Link-up Between Abuse and Childhood Asthma Confirmed

It has been found in a recent survey that children who have faced any kind of physical or sexual abuse in their childhood are at a greater risk of developing asthma at some point in time, than those who have had no such traumatic experience.

According to a study of urban children in Puerto Rico, which has been published in the first issue for September, of the American Journal of Respiratory and Critical Care Medicine, children who were physically or sexually abused, had more than twice the chances of developing asthma than those of their peer group who were not.

The researchers in the Brigham and Women's Hospital in Boston, studied 1200 urban children in Puerto Rico, for their research and found a direct cause and effect relationship, between child abuse and asthma, which found its roots in stress or more rightly termed distress/trauma, as the real reason.

"It certainly seems biologically plausible, particularly considering that it's hard to think of any more stressful circumstance for a child than physical or sexual abuse, especially when that abuse comes from within the family," said Dr. John Heffner, Former American Thoracic Society President, speaking on the subject.

Out of the 1200 children interviewed by the researchers it was found that 20 percent of them who had a past associated with either form of abuse, suffered from asthma too. Not only this, these numbers were double than those obtained for children without a past dogged by abuse. They had an 11.5 percent rate of asthma.

Specifically, 15 of the 75 children (20%) with a history of abuse had current asthma compared to 128 of 1,117 children (11.5%) without history of abuse had current asthma.

These same children, almost 1353 in number and their parents were earlier studied in pairs between 2001 and 2003 and re-surveyed almost two years later, when only 1200 were available for the study, on parameters like - stress, violence, diagnosis of asthma, and treatment the children experienced.

"We already know that there is a high prevalence of asthma in Puerto Rican children, and many studies have linked stress and exposure to violence to health problems in childhood, including asthma," said principal investigator, Juan C. Celedón, M.D., Dr.P.H. of Brigham and Women's Hospital in Boston.

The real reason behind this kind of a link up as speculated by the researchers is the altered hypothalamic-pituitary-adrenal (HPA) axis, due to the abuse and the trauma related with it, which further depresses the glucocorticoid response, as a result of which there is decreased suppression of airway inflammatory responses, leading to asthma.

Many other studies from the past have also shown a clear relationship between stress, trauma and asthma both in children as well as adults however, it is more pronounced in children due to lesser immunity. As per these studies stress increases the chances of having an asthma attack in children by almost five times. It can have both immediate as well as delayed effects.

Asthma is one of the most common chronic diseases worldwide, especially in children. It occurs early in life and chances are that in many cases it stays life long. Here are some facts regarding asthma in children –
• Asthma accounts for 14 million lost school days.
• After maternal asthma, physical and sexual abuse are the second most common causes of asthma in children.
• In US an estimated 4.1 million children suffer from asthma in the under 18 years category.
• The prevalence of asthma in under 4year olds has risen an alarming 160% from 1980 to 1994.
• 80% of asthma onset in children is after the age of 5 years.
• 40% of asthmatics have sleep disturbances and it is the main reason for children being hospitalized world over.