Reducing the burden of recurrent preschool wheeze and asthma in children and young people in England
Research Team: Dr Hanna Creese, Prof Sonia , Dr Dougal Hargreaves, Prof David Taylor-Robinson, Prof Jennifer Quint, Prof Alex Bottle, Prof Sejal Saglani & Dr Kate Mason
Who's involved: Imperial College London & LiLaC
July 2019 - March 2022
Our findings will add to the evidence for public health policy makers about early prevention strategies to ensure optimal conditions during pregnancy and childhood to support the healthy development of children, and the reduction in inequalities and burden of recurrent preschool wheeze and asthma in children and young people.
Recognising which children and young people are at risk of recurrent preschool wheeze and the eventual development of asthma will help general practitioners (GPs) to reduce the risk of severe, and sometimes fatal, attacks.
Parents and children will benefit from knowing about the impact of preventive care and limiting environmental risk factors on recurrent preschool wheeze and asthma. This may encourage closer monitoring of at-risk children and lifestyle changes to reduce the risk of attacks.
To compare modifiable factors to reduce the number of children and young people with recurrent preschool wheeze and asthma.
Around a third of children under the age of 5 years experience wheeze. Recurrent wheeze is potentially preventable through effective primary care following an initial wheeze attack and limiting environmental risk factors such as passive smoke exposure. Few studies have examined the risk factors for re-admission or future attacks in the preschool population.
One in three children with preschool wheeze progress to an asthma diagnosis by their 6th birthday. Asthma disproportionately affects disadvantaged groups with steep social gradients in admissions. The extent to which environmental exposures in early life contribute to recurrent preschool wheeze and persistent asthma in children and young people is unknown.
We will use longitudinal data sources from the NHS to investigate the timing, and rate of, re-attendance and re-admissions for preschool wheeze. We will examine the impact of preventive care and environmental characteristics on rates of recurrent wheeze. Using a national birth cohort study, the Millennium Cohort Study, we will compare the relative impacts of modifiable early life environmental exposures on risk of recurrent wheeze and the development of asthma in mid to late childhood and adolescence.
We are in discussion with the NIHR Northwest London Applied Research Collaboration to facilitate local patient and public involvement. We will have a lay representative on the steering group for input and advice for the duration of the study.
The study findings will be presented at local national and international conferences and submitted for publication in open access peer-reviewed scientific journals. We will disseminate our findings to the public through research networks, social, print and media broadcasts and community engagement opportunities. To ensure impact of our findings we will work with policy makers for direct application.
Creese H, Orchard E, Pike V, Saglani S, Saxena S. (2021). The Covid-19 Pandemic and Children With Recurrent Wheeze and Asthma in the UK: Parents Views on Next Steps for Research. Res Pediatr Neonatol. 6(2).
Creese H, Lai E, Mason K, et al. (2021) Disadvantage in early-life and persistent asthma in adolescents: a UK cohort study. Thorax.
Creese H, Taylor-Robinson D, Saglani S, Saxena S (2020). Primary care of children and young people with asthma during the Covid-19 era. British Journal of General Practice.
Creese H, Mason, K, Schlüter D K, Taylor-Robinson D, Saxena S (2020). Abstract: Early years pathways to inequalities in childhood asthma? A causal mediation analysis. European Journal of Public Health.
Background Many children in England are overweight. In 2022/23, about 23 out of 100 children aged 10–11 years were obese. Some children drink lots of sugary drinks, eat too much highly processed food and do not eat enough fruit and vegetables. It can be harder for families with less money…
Background Discrimination is a profound social injustice that fundamentally affects people’s physical and mental health. People often experience more than one form of discrimination at a time, based on race, age, gender, sexual orientation, etc, and this makes its impacts even more complex. We know that…
Background In our day-to-day lives, we are exposed to companies trying to sell us things through advertising and sponsorship. This is often for products that can be harmful to people and to the planet. Examples of this include unhealthy food and drink, vaping, gambling and cars and can often be…