Children and young people

Worldwide incidence of asthma readmission is up to 40% (ref 1, intro).

NSW (ref 1,3)

A retrospective longitudinal study looking at 48,217 asthma hospitalisations in children aged 2-17 years reported that over 1 in 5 children hospitalised for asthma in NSW between 2007 and 2022 were readmitted for asthma within a year, costing an average AU$2593 per readmission. (ref 1)

The study included all children born in NSW between 2005 and 2015 who had at least one asthma hospitalisation across NSW between 2007 and 2022.

Findings (ref 1):

• 21.6% of children were readmitted to hospital due to asthma within 12 months
• readmitted children were younger than non-readmitted ones (mean age 3.8 vs 4.37) with 81% of readmitted children being aged 2-4 years (vs 65% of non-readmitted)
• overall incidence rate for the first asthma readmission within the 12 months was 23.8 per 100 person-years (95% CI 22.6 to 25.1)
• the incidence rate of asthma readmission was twice as high in children 2-4 years and went down with age up to the age group (28.7 per 100 person-years for 2-4 yo; 14.7 for 5-9 yo; 11.2 for 10-14 yo) but then increased again in older adolescents (18.0 per 100 person-years in 15-17 yo)
• the readmission incidence rate was highest in the first month following hospitalisation

• readmission incidence rate was higher in the more disadvantaged areas and major cities, implying socioeconomic disparities with higher population density, traffic congestion, and environmental pollution

• First readmission cost on average AU$2593 in direct medical cost per episode,  but increased with age up to 10-14yo: lowest cost in children 2-4 yo (AU$2867 per episode) and highest cost in children 10-14 yo (AU$4392 per episode).
• the medical cost of first asthma readmissions within 12 months was AU$ 15.6million.

Possible reasons:

• Hospital discharge without proper disease management, guideline-discordant asthma care, lack of education including reviewing inhaler technique and adequate counselling during discharge have been demonstrated to influence the risk of asthma readmission within the first few months of index hospitalisation
• Causal factors for higher readmission rate in younger children may include the high incidence of respiratory infections, particularly viral infections, environmental triggers such as environmental tobacco smoke, secondary smoking at home, traffic-related air pollution, moulds at home, dust-mite allergens, food allergens and inhalant allergens are causal risk factors for asthma readmissions among young children.

The same study/data was used to identify risk factors for these asthma readmissions (ref 3).

This second publication reported: (ref 3)

• 22% were readmitted within a year: 18% of these readmitted within 30 days (early readmission) and 82% readmitted after 30 days (late readmission)
• Most readmitted children were aged between 2 and 4 (77% of early readmissions, 81.5% of late readmissions)

Risk factors for early readmissions:(ref 3)

• children’s age 2–4 years (adjusted Relative Risk (adjusted risk ratio 1.71)
• No older siblings (1.26)
• Length of stay ≥ 2 days (1.42)
• Intensive care unit admission (2.27)
• Underlying chronic comorbidities and/or congenital anomalies (1.27)
• Admissions related to allergies or eczema (1.54)

Risk factors for late readmissions:(ref 3)

• Children’s age 2–4 years (1.93) – nearly twice as likely!
• No older siblings (1.09)
• Residence in the most socio‐economically disadvantaged areas (1.16)
• Residence in major cities (1.20)
• Index admission during spring (1.16) or summer (1.10)
• Length of stay ≥ 2 days (1.21)
• Admissions related to allergies or eczema (1.40)

VIC (ref 2)

A smaller study was conducted in VIC across 3 hospitals for 767 children 3-18 years hospitalised for asthma between 2017 and 2018. The study found that 34.3% of children were radmitted within 12 months, 69% of them being aged 3-5 yo.(ref 2)

note: the NSW data is stronger evidence as it is a population-based large study in NSW and included longer follow-up.

Asthma hospitalisations 2023 – 2024 (AIHW)
In 2023 – 2024, there were 31,994 hospitalisations with asthma as principal diagnosis.(ref 1)
This is very small increase compared to the previous year (31,107 hospitalisations in 2022-2023), a substantial increase compared to years affected by COVID-19 restrictions (e.g. about 25,500 in 2021-22) but remains below pre-pandemic level (about 37,000 in 2018-19).(ref 2)

Children under 15 accounted for 43% of all asthma hospitalisations.(ref 1)

In 2023-2024, 90% of asthma hospitalisations were potentially preventable.(ref1, 3)

*PPH: Potentially Preventable Hospitalisations (hospitalisations for asthma in people 4 years and over).

