Clinical Picture
A precise diagnosis of a given respiratory complaint is complicated
by the fact that there may be multiple causes from both indoor
and outdoor sources, symptoms are often non-specific and
may be atypical in children. Symptoms may also be non-distinct
when there is exposure to low levels of pollutants, or they
may mimic those related to allergic responses or respiratory infections.4
Children can present with a range of
respiratory and related symptoms including:
- sneezing
- wheezing
- sore throat
- coughing
- shortness of breath
- chest tightness
- hyper-responsive bronchi
- irritated eyes, nose
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The physician will have to carefully consider the variety of possible
environmental exposures that might be influencing the child’s respiratory
health when deciding on the differential diagnosis.
Asthma
- Asthma is the most common chronic childhood illness
and has substantially increased in prevalence over the last two
decades. In Canada, research indicates that there has been a fourfold
increase in asthma prevalence in children under age 15 in the
last 15 years.6
- The exact etiology and pathogenesis of asthma is poorly understood,
although it is likely a result of both genetic (i.e., inherited
differences) and environmental influences. It is believed
that asthma may be initiated by exposure to indoor air
allergens, including those from house dust mites, cats, cockroaches
and moulds. Children’s exposure to indoor allergens and pollutants
has increased as houses and buildings have become more airtight
with reduced air exchange and ventilation.
- Indoor and outdoor air quality definitely contributes substantially
to the burden of illness from asthma. Exposure to pollutants in
air appears to trigger asthmatic attacks and/or worsen existing
symptoms.
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