FRESNO, Calif. (KFSN) -- The number of children going to Valley Children's Healthcare each year for asthma has remained steady.
According to 2018 data, a little more than 14% of California kids are diagnosed with asthma. Tulare, Kings and Fresno counties have rates higher than the state.
One Valley doctor said it's around the wintertime when cases start to increase.
"The one year though, however, that we didn't see a lot of asthma was when we went on initial lockdown and kids were out of school," said Dr. Carmela Sosa, medical director for primary care at Valley Children's.
Indoor and outdoor air quality and respiratory infections can cause asthma. Now, COVID-19 is also playing a role in pediatric asthma cases.
"COVID symptoms can be just like the cold," said Dr. Sosa. "So COVID can trigger an asthma attack as well."
According to health officials, there are Valley asthma cases linked to air pollution.
According to a 2021 State of the Air report, several cities in the San Joaquin Valley appeared on a list of most polluted cities in the nation.
However, Dr. Sosa said cases could be linked to other factors seen around the Valley.
"Secondhand tobacco smoke or any kind of secondhand smoke, mold, cockroaches, dust, dust mites, again, that outdoor air pollutants, ozone, wood smoke from fires," she said.
Action News spoke with the Central California Children's Institute, which did a study in 2004 about children with asthma in the San Joaquin Valley.
According to Nicole Smith, a faculty fellow, the institute continues to look at the latest data on, what it calls, an "epidemic."
"If you're struggling to breathe, you're struggling to live," said Smith. "I think we can all agree that there would be negative, emotional, physical, you know, even social consequences to not being able to breathe on a day-to-day basis."
While asthma isn't preventable, Dr. Sosa said it is controllable with medications.
In addition, it's also important to find ways to minimize the most common triggers.