According to AIHW asthma webpage (ref 4), in 2023-24 there were:

• 32,000 hospitalisations with a principal diagnosis of asthma, representing 0.3% of all hospitalisations in Australia, and 119 hospitalisations per 100,000 population. Children 0-14 yo made up 43% of these hospitalisations (about 13,600 admissions)
• 65% of asthma hospitalisations were overnight stays, with an average length of 2.6 days
• the median age for asthma hospitalisations was 23
• When counting asthma hospitalisations as principal or additional diagnosis (any diagnosis), there were about 47,200 hospitalisations (0.4% of all hospitalisations)
• First Nations: 2,3000 hospitalisations due to asthma in First nations people, a rate of 220 per 100,000, which after adjustement for age, was 1.8 times higher than non-Indigenous Australians

Hospitalisation rates (ref 4):

• 119 per 100,000 (all ages, principal diagnosis)
• Highest among children aged 5-9 (around 405 per 100,000)
• boys aged 0–4, 5–9, and 10–14 had higher rates of hospitalisation than girls of the same age. For example, boys aged 0–4 were 1.8 times as likely as girls of the same age to be admitted to hospital

Data collected from AIHW:

• Ref 1 – asthma hospitalisations: AIHW Principal diagnosis data cubes [Internet]. Separation statistics by principle diagnosis. https://www.aihw.gov.au/reports/hospitals/principal-diagnosis-data-cubes/contents/data-cubes => open data cube Separation statistics by principal diagnosis for each year; navigate to tab 5-char PDx counts summary and add Sum of Separations for J45 and J46, tab 5-char PDx counts Data for age-specific hospitalisation counts)
• Ref 2 – asthma potentially preventable hospitalisations (PPH): AIHW. Admitted patients. https://www.aihw.gov.au/reports-data/myhospitals/sectors/admitted-patients#more-data => Download data table, chapter 8, Admitted patient care 2020–21 or 2021-22, 8 Safety and quality of the health systems, Tab S8.2. https://www.aihw.gov.au/reports-data/myhospitals/sectors/admitted-patients#more-data
• Note: PPH are all hospitalisations with asthma as principle diagnosis in people aged 4 and over. Ref: AIHW. METEOR. National Healthcare Agreement: PI 18–Selected potentially preventable hospitalisations, 2021. (https://meteor.aihw.gov.au/content/725793)

Hospitalisations (ref 1), PPH (ref 2) and Hosp. rate (ref 3) 2016-2017 to 2020-23:

* Hospitalisation counts potentially affected by Covid pandemic measures

Hospitalisation rates 2011-12 to 2021-22 (age standardised, principal diagnosis, per 100,000 population) – ref 3, Fig 15

Information from the burden of Disease study 2024:(ref 1)

In 2024, Asthma was the 10th leading contributor to the total burden of disease in Australia with a disability-adjusted life years (DALY) rate of 5.35 per 1,000 population (143,782 DALY, crude number), similar to 2023
– After adjustment for age structure, asthma was the 8th leading cause of total burden, with an age-standardised DALY rate of 5.3 DALY per 1,000, similar to 2023 (8th) but up from 9th in 2018 and 2015, and 10th in 2011 and 2003, with an increase by 8.5% in the last 21 years (from 4.9 per 1,000 in 2003; 4.4 in 2011; 5.0 in 2015; 5.2 in 2018; 5.3 in 2023 and 5.3 in 2024)
– 5.7% of the total asthma burden was fatal, 94.3% was non-fatal

By gender:
– Asthma ranked 6th in females of all ages for total burden (after adjusting for age) with an age-standardised DALY rate of 5.7 DALY per 1,000, up from 7th in 2018 and a 4.3% increase since 2003, but unchanged compared to 2023
– Asthma ranked 10th in males of all ages for total burden (after adjusting for age) with an age-standardised DALY rate of 4.9 DALY per 1,000, down from 9th in 2018 and a 13.5% increase since 2003, but unchanged compared to 2023

