Childhood Asthma in Korea

Asthma is a chronic inflammatory condition of the airways characterised by reversible airflow obstruction. In children, it causes recurring episodes of wheezing, breathlessness, chest tightness, and cough — typically worse at night or in the early morning, and triggered by specific exposures.

Asthma is a significant concern in Korea, affecting a meaningful share of children — a rate broadly comparable to or higher than many developed countries. Key contributing factors include: seasonal fine dust (미세먼지) and ultrafine dust (초미세먼지), which spike during spring yellow dust (황사) events, indoor allergens (dust mites thrive in heated, poorly ventilated homes during winter), high pollen counts in spring, and high rates of other atopic conditions (eczema, allergic rhinitis).

Diagnosis in children under 5 is challenging as they cannot perform spirometry. In young children, diagnosis is often clinical — based on recurrent wheeze, response to bronchodilators, and exclusion of other causes. In older children, spirometry before and after a bronchodilator confirms the diagnosis.

Treatment follows a stepwise approach. Mild intermittent asthma: short-acting bronchodilator (salbutamol) as needed. Mild persistent asthma: regular low-dose inhaled corticosteroid (preventer inhaler — most commonly budesonide or fluticasone). Moderate and severe persistent asthma: step up therapy with long-acting bronchodilators, leukotriene receptor antagonists, or biologics.

Inhaler technique is critical — correct technique is as important as the medication. Young children should use a spacer device with their metered dose inhaler for maximum drug delivery.

Asthma management in Korean schools: provide the school nurse with a written asthma action plan, ensure a reliever inhaler is kept at school, and educate teachers about asthma symptoms and emergency response.

Korea-specific triggers to minimise: check the daily fine dust forecast and limit outdoor activity on high-pollution days, use HEPA air purifiers indoors, maintain humidity between 40–60% to reduce dust mite growth, and ventilate the home regularly even in winter.