Asthma risk factors

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Philip Marcus, M.D., M.P.H. [2]; Associate Editor(s)-in-Chief: Lakshmi Gopalakrishnan, M.B.B.S. [3]

Overview

Asthma is usually diagnosed in childhood. Numerous risk factors such as gender, allergen exposure, airway hyper-reactivity have been identified to play a role in the development of asthma.[1]

Risk Factors

The risk factors for asthma include:

  • Personal or family history of asthma or atopy.[2][3][4][5]
  • Allergic rhinitis is a significant risk factor for adult-onset asthma in both atopic and non- atopic individuals.[6][7][8][9]
  • Triggers such as: smoke, dust, pollen, emotional stress and consumption of milk, peanuts, or eggs.[10][11][12][13]
  • Exposure to indoor nitrogen dioxide at levels well below the Environmental Protection Agency outdoor standard (53 ppb) has been shown to be associated with respiratory symptoms among children with asthma in multifamily housing.[14]
  • Obesity has shown to be associated with increased severity of asthma.[15][16][17][18][19]
  • Male preponderance for asthma in prepubertal children.[20]
  • Female preponderance results in the persistence of asthma into adulthood.[21]
  • Maternal smoking[22][23][24][25]
  • Premature birth or low birth weight[26][27][28]: Reduced lung function at birth has shown to be associated with an increased risk of development of asthma by 10 years of age.[29]
  • Upper respiratory viral infections are associated with an increased incidence of asthma exacerbations in childhood and in adults.[30][31][32][33]
  • The presence of bronchial hyperresponsiveness and concomitant atopic manifestations in childhood increase the risk of developing asthma in adulthood.[34][35][36]
  • There is a reduced occurrence of asthma in people who were breast-fed as babies.[37][38][39]