By age groups (age-specific DALY per 1,000), asthma ranked as leading cause of total burden of disease:
– Under 5 year-olds (0-4): 5th in females ( accounting for 2.9% of total burden) and in males (3.4% of total burden)
– under 1 year-olds: ranking 25th overall (24th in males, not in top 25 for females)
– 1-4 year-olds: ranking 1st in boys, girls and overall
– 5-9 year-olds: 1st in females, 2nd in males after Autism spectrum disorder, ranking 1st overall
– 10-14 year-olds: 2nd in females, 2nd in males and 2nd overall
– 5-14 year olds: 1st in females (accounting for 10.7% of burden) and 2nd in males (accounting for 12.8% of burden)
– 15-19 year-olds: 6th in females, 5th in males, 4th overall
– 20-24 year-olds: 5th in females, 8th in males, 6th overall
– 25-44 year olds: 4th in females (accounting for 4.7% of burden), not in the top 5 for males
For asthma burden for other age groups, see Fig 3.4 (Rank by number) on AIHW web report.

Note: to compare epidemiological data, it is usually preferred to use age-standardised statistics to ensure the differences are not caused by variations in age structure and an ageing population, unless the data is for specific age ranges in which case “crude” age-specific statistics are used.

Figure 3.5: Disease- or injury-specific summary of disease burden in Australia: Asthma

Risk factors attributable burden of asthma: it was estimated that in 2024
– 36% of asthma total burden was due/attributed to all risk factors combined
– 24% was due/attributed to being overweight (including obesity)
– 7% was due/attributed to tobacco use
– 5% was due/attributed to occupational exposures and hazards
Air pollution, although not directly linked to asthma burden, was linked to other respiratory conditions and was estimated to contribute 7.5% to the burden of Chronic Obstructive Pulmonary Disease.

Additional information reported in AIHW Asthma webpage: (ref 2)

In 2024, asthma accounted for:

• 2.5% of total disease burden (DALY), 4.3% of non-fatal burden (YLD) and 0.3% of fatal burden (YLL)
• within the respiratory disease group, it accounted for 35% of total disease burden, 51% of non-fatal burden and 5.3% of fatal burden

The rate of burden from asthma was higher in females vs males (1.2 times higher with 5.8 vs 4.9 DALY per 100,000 population)

Trends over time:

The age-adjusted rate of burden due to asthma increased between 2003 and 2024 from 4.9 to 5.3 DALY per 100,000. The increase was driven by non-fatal burden.

Age-standardised DALY rates due to asthma, 2003 to 2024:

Ecological study using data from the Census 2021 (self-reported asthma prevalence in 4,6 million aged 0-14) for spatial clustering using statistical area level 2 (SA2, a ‘suburb’ within cities and catchments of rural areas, population around 3000 to 25000) and statistical modelling. The study reported that: (ref 1)
– 6.27% overall (average) childhood asthma prevalence in these geographical areas, ranging from 0 to 16.5%
– 465 areas (suburbs) were hotspots (they had a prevalence above the average 6.27% and were surrounded by areas with similar prevalence) , representing 20% of all areas
– NSW had the most hotspots (39%) followed by VIC (21%), QLD (18%) and TAS (11%)
– More than 60% of hotspots were in socio-economically disadvantaged areas
– Higher asthma prevalence in areas of areas of SE disadvantage vs advantage (10% higher, PR=1.10)
– Higher asthma prevalence in areas with high proportions of First Nations people (13% higher, PR=1.13)
– Hotspots mostly observed in regional or remote areas of New South Wales, Victoria, Queensland, and Tasmania

Concl/Discussion: Childhood asthma variation was found to be associated with area-level sociodemographic features, such as social deprivation and Indigenous density. These findings can be attributed to environmental features including socioeconomic deprivation, race or ethnicity, pollen, dust, exhaust pollutants, air pollution, violence, or crime, as well as limited access to healthcare because the majority of specialised paediatric asthma services are located in tertiary metropolitan hospitals.

Note/Limitations: ecological studies can demonstrate associations rather than causal relationships, and parent-reported data may not be reliable due to reporting bias.

23 Hotspot Regions

The hotspot suburbs with high asthma childhood prevalence were identified in 23 SA4 areas (regions/shires, mostly with a population over 100,000) listed below: (ref 1 and 3)

Note: reference 3 is a Data on File ( UNSW Asthma hotspots – Childhood-Asthma-Clusters-Data-by-suburb-SA2-with-electorates .xlsx) provided by UNSW and can’t be shared without approval from UNSW.

