital for Children, Perth, Western Australia.
Children, parents and school staff who participated in the surveys.