Dr. Donna Rennie
What drew you to working in lung health research?
It is a personal story coupled with a history of natural curiosity about everything. My youngest child had allergies shortly after birth and was diagnosed with asthma at 18 months of age. At that time, the only treatment for asthma was theophylline and bronchodilator medication. Asthma exacerbations in the middle of the night were the normal routine for us. My calls to the ER department were often met with another dose of a bronchodilator as treatment. I knew this was not working and needed to find answers concerning what was it in the environment that was worsening his asthma and ultimately identify solutions to the problems children and families were having managing childhood asthma. My first graduate degree was in nursing and my PhD was completed in respiratory epidemiology. My PhD mentor, Dr. James Dosman, a respirologist and scientist, provided me with the enthusiasm and expertise to continue my research in rural health and respiratory disease.
You’re also a Certified Asthma Educator. What does this work entail?
Most of my work as an asthma educator is in consultation with other health professionals regarding asthma management and treatment. I do not have a practice, due to my current position as an educator of nurses in a university setting. Findings from my collaborative research regarding risk factors for asthma and related diseases are translated and presented to families, health practitioners, and policy makers at the community and other government levels.
You’ve published a number of studies on rural health and risk factors. What are some of your findings on rural environments and lung health?
- In a cross-sectional study of 2450 school age children, we found that asthma prevalence was lowest in Hutterite children followed by farm children and then by other rural children not living on farms. Furthermore, children with asthma who lived on a farm were less likely to be exposed to farming activities whereas children with wheeze were more likely playing in these environments.
- Children living in Estevan SK had a very high rate of asthma and lower lung function compared to children living in Swift Current Saskatchewan.
- Women who lived on a farm in the first year of life have lower-rate of asthma and hay fever compared to women who did not live on a farm in the first year of life. Men currently living on a farm without this earlier exposure had an increased risk of asthma.
- While endotoxin in the dust of children’s mattresses and play areas is not associated with childhood asthma in a study of Estevan school-age children, children who had allergic asthma and had high endotoxin levels in these dust samples were likely to absent in the past year from school with chest illnesses.
- In the Humboldt, SK, our studies found that increased waist circumference was an important predictor of pulmonary function in both adults and children, and for asthma in women. Obesity was associated with respiratory allergy as measured by skin prick testing. Our data also show that there is a stronger association between obesity and asthma in persons who do not have respiratory allergies.
- Farming activities such as playing in areas where the emptying or filling of grain bins is associated with more asthma whereas, playing on or near hay bales, and cleaning pens was associated with increased respiratory symptoms.
- Our initial work examining the genetic effects of family aggregation of airways disease found evidence for a single loci influencing airway-parenchymal dysnapsis; part of the expression of wheeze related to allergy was controlled by a single locus; and that a major gene related to respiratory allergy may explain family aggregation of asthma. Our later work in genetics examining Toll4 and CD 14 receptors demonstrate that there is reduced airways inflammation in adults with variants of the TLR4 genes; a decreased risk of croup in children with the CD 14 C-159-T gene variant and an increased risk of asthma with the CD14 C-1359-T variant.
- Damp homes both in First Nation reserve settings and other rural environments in Saskatchewan has been shown to be a risk factor for asthma in children and also associated with respiratory symptoms in children. A recent report from the Estevan studies of home environments of children identified that high mold counts found in children’s mattresses and from floors of play areas were associated with asthma. Sensitization to mold allergens was also associated with having childhood asthma.
What questions about rural lung health are still being answered?
Many of the issues related to rural lung health relate to prompt diagnosis of lung disease and access to appropriate services. Although we tend to find that children in rural areas and in particular, children in farming environments, experience less asthma than children living in large urban centres, children with asthma living in rural environments tend to have more severe asthma as shown by lung function and reported frequency symptoms. We are continuing to explore whether this is an access issue, both to respiratory health professionals and medication, or a result of rural environmental factors.
What has been the most rewarding part of your work and research on asthma and lung health?
I enjoy my work with young graduate students and nurses that have a particular interest in pursuing careers as educators or as researchers in respiratory health, primarily in asthma and allergy. My many years of work with the Lung Association continues to provide the connection with the public - the ultimate driver of all research.