Refer to attached file (Ref 3) for detail of hotspot suburbs (SA2s) included in each region (SA4).

Reproduced from Ref 4:

UNSW data – Asthma Hotspots in WA and NT (ref 5):

UNSW data on file – asthma hotspots WA – email J Khan 20 Jan 2026.pdf

UNSW team shared with AA that 4 hotspot suburbs (SA2) out of 465 were located in WA, and none were located in NT:

Note that most areas in WA exhibited relatively low asthma prevalence. This pattern may reflect a combination of low population density, and the potential for underdiagnosis, particularly in remote communities.

According to AIHW asthma report 2024 (ref 1), the peaks for asthma hospitalisations generally occur for children:

• in late summer (February): the peak in February is related to respiratory infections spreading with return to school and childcare after the summer break, and possibly a lower use of preventer medicines during the summer break
• in autumn (May)
• One-off natural events occurring on a seasonal basis like bushfires and thunderstorms can also impact asthma hospitalisations

2020 was an exception to this general trend, with a large decrease in hospitalisations in April and May for all age groups, due to COVID measures and lockdowns.

Figure 16: Monthly variation in hospitalisations due to asthma, by age group, 2017 to 2021 (ref 1)

Refer to Fig 16 on AIHW website to obtain exact hospitalisation rates per months and age groups.

New research using geographical modelling of the 2021 Census data to map the prevalence of asthma in children aged 5-14 reported:
– On average, childhood asthma prevalence was 7.9%, 8.2%, 8.5%, and 7.6% in Sydney, Melbourne, Brisbane, and Perth, respectively (intra-city special variation)
– prevalence ranged between 6 and 12% between least and most affected locations in each city (intra-city special variation)
– 66% of this intracity variation was attributed to the following covariates in Australian-born non-Indigenous children: climatic and environmental factors (30%), outdoor air pollution (19%), Socio-economic status (51%)

Letter to the Editor, emphasising latest data/findings on childhood asthma in Australia including:
Facts:
– High prevalence (8.5% for children 0-14)
– Leading cause of burden of disease
– Hospital admissions have decreased in the last decade
– About 1 in 10 children dispensed SABA (e.g. Ventolin) through the PBS (as opposed as over the counter) have poor asthma control
– Only one in three (29%) children that have been dispensed a preventer used it regularly
– Overreliance on SABAs (reliever) and underuse of ICS are an enduring problem in childhood asthma, as these indicators have not improved in the last 5 years
– 1 in 3 hospitalised children is readmitted within 12 months for asthma (compared to 1 in 5 a decade ago) — Note: this is from a study looking at children admitted in 2017-18
– only 16.2% of children admitted to the hospital due to asthma were prescribed ICS before admission, and of those who were not on a preventer at the time of admission only 12.2% were commenced during the admission
– only 25.6% of children admitted to the hospital with asthma received asthma education and only one‐third of children had an assessment of their inhaler technique during their admission
– several studies from across Australia highlight guideline‐ discordant care across many settings (including pediatricians), which is a known risk factor for hospital readmission

Barriers:
A lack of standardized management and asthma action plans, inadequate systems to allow for timely follow‐up with GPs, inadequate asthma education for parents/carers, and lack of integrated asthma care between GPs and hospitals7 are some of the barriers to optimal asthma management in Australian children.

What is needed:
Multidimensional interventions have been shown to improve asthma control and reduce hospitalization, including asthma self‐management education, home environmental assessment regarding potential asthma triggers and supporting families to deliver asthma care at home, care coordination between primary and tertiary care, and school involvement to support the administration of asthma medications.

According to the National Health Survey 2022, amongst people with asthma in 2022:
– Just under half (48.7%) of children used asthma medication in the prior 2 weeks, compared to more than 3 in 5 (63.5%) of adults
– 1 in 3 (33.9%) people with asthma used daily medication in the prior 2 weeks
– 2 in 5 (39.1%) did not take medication in the prior two weeks

