Asthma, Rhinitis, Other Respiratory DiseasesAsthma prevalence and morbidity among rural Iowa schoolchildren☆
Section snippets
Methods
The study was approved by the Institutional Review Board of the University of Iowa. The study sample was all children aged 6 to 14 years who were enrolled in one of 10 school districts in either of 2 noncontiguous rural Iowa counties during the academic years 1999-2000, 2000-2001, and 2001-2002. The 2 counties were selected because of their close similarity in agricultural production. Screening was conducted during 3 separate time periods, each consisting of approximately equal numbers of
Results
The study population is described in Table I. The lifetime prevalence of wheeze was 30.9%. Wheezing in the past year was reported by 19.1%. A physician diagnosis of asthma was reported by 13.4%. Among those who had ever wheezed, more than a third reported frequent symptoms, and 15.3% reported severe symptoms in the past year.
Multivariable analyses are displayed in Table II. Results of stratified analyses and tests for county by residence–type interactions (P values between .07 and .26)
Discussion
A high response rate was obtained in this large, rural, population-based study using an internationally standardized instrument for measuring the prevalence of wheeze and asthma. We found a prevalence of wheeze or asthma comparable with that seen in Midwestern cities, thus casting doubt on a protective effect of rural living for the development of asthma. Comparing our results with those of other studies that used the ISAAC questionnaire, the 12-month prevalence of wheeze (19.1%) was comparable
Acknowledgments
We acknowledge the advice and collaboration of the following asthma subcommittee members in the 2 counties: Rob Baker, Tadd Davis, Valerie Hammes, David Harris, Linda Northup, Mary Beth Adams, Sharon DellaVedova, Linda Grande, Chris McFarland, Thomas O'Toole, and Scott Rollinger. Study research staff collected and entered the data and were responsible for achieving the questionnaire response rate: Ruth Walker, Linda Harris, and Avis Hill.
We acknowledge the guidance and cooperation of numerous
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Supported by a grant jointly funded by the NIEHS (ES09607) and the EPA (R826711). The authors also acknowledge support from the University of Iowa, Environmental Health Sciences Research Center (NIEHS P30-ES05605).