Lum, S; Sonnappa, S; Wade, A; Harding, S; Wells, J; Trelevan, P; Cole, T; + view all Lum, S; Sonnappa, S; Wade, A; Harding, S; Wells, J; Trelevan, P; Cole, T; Griffiths, C; Kelly, F; Bonner, R; Bountziouka, V; Kirkby, J; Lee, S; Raywood, E; Legg, S; Sears, D; Stocks, J; - view fewer (2014) Exploring ethnic differences in lung function: the Size and Lung function In Children (SLIC) study protocol and feasibility. UCL Institute of Child Health: London, UK.

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Abstract

The Size and Lung function In Children (SLIC) study was designed as a prospective, cross-sectional and longitudinal study to investigate the factors contributing to ethnic differences in lung function. After adjusting for sex, age and height, the degree to which these differences can be reduced after further adjustment for body shape, size and composition was examined. The aim of this technical report is to describe the study design and protocol and to examine the feasibility of conducting complex physiological investigations in London primary schools. Methods: Recruitment and assessments were undertaken in London primary schools. Children with parental consent were eligible and categorised into 4 broad ethnic groups: White; Black; South-Asian and other/mixed ethnicities. Assessments were performed in children aged 5-11y, on 2 occasions a year apart and included detailed anthropometry; 3D photonic scanning for regional body shape; body composition using bioelectrical impedance analysis and isotope dilution technique; spirometry and saliva samples (for cotinine & DNA analysis of genetic ancestry). Information on country of origin (child-parents-grandparents); self-reported ethnicity; the child’s respiratory history, family socio-economic circumstances and tobacco smoking exposure were obtained, principally from parents via a questionnaire. Health status of the children was verified from medical records where feasible. Data linkages to pollution index and area deprivation scores were based on home postcodes. Results: Fourteen London primary schools participated with 52% parental consent for children to take part in the study. Consent rate for each type of assessment was generally high and ranged from near 100% for spirometry and anthropometry to 88% for DNA sample collection. With the exception of 3D scanning for body shape, where acceptable data were only achieved in 68% children assessed, success rate for all assessments ranged from 88% to 99%. In total, 2171 (47% boys; 34% White; 29% Black; 25% South-Asian; 12% Other/mixed) children were assessed on 3302 test occasions over the two year period, with successful spirometry being achieved in 90% (2986/3302) of assessments. After excluding 20% of children with acute or chronic illness and 10% with failed spirometry, data was available from 1520 healthy children for final analysis. Summary: This is the first study to demonstrate the feasibility (in terms of consent and success rate) of undertaking complex physiological assessments within the school environment in children as young as 5 years of age, including those for DNA. However, until software is refined and adapted for children, current technology for performing 3D scans for health related studies is not cost-effective. Approximately 30% of the children studied were preterm/LBW, had prior asthma or were symptomatic. Hence if the target population is healthy young children then the recruited sample size may need to be increased by 30% to ensure adequate power.

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