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Canterbury Respiratory Research Group - NewsWHY DOES N.Z. HAVE SUCH HIGH RATES OF ASTHMA?Despite high-tech medicine, despite a battery of pharmaceuticals, the prevalence of asthma in this country continues to climb, and no one knows exactly why. That is the motivation for the Canterbury Respiratory Research Group at the Christchurch School of Medicine to investigate the risk factors which might cause asthma and atopy or inherited allergies in infants. Research Group Director, and Respiratory Physician, Professor Ian Town says asthma is now the most common serious medical condition affecting New Zealanders. "The numbers are very significant; 21% of children under 14 have asthma, and it's been estimated approximately 450,000 people have been diagnosed at some time in their lives," he says. " There is a huge direct cost to the health system of about $160 million, let alone the indirect costs of days off work etc." The Canterbury Respiratory Research Group has been collaborating with researchers from the Wellington Asthma Research Group to examine 1000 new-born infants and follow them for the first five years of life to isolate the risk factors which contribute to the onset of this debilitating illness. Detailed information is being collected on diet, infections, immunisations and the domestic environment, and blood is also taken from the umbilical cord for later analysis. "Our approach has been driven by the fact that the increased rates of asthma in this country is a relatively recent phenomenon, and therefore any change in genetic susceptibility seems unlikely. This is reflected in the fact that a lot of recent attention internationally has been paid to links between environmental factors and the onset of asthma; such as allergen exposure, infections diet, and other non-genetic variables." "Quite how all these possible causes interact is still unclear. We're hoping our research over five years of several hundred children will help us understand more clearly why one particular infant develops asthma or allergy while another doesn't." Although Wellington has completed recruitment for this study, recruitment for the Christchurch cohort is still in progress and should be completed by May 2001. Participants are recruited antenatally through selected midwives. The infants enrolled in the study will, with their parents' consent, be followed from birth to see if they develop any allergies or symptoms of asthma. A research nurse visits the mothers in their homes after the birth and when the babies are 3 months and 15 months old. A short questionnaire is administered at the first visit and more detailed questionnaires are administered at the 3-month and 15-month visits, covering the topics of feeding practices, family health, vaccinations, medications, indoor environment, smoking and child care. Dietary information is updated by telephone when the infants are 6 months old. Dust samples are collected from the infant's bed and floor at the 3-month and 15-month visits. At the 15-month visit the infant's vital statistics (height, weight, head circumference etc) are recorded and, with parental consent, each infant is skin tested for 9 common allergens. Telephone questionnaires are administered when the infants are two, three and four years old. The Infant Cohort Study has been running for nearly three years and is expected to continue for another 2 years at least with results published for the 15 month assessment in 2002. It will share many common features with similar studies in Europe, but will focus on specific New Zealand conditions and risk factors. Finally, it is expected this study will provide further important information for GPs and respiratory physicians in this country as to some of the key causes of asthma and allergies in young children, assisting doctors with more accurate and effective early management. This research is funded by the Health Research Council of New Zealand, The Canterbury Respiratory Research Trust, and The Guardian Trust.
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