International asthma research program

Since October 2008, Drs. Lawson and Rennie have been participating in an international, multicenter study of childhood asthma: the Belarus, Ukraine, Poland Asthma Study (BUPAS). The ongoing collaboration is conducted by an interdisciplinary team of international researchers from the fields of medicine, epidemiology, and nursing. The initial involvement by Canadian researchers was to help build research capacity with an international group of researchers focusing on childhood asthma prevalence within their countries. The Canadian researchers have assisted by providing workshops on epidemiology, research methods, and data analysis. The international group has now gone on to identify and act upon research-related priorities for asthma based on the findings from BUPAS. Knowledge dissemination of results at the local, national and international level has been a major aim.  

The initial research collaboration expanded in 2014 to include primary data collection sites in Canada (Saskatchewan), Republic of Macedonia, and Republic of Georgia. What makes this collaboration even more exceptional is that researchers from the various centres are actively involved in research and work in areas where there is extensive agricultural industry. The Canadian members of this research team have greatly benefitted from the international collaboration. We have been able to expand our research activities and improve our global understanding of asthma as well as reciprocal learning and training opportunities.

The Saskatchewan Lung Health Study was initiated to quantify the amount of asthma and health care utilization for asthma in children as well as to identify risk factors for childhood asthma. In spring 2013, we conducted a cross-sectional study examining the prevalence and severity of asthma between urban and rural areas of Saskatchewan including Regina, Prince Albert, and rural areas outside of Prince Albert. A follow-up survey was completed in 2015. As part of this follow-up survey, clinical testing was also completed including spirometry, exercise challenge testing, skin prick testing, and urine collection for metabolomic and proteomic analyses. In addition to this, dust samples were collected from the homes of participants. Finally, as part of this research program, data will be received from Saskatchewan Health to investigate the health care utilization and prescription medication use.

A major trigger and potential cause of asthma can be to what children are exposed to in the air they breathe. As part of the SHRF-CID program, we have been developing a personal monitoring backpack to be used in children’s health studies. This backpack can be worn by children as they play and will collect information about dust in their personal airspace. Objective measurement of such exposures are preferable in research studies of children but they are often not used. This pilot study is being conducted to develop and test the feasibility of wearing this backpack for children.

The Saskatchewan Rural Health Study (SRHS) is a new large prospective cohort study of ages 6 and over currently being conducted in farming and non-farming communities to evaluate potential health determinants associated with respiratory outcomes in rural populations. The study is being conducted over 5 years (2009-15) in two phases, baseline and longitudinal. Phase 1 is a baseline survey with a clinical component completed in 2010–11 and Phase 2 is a follow-up study that is being conducted in 2014–2015. The overall objective of the cohort study is to assess the determinants of health and their relationship with respiratory health in a farming and non-farming rural population. Specific objectives include:

1. To conduct an overall assessment of the relationship between various determinants and respiratory health outcomes in farmers and small town dwellers.
2. To conduct a prospective cohort evaluation of respiratory health outcomes in farmers and small town dwellers.
3. To assess rural/urban differences in health care utilization patterns with regard to respiratory health outcomes.

The study team has completed all portions of this study and results will be disseminated soon in forms of journal publications.

Asthma is one of the most common conditions of childhood. Proper management of asthma can reduce health care costs and improve the quality of life for children and their families. This study, funded in 2016 will use information from 18 years of the Saskatchewan Health Databases and identify what are the associated factors with hospitalization and physician visits for asthma in children. We are particularly interested in determining accessibility to services for childhood asthma. The study will also assess the prescription filling patterns of children diagnosed with asthma. The information from this study can be used to determine the burden associated with asthma and identify compliance issues. Results from this study can provide valuable information for asthma educators, clinicians, other researchers and policy makers.