In 2023, Asthma was the 10th leading contributor to the total burden of disease in Australia with a disability-adjusted life years (DALY) rate of 5.34 per 1,000 population (141,621 DALY, crude number).
– After adjustement for age structure, asthma was the 8th leading cause of total burden, with an age-standardised DALY rate of 5.3 DALY per 1,000, up from 9th in 2018 and 2015, and 10th in 2011 and 2003, an increase by 8.4% in the last 20 years (from 4.9 per 1,000 in 2003; 4.4 in 2011; 5.0 in 2015; 5.2 in 2018 and 5.3 in 2023)
– 5.7% of the total asthma burden was fatal, 94.3% was non-fatal

By gender:
– Asthma ranked 6th in females of all ages for total burden (after adjusting for age) with an age-standardised DALY rate of 5.7 DALY per 1,000, up from 7th in 2018 and a 4.1% increase since 2003
– Asthma ranked 10th in males of all ages for total burden (after adjusting for age) with an age-standardised DALY rate of 4.9 DALY per 1,000, down from 9th in 2018 and a 13.8% increase since 2003

By age groups (age-specific DALY per 1,000), asthma ranked as leading cause of total burden of disease:
– Under 5 year-olds (0-4): 5th in females ( accounting for 3% of total burden) and in males (3.5% of total burden), ranking 5th overall — however, ranking 1st in boys, girls and overall for the age group 1-4
– 5-14 year-olds: 1st in females (11.1% of total burden) and 2nd in males (12.8% of total burden) after Autism spectrum disorder, ranking 1st overall
– 15-24 year-olds: 5th in females (5.1% of total burden) and in males (4.7% of total burden), ranking 4th overall
– 25-44 year-olds: 4th in females (4.7% of total burden) and 9th in males (5th overall)
– In 45-64 year-olds: 8th in females and 15th in males (12th overall)
– In 65-84 year-olds: 17th in females and beyond 20th in males (20th overall)
– In 85 year-olds and older: beyond 20th for females, males and overall

Note: to compare epidemiological data, it is usually preferred to use age-standardised statistics to ensure the differences are not caused by variations in age structure and an ageing population, unless the data is for specific age ranges in which case “crude” age-specific statistics are used.

COVID measures: lockdowns and travel restrictions until end of 2021, returning to normal in early 2022, all compulsory public health restrictions ceased by September 2022

Hospitalisations (in public hospitals) in 2021/22- pandemic year:
* In 2021/2022, there were over 25,000 hospitalisations for asthma (in public and private hospitals), of which more than 10,000 (42%) were in children aged under 15.(ref 1)
*90% of asthma hospitalisations were considered potentially preventable.(ref 1, 2) — scroll down to PPH by states and territory table

* there were about 25,500 hospitalisations with asthma as principal diagnosis in 2021-22 (hospitalisation rate of 99 per 100,000 population, or 101.5 per 100,000 when age-standardised), representing 0.2% of all hospitalisations in Australia (ref 3)

By age groups: (see graph below)
* most of asthma hospitalisations were in children aged 0-9 (ref 3)
* children aged 0–14 had a markedly higher hospitalisation rate than people aged 15 and over (225 vs 70 per 100,000 population) (ref 3)
* boys aged 0–14 were 1.6 times as likely as girls of the same age to be admitted to hospital for asthma (ref 3)
*in people aged 15 and over, females were 2.4 times as likely as males to be admitted to hospital for asthma (ref 3)

For potentially preventable hospitalisations by states, see: AIHW. Admitted patient care 2021-22. Table S8.2. https://www.aihw.gov.au/reports-data/myhospitals/sectors/admitted-patients

For potentially preventable hospitalisations counts, rates and average length of stay at the National, PHN and SA3 level, download data table from https://www.aihw.gov.au/reports/primary-health-care/potentially-preventable-hospitalisations-2020-22/data (ref 4)

Graph available at https://www.aihw.gov.au/reports/chronic-respiratory-conditions/asthma (Ref 3, accessed 8 Oct 2024):

Note: first entry on 13/07/2023; last update on 8/10/2024

Asthma was the 8th leading contributor to the total burden of disease in Australia in 2022, with a disability-adjusted life years (DALY) age-standardised rate of 5.2 per 1,000 population (138,048 DALY) compared to 9th in 2018 and 10th in 2003. This represents a 7.8% change since 2003. In, 2022, 5.9% of the asthma burden was fatal (8,087 years of life lost), and 94.1% was non-fatal (129,954 years lived with disability). Asthma contributed 2.5% to the total burden in Australia.