References

  1. ↑ Liu WY, Yu Q, Yue HM, Zhang JB, Li L, Wang XY; et al. (2016). "[The distribution characteristics of etiology of chronic cough in Lanzhou]". Zhonghua Jie He He Hu Xi Za Zhi. 39 (5): 362–7. doi:10.3760/cma.j.issn.1001-0939.2016.05.006. PMID 27180590.
  2. ↑ Weinmayr G, Weiland SK, Björkstén B, Brunekreef B, Büchele G, Cookson WO et al. (2007) Atopic sensitization and the international variation of asthma symptom prevalence in children. Am J Respir Crit Care Med 176 (6):565-74. DOI:10.1164/rccm.200607-994OC PMID: 17575099
  3. ↑ Arbes SJ, Gergen PJ, Vaughn B, Zeldin DC (2007) Asthma cases attributable to atopy: results from the Third National Health and Nutrition Examination Survey. J Allergy Clin Immunol 120 (5):1139-45. DOI:10.1016/j.jaci.2007.07.056 PMID: 17889931
  4. ↑ Sears MR, Burrows B, Flannery EM, Herbison GP, Hewitt CJ, Holdaway MD (1991) Relation between airway responsiveness and serum IgE in children with asthma and in apparently normal children. N Engl J Med 325 (15):1067-71. DOI:10.1056/NEJM199110103251504 PMID: 1891008
  5. ↑ Burrows B, Martinez FD, Halonen M, Barbee RA, Cline MG (1989) Association of asthma with serum IgE levels and skin-test reactivity to allergens. N Engl J Med 320 (5):271-7. DOI:10.1056/NEJM198902023200502 PMID: 2911321
  6. ↑ Guerra S, Sherrill DL, Martinez FD, Barbee RA (2002) Rhinitis as an independent risk factor for adult-onset asthma. J Allergy Clin Immunol 109 (3):419-25. PMID: 11897985
  7. ↑ Burgess JA, Walters EH, Byrnes GB, Matheson MC, Jenkins MA, Wharton CL et al. (2007) Childhood allergic rhinitis predicts asthma incidence and persistence to middle age: a longitudinal study. J Allergy Clin Immunol 120 (4):863-9. DOI:10.1016/j.jaci.2007.07.020 PMID: 17825896
  8. ↑ Huovinen E, Kaprio J, Laitinen LA, Koskenvuo M (1999) Incidence and prevalence of asthma among adult Finnish men and women of the Finnish Twin Cohort from 1975 to 1990, and their relation to hay fever and chronic bronchitis. Chest 115 (4):928-36. PMID: 10208188
  9. ↑ Shaaban R, Zureik M, Soussan D, Neukirch C, Heinrich J, Sunyer J et al. (2008) Rhinitis and onset of asthma: a longitudinal population-based study. Lancet 372 (9643):1049-57. DOI:10.1016/S0140-6736(08)61446-4 PMID: 18805333
  10. ↑ Platts-Mills TA (1994) How environment affects patients with allergic disease: indoor allergens and asthma. Ann Allergy 72 (4):381-4. PMID: 8154638
  11. ↑ Lau S, Illi S, Sommerfeld C, Niggemann B, Bergmann R, von Mutius E et al. (2000) Early exposure to house-dust mite and cat allergens and development of childhood asthma: a cohort study. Multicentre Allergy Study Group. Lancet 356 (9239):1392-7. PMID: 11052581
  12. ↑ Brussee JE, Smit HA, van Strien RT, Corver K, Kerkhof M, Wijga AH et al. (2005) Allergen exposure in infancy and the development of sensitization, wheeze, and asthma at 4 years. J Allergy Clin Immunol 115 (5):946-52. DOI:10.1016/j.jaci.2005.02.035 PMID: 15867850
  13. ↑ Tovey ER, Almqvist C, Li Q, Crisafulli D, Marks GB (2008) Nonlinear relationship of mite allergen exposure to mite sensitization and asthma in a birth cohort. J Allergy Clin Immunol 122 (1):114-8, 118.e1-5. DOI:10.1016/j.jaci.2008.05.010 PMID: 18602569
  14. ↑ Belanger K, Gent JF, Triche EW, Bracken MB, Leaderer BP (2006) Association of indoor nitrogen dioxide exposure with respiratory symptoms in children with asthma. Am J Respir Crit Care Med 173 (3):297-303. DOI:10.1164/rccm.200408-1123OC PMID: 16254270
  15. ↑ Taylor B, Mannino D, Brown C, Crocker D, Twum-Baah N, Holguin F (2008) Body mass index and asthma severity in the National Asthma Survey. Thorax 63 (1):14-20. DOI:10.1136/thx.2007.082784 PMID: 18156567
  16. ↑ Coogan PF, Palmer JR, O'Connor GT, Rosenberg L (2009) Body mass index and asthma incidence in the Black Women's Health Study. J Allergy Clin Immunol 123 (1):89-95. DOI:10.1016/j.jaci.2008.09.040 PMID: 18980776
  17. ↑ Beuther DA, Sutherland ER (2007) Overweight, obesity, and incident asthma: a meta-analysis of prospective epidemiologic studies. Am J Respir Crit Care Med 175 (7):661-6. DOI:10.1164/rccm.200611-1717OC PMID: 17234901
  18. ↑ Shore SA, Fredberg JJ (2005) Obesity, smooth muscle, and airway hyperresponsiveness. J Allergy Clin Immunol 115 (5):925-7. DOI:10.1016/j.jaci.2005.01.064 PMID: 15867846
  19. ↑ Stenius-Aarniala B, Poussa T, Kvarnström J, Grönlund EL, Ylikahri M, Mustajoki P (2000) Immediate and long term effects of weight reduction in obese people with asthma: randomised controlled study. BMJ 320 (7238):827-32. PMID: 10731173
