Pre-, Peri-, and Postnatal (pregnancy and birth)
Upper and Lower Airway (breathing)
Obesity
(body weight)
Neurodevelopment (brain development)
Positive Health
(well-being)Breathing
ECHO researchers use data from more than 64,000 diverse children and their families across the U.S. to examine associations between environmental influences—such as neighborhood conditions, air pollution, or chemical exposures-a child's health history, family health history and circumstances, and airway health outcomes. In addition, the ECHO IDeA States Pediatric Clinical Trials Network (ISPCTN) conducts clinical trials focused on airway health.
ECHO Discovery
Webinar Recording
Upper and Lower
Airway Resources
CDC: Learn How to Control Asthma
Provides information, facts, and articles from the CDC on asthma in children and adults.
MedlinePlus: Asthma in Children
Gives an overview of asthma in children, including information on preventing, identifying, treating, and living with childhood asthma.
U.S. Food and Drug Administration: Allergy Relief for Your Child
Describes allergies in children and treatments that may help.
QUESTIONS
For more information, please email the NIH at NIHKidsandEnvironment@od.nih.gov.
For media inquiries or to request an interview, contact Rebekah Yeager at rebekah.yeager@nih.gov.
How ECHO Advances Research on Upper and Lower Airway Health
In the U.S., asthma affects an estimated 5 million children—with higher rates for children living in poverty (11%), boys ages 5-14 (11%), and Black children (14%). Each year, children with poorly managed asthma experience more than 10 million missed school days, 74,000 hospital stays, and 767,000 trips to the emergency room.
Many factors can affect a child's airway health and disease and whether a child might develop breathing problems or respiratory diseases such as asthma. Research by the ECHO Program explores the social, physical, and behavioral factors that affect children's airway health. The focus is on understanding the early stages of airway health and disease, which may start during fetal development. It can also help to explain how a child's airway function might affect other areas of their health and well-being during childhood and adolescence. This research can help inform programs, policies, and practices that address health differences from the beginning, promoting a lifetime of good health that continues for generations.
What We're Learning
Since its launch, the ECHO Program has published more than 2,000 research articles on a wide range of child health topics. Within this body of work, many studies have examined upper and lower airway health.
Here are some research highlights:
The BREATHE Study: Bronchiolitis Recovery and Use of HEPA Filters
October 2025
In an ISPCTN study, infants living in homes with HEPA air filters had slightly fewer breathing problems and lower indoor air pollution than those in homes with control units.
ECHO Study Observes Health Disparities in Air Pollution-associated Risk of Childhood Asthma
August 2025
Children with higher early-life exposure to fine particulate matter, nitrogen dioxide, or ground-level ozone were more likely to develop asthma by age 10.
Children Living in Low-income Neighborhoods with Low Food Access at Higher Risk of Developing Asthma, ECHO Study Finds
June 2025
Children growing up in low-income neighborhoods with limited food access faced a higher asthma risk.
Children Born in Lower-Opportunity Neighborhoods Had Higher Rates of Asthma with Recurrent Exacerbations
March 2025
Children born in neighborhoods with low community opportunity had a much higher incidence rate of asthma with recurrent exacerbations (ARE) compared to those from other neighborhoods.
No Significant Associations Observed Between Prenatal Antibiotic Use and Wheezing Symptoms in Infants
February 2025
Prenatal antibiotic use was generally not linked to infant wheezing or hospital visits in the first 18 months, though it was associated with increased medication use for wheeze or cough.