By sex and age groups, asthma ranked (age-specific DALY rates):
– 5th leading cause of total burden for children under 5 boys (3.5% of total burden) and girls (3.0% of total burden)
– 1st leading cause of total burden in children 5-14 for boys (14.2% contribution) and girls (11.7% contribution)
– 5th leading cause for boys (4.9% contribution) and 4th leading cause for girls (6.2% contribution) aged 15-24
– 4th leading cause for girls aged 25-44 (4.9% contribution)

The Census 2021 data was released, including a question on whether people had asthma. The ABS media release reported:(ref 1)
– Asthma was the third most reported long-term condition, with 2,068,020 people reporting having asthma
– Asthma is the most commonly reported health condition for 0–14 year olds, with a notable difference between male children with 7.4%reporting asthma compared to 5.3% of female children.

Note: ABS recommends to use the National Health Survey rather than the Census as definite and correct source for national prevalence rates.

PHIDU maps: (ref 2)

The Public Health Information Development Unit has mapped the results from the ABS Census 2021, including asthma prevalence.
Note that when available, particularly for national or state prevalence, data from the National Health Survey is more reliable and preferred over the Census data.
Prevalence is reported as age-standardised rates (the ABS reports crude rates).

Data can be visualised for ages 0-14, 15+ or all-ages, and by states and territories, Local Government Areas (LGAs), Population Health Areas (PHAs) or Public Health Networks (PHNs) here: https://phidu.torrens.edu.au/social-health-atlases/maps#2021-census-population-health-areas  

Cohort study of people aged up to 18 years old hospitalised for asthma during 2005-2018 in NSW, Australia, looking at school performance.
Findings:

• young males hospitalised with asthma had a 13% and 15% higher risk of not achieving the national minimum standard for numeracy and reading respectively, a 51% higher risk of not completing year 10, and around 20% higher risk of not completing year 11 or 12, compared to peers.
• Young females with asthma presented no difference in achieving national minimum standard in numeracy and reading, but a 21% higher risk of not completing year 11 and a 33% higher risk of not completing year 12.

Conclusions: Educational attainment is worse for young people hospitalized with asthma compared to matched peers. Early intervention and strategies for better management of asthma symptoms may enhance academic performance for students.

Multicentre cohort study by the Murdoch Children’s Research Institute following-up for 12 months 767 children aged 3–18 years admitted to hospital for asthma in Victoria in 2017-2018.
Results:
– About one third (34.3 %) were readmitted to hospital for asthma, (those aged 3-5 years accounting for 69.2 per cent): 20.6 % were readmitted once and 13.7 % had two or more readmissions in 12 months.
– children were 57% more likely to be readmitted when their general practitioners did not adhere to recommended asthma management guidelines
– almost 75% were discharged without a preventer and more than 80% did not have a follow-up appointment at the hospital
– Over a third hadn’t had a review of inhaler technique
Conclusion: Hospital readmissions among Australian children with asthma are increasing (compared to a decade ago when about 1 in 5 were readmitted), and the study highlights the gaps in children’s asthma care throughout their care journey such as reviewing their baseline asthma control, inhaler technique and asthma medication, lack of booked follow-up arrangements before discharge, and guideline discordant care.

see MCRI website: https://www.mcri.edu.au/news-stories/hospital-readmissions-for-asthma-on-the-rise-among-children

According the National Health Survey for 2020-2021 (a year impacted by the Covid pandemic), it is estimated that:
• Just under 2.7 million (10.7%) Australians had asthma in 2020-21 (ref 1)
• Females were more likely than males to have asthma (12.0% compared to 9.4%) (ref 1)
• The rate of asthma was similar in boys and girls aged 0-14 years (9.5% and 7.9%) (ref 1)
• 411,000 children aged 0-14 have asthma (8.7%) (ref 2)
Note: due to Covid restrictions, data for the NHS 2020/21 was self-reported online rather than via interviews, and with a low response rate. Therefore it is less representative compared to previous NHS and comparisons with previous reports are limited (see Australian Institute of Health and Welfare (2022) Chronic respiratory conditions, AIHW, Australian Government, accessed 20 July 2022. https://www.aihw.gov.au/reports/australias-health/chronic-respiratory-conditions for details).

