{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T04:41:04Z","timestamp":1777610464786,"version":"3.51.4"},"reference-count":76,"publisher":"BMJ","issue":"6","license":[{"start":{"date-parts":[[2022,5,30]],"date-time":"2022-05-30T00:00:00Z","timestamp":1653868800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2022,4,22]]},"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Asthma is one of the greatest health burdens, yet contributors to asthma symptom trajectories are understudied in Australian children. We aimed to assess the trajectories of asthma symptom and their associations with several family environmental factors during the childhood period in Australia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Secondary analysis from a cross-sequential cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Nationwide representative data from the \u2018Longitudinal Study of Australian Children (LSAC)\u2019.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Participants from the LSAC birth cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcome measures<\/jats:title>\n                    <jats:p>Asthma symptom trajectory groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Asthma symptom presenting as wheezing, family environmental factors and sociodemographic data (2004\u20132018) were obtained from the LSAC. Group-based trajectory modelling was applied to identify asthma symptom trajectories and multivariable logistic regression models were used to assess the associations between these and environmental factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 5107 children in the LSAC cohort, 3846 were included in our final analysis. We identified three distinct asthma symptom trajectories from age 0\/1 year to 14\/15 years: \u2018low\/no\u2019 (69%), \u2018transient high\u2019 (17%) and \u2018persistent high\u2019 (14%). Compared with the \u2018low\/no\u2019 group, children exposed to \u2018moderate and declining\u2019 (relative risk ratio (RRR): 2.22, 95%\u2009CI 1.94 to 2.54; RRR: 1.26, 95%\u2009CI 1.08 to 1.46) and \u2018high and persistent\u2019 prevalence of maternal smoking (RRR: 1.41, 95%\u2009CI 1.23 to 1.60; RRR: 1.26, 95%\u2009CI 1.10 to 1.44) were at increased risk of being classified into the \u2018transient high\u2019 and \u2018persistent high\u2019 trajectories of asthma symptom. Persistently bad external dwelling conditions (RRR: 1.27, 95%\u2009CI 1.07 to 1.51) were associated with \u2018transient high\u2019 trajectory while \u2018moderate and increasing\u2019 conditions of cluttered homes (RRR: 1.37, 95%\u2009CI 1.20 to 1.56) were associated with \u2018persistent high\u2019 trajectory of asthma symptom. Exposure to tobacco smoke inside the house also increased the risk of being in the \u2018persistent high\u2019 trajectory group (RRR: 1.30, 95%\u2009CI 1.12 to 1.50).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Poor home environment increased the risk of asthma symptom during childhood. Improving home environment and reducing exposure to tobacco smoke may facilitate a favourable asthma symptom trajectory during childhood.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2021-059830","type":"journal-article","created":{"date-parts":[[2022,6,6]],"date-time":"2022-06-06T11:30:14Z","timestamp":1654515014000},"page":"e059830","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":11,"title":["Trajectories of asthma symptom presenting as wheezing and their associations with family environmental factors among children in Australia: evidence from a national birth cohort study"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9345-206X","authenticated-orcid":false,"given":"K M","family":"Shahunja","sequence":"first","affiliation":[{"name":"Institute for Social Science Research, The University of Queensland, Saint Lucia, Queensland, Australia"},{"name":"ARC Centre of Excellence for Children and Families over the Life Course, The University of Queensland, Brisbane, Queensland, Australia"},{"name":"The Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, Brisbane, Queensland, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter D","family":"Sly","sequence":"additional","affiliation":[{"name":"Child Health Research Centre, Faculty of Medicine, The University of Queensland, Saint Lucia, Queensland, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Md Jobayer","family":"Chisti","sequence":"additional","affiliation":[{"name":"Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1535-8086","authenticated-orcid":false,"given":"Abdullah","family":"Mamun","sequence":"additional","affiliation":[{"name":"Institute for Social Science Research, The University of Queensland, Saint Lucia, Queensland, Australia"},{"name":"ARC Centre of Excellence for Children and Families over the Life Course, The University of Queensland, Brisbane, Queensland, Australia"},{"name":"The Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, Brisbane, Queensland, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2022,6,6]]},"reference":[{"key":"2025121407522160000_12.6.e059830.1","unstructured":"Global Initiatives for Asthma . 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