The Woolcock Institute of Medical Research

Dr Chetan Pandit is a paediatric sleep and respiratory specialist in the Woolcock Clinic. Around 30-40 percent of his patients come to him with respiratory issues and the majority of those are referred for one of two reasons: either to be diagnosed with asthma or undiagnosed with asthma.

“What I mean be that is that most of these children have suspected asthma and have been started on preventers but the question is whether they actually have asthma and, if they do, what we need to do about it in terms of management and optimising their treatment.

In Australia, we have one of the highest rates of asthma prevalence in the world. Around half a million children have asthma (as reported in 2022). It is one of the most common reasons for them to visit their doctor, miss school or have to go to hospital and it’s the leading cause of total disease burden in children aged 1-14.

But, a French study published earlier this year in Respiratory Medicine, reported that despite asthma prevalence being less than 10 percent, 83.1 percent of children there had been treated with respiratory medications before the age of 10. Similar patterns have been reported in the US with inhaled corticosteroids and SABA often prescribed for recurring wheezing or viral symptoms without a confirmed asthma diagnosis.

That could have important implications for children on asthma medications here.

“It’s hard because you have different types of asthma,” says Dr Pandit. “What we call commonly virus induced wheezing is very common, occurring in about 40-50 percent of children under five. That often gets called as asthma, but virus-induced wheezing typically gets better as they get older. We need to be keeping a close eye on them because some of them don't need to be on preventers and often they are for long periods. I had one patient who had been on a preventer for two years – they may have needed it at first but by the time I saw them it was not necessary, so we stopped treatment.”

At the Woolcock, we have a dedicated paediatric lung function team who conduct spirometry to diagnose or undiagnose asthma for children who are eight years and over. The tests are conducted by a researcher/technician who has the experience to ensure that the results are accurate.

“That’s important because children's effort can be quite variable. There are certain criteria that must be met for it to be called Grade A spirometry, for it to be considered reliable lung function and for the specialist to be confident in the results and an experienced technician has the best chance of achieving that.”

Dr Pandit says that with the move to Macquarie Park, he is seeing more and more patients from Sydney’s west who are bypassing long waiting times for testing at Westmead Children’s Hospital where he also works.

“We have much shorter waiting times, we have a multidisciplinary team in the Woolcock Clinic and we have comprehensive paediatric respiratory and sleep facilities and testing, which is a huge advantage.”

That’s because respiratory conditions can also lead to sleep issues in children and vice versa and the Woolcock is one of only three centres in Sydney equipped to address them under the one roof.

“I’ve seen a three-year-old patient who was referred to me for coughing, wheezing and suspected asthma but actually they had large tonsils that were causing that noisy breathing and disturbed sleep. A lot of asthma is caused by mouth breathing and exposure to cold, dry air. So, if a child has sleep apnea and you treat that, their breathing improves, they’re breathing warm humidified air through the nose and that significantly reduces their asthma exacerbations.”

With the number of children being treated with respiratory medications for virus-induced wheezing from an early age, testing and assessment by a respiratory specialist ensures their treatment is on the right track.

Find out more

• Our Paediatric Specialists
• Lung Function Testing
• Asthma Symptoms and Treatment