A study of asthma exacerbation emergency department visits in Brisbane suggests that the risk of childhood asthma exacerbations increases within a few hours of air pollution exposure in children aged 0-14, with the risk increasing within the same hour of exposure to O3, and 4 hours after exposure to NO2.
In the study, there was also an association between exposure to PM2.5 and PM10 in some age groups, with children aged 0-4 being more vulnerable to PM10 but less vulnerable to NO2 compared to school-aged children (5-14 years).

According to the National Health Survey for the 2020-2021 financial year:
– One in three people with asthma (34.9%) used asthma-related medication daily
– Just under half (48.8%) of children under 18 years of age used asthma-related medication in the two weeks prior to the survey
– More than three in five (63.2%) people aged 18 years and over used asthma-related medication in two weeks prior to the survey
– One in three (34.9%) people of all ages used medication to help manage symptoms daily and two in five (39.8%) did not take medication in the two weeks prior to survey.

Note: NHS 2020-21 should not be compared to other years as it was conducted differently (online) due to the Covid pandemic.

Article in the Australian Journal of General Practice summarising the increased risk of asthma associated with gas cooking, how to recognise the clinical implications in children and adults with asthma, and how to advocate for them.
Some reported facts: (please refer to article for exact references)
– 65% of houses in Australia use gas for cooking or heating
– The most important gas-related health effects are due to nitrogen dioxide (NO2) and carbon monoxide (CO)
– an estimated 30% of the risk of asthma for a child with current asthma living in a home with a gas stove comes from the stove
– across the community in Australia, 12% of childhood asthma is attributable to the use of gas stoves
– the risk of persistent asthma was also increased in Tasmanian aged 43-53 years living with gas heating and cooking, with OR 2.64 (1.22–5.70)
– questions about indoor gas exposure should be part of asthma review, and strategies discussed to reduce exposure

Asthma was the 9th leading contributor to the total burden of disease in Australia in 2018, with a disability-adjusted life years (DALY) rate of 5.2 per 1,000 population, compared to 10th in 2003. Asthma was the 4th leading cause of non-fatal disease burden in 2018 (from 5th in 2003). The equivalent of 130,886 years of healthy life were lost due to asthma in 2018, including 123,315 of these due to years lived with a disability.

Asthma was the leading cause of total burden in children aged 5-14, contributing to 14% and 11% of the total burden in boys and girls, respectively. It was the leading cause of non-fatal burden for children aged under 5.

By age groups, asthma’s total burden of disease ranked: 5th in children aged under 5; 1st in all children aged 5-14 (1st in males and 2nd in females); 5th in males and 4th in females aged 15-24; 8th in males and 4th in females aged 25-44; 10th in males and 6th in females aged 45-54; 10th in females aged 55-64; higher than 10th in males aged over 54 and females aged over 64. (see Fig 2.6 and 2.7 for DALY rates and proportions)

By age groups, asthma’s non-fatal burden of disease ranked: 1st in children aged under 5; 1st in males and 2nd in females aged 5-14; 3rd in males and 4th in females aged 15-24; 6th in males and 4th in females aged 25-44; 5th in both males and females aged 45-54; 8th in males and 6th in females aged 55-64; 8th in females aged 65-74; higher than 10th in males aged over 64 and females aged over 74.

Asthma was the 10th leading cause of fatal burden in males and 7th in females aged 5-14.

Note that the report also contains data specific to states, remoteness and socioeconomic groups.

In 2017-2018 there were nearly 39,000 hospitalisations for asthma. The rate of hospitalisations for asthma was 158 per 100,000 population.

Nearly half (44%) of these were for children aged 0-14 years old, giving asthma an age profile of hospitalisation much younger compared to hospitalisations for all causes.

The age-standardised rate of hospitalistions for asthma in children aged 0-14years old has decreased overall during the last decade, falling from 542 per 100,000 population in 2009–2010 to 363 per 100,000 population in 2017–2018.

Asthma was the 10th leading contributor to the overall burden of disease in Australia in 2015 (5th leading cause of non-fatal disease burden). The equivalent of 120,774 years of health life were lost due to asthma in 2015. 113,129 of these due to years lived with a disability and 7,645 due to premature death.
Asthma was the leading cause of burden of disease for people aged 5-14 years.

In 2014/15
– 42.4% of children aged 0-14 had to take time of school due to their asthma.
– Asthma interfered with daily activities at least once in a four week period for 67.7% of Australians. This was highest for people aged 35-44 (76%)