  20. ↑ Sennhauser FH, Kühni CE (1995) Prevalence of respiratory symptoms in Swiss children: is bronchial asthma really more prevalent in boys? Pediatr Pulmonol 19 (3):161-6. PMID: 7792118
  21. ↑ Weiss ST, Gold DR (1995) Gender differences in asthma. Pediatr Pulmonol 19 (3):153-5. PMID: 7792116
  22. ↑ Strachan DP, Butland BK, Anderson HR (1996) Incidence and prognosis of asthma and wheezing illness from early childhood to age 33 in a national British cohort. BMJ 312 (7040):1195-9. PMID: 8634562
  23. ↑ Gilliland FD, Islam T, Berhane K, Gauderman WJ, McConnell R, Avol E et al. (2006) Regular smoking and asthma incidence in adolescents. Am J Respir Crit Care Med 174 (10):1094-100. DOI:10.1164/rccm.200605-722OC PMID: 16973983
  24. ↑ Polosa R, Knoke JD, Russo C, Piccillo G, Caponnetto P, Sarvà M et al. (2008) Cigarette smoking is associated with a greater risk of incident asthma in allergic rhinitis. J Allergy Clin Immunol 121 (6):1428-34. DOI:10.1016/j.jaci.2008.02.041 PMID: 18436295
  25. ↑ Weitzman M, Gortmaker S, Walker DK, Sobol A (1990) Maternal smoking and childhood asthma. Pediatrics 85 (4):505-11. PMID: 2314963
  26. ↑ Jaakkola JJ, Ahmed P, Ieromnimon A, Goepfert P, Laiou E, Quansah R et al. (2006) Preterm delivery and asthma: a systematic review and meta-analysis. J Allergy Clin Immunol 118 (4):823-30. DOI:10.1016/j.jaci.2006.06.043 PMID: 17030233
  27. ↑ von Mutius E, Nicolai T, Martinez FD (1993) Prematurity as a risk factor for asthma in preadolescent children. J Pediatr 123 (2):223-9. PMID: 8345417
  28. ↑ Frischer T, Kuehr J, Meinert R, Karmaus W, Urbanek R (1993) Risk factors for childhood asthma and recurrent wheezy bronchitis. Eur J Pediatr 152 (9):771-5. PMID: 8223814
  29. ↑ Håland G, Carlsen KC, Sandvik L, Devulapalli CS, Munthe-Kaas MC, Pettersen M et al. (2006) Reduced lung function at birth and the risk of asthma at 10 years of age. N Engl J Med 355 (16):1682-9. DOI:10.1056/NEJMoa052885 PMID: 17050892
  30. ↑ Johnston SL, Pattemore PK, Sanderson G, Smith S, Lampe F, Josephs L et al. (1995) Community study of role of viral infections in exacerbations of asthma in 9-11 year old children. BMJ 310 (6989):1225-9. PMID: 7767192
  31. ↑ Nicholson KG, Kent J, Ireland DC (1993) Respiratory viruses and exacerbations of asthma in adults. BMJ 307 (6910):982-6. PMID: 8241910
  32. ↑ Thomsen SF, van der Sluis S, Stensballe LG, Posthuma D, Skytthe A, Kyvik KO et al. (2009) Exploring the association between severe respiratory syncytial virus infection and asthma: a registry-based twin study. Am J Respir Crit Care Med 179 (12):1091-7. DOI:10.1164/rccm.200809-1471OC PMID: 19286626
  33. ↑ Kuehni CE, Spycher BD, Silverman M (2009) Causal links between RSV infection and asthma: no clear answers to an old question. Am J Respir Crit Care Med 179 (12):1079-80. DOI:10.1164/rccm.200904-0567ED PMID: 19498062
  34. ↑ Porsbjerg C, von Linstow ML, Ulrik CS, Nepper-Christensen S, Backer V (2006) Risk factors for onset of asthma: a 12-year prospective follow-up study. Chest 129 (2):309-16. DOI:10.1378/chest.129.2.309 PMID: 16478846
  35. ↑ Carey VJ, Weiss ST, Tager IB, Leeder SR, Speizer FE (1996) Airways responsiveness, wheeze onset, and recurrent asthma episodes in young adolescents. The East Boston Childhood Respiratory Disease Cohort. Am J Respir Crit Care Med 153 (1):356-61. PMID: 8542143
  36. ↑ Zhong NS, Chen RC, Yang MO, Wu ZY, Zheng JP, Li YF (1992) Is asymptomatic bronchial hyperresponsiveness an indication of potential asthma? A two-year follow-up of young students with bronchial hyperresponsiveness. Chest 102 (4):1104-9. PMID: 1395752
  37. ↑ Pali-Schöll I, Renz H, Jensen-Jarolim E (2009) Update on allergies in pregnancy, lactation, and early childhood. J Allergy Clin Immunol 123 (5):1012-21. DOI:10.1016/j.jaci.2009.01.045 PMID: 19249083
  38. ↑ Greer FR, Sicherer SH, Burks AW, American Academy of Pediatrics Committee on Nutrition. American Academy of Pediatrics Section on Allergy and Immunology (2008) Effects of early nutritional interventions on the development of atopic disease in infants and children: the role of maternal dietary restriction, breastfeeding, timing of introduction of complementary foods, and hydrolyzed formulas. Pediatrics 121 (1):183-91. DOI:10.1542/peds.2007-3022 PMID: 18166574
  39. ↑ Høst A, Koletzko B, Dreborg S, Muraro A, Wahn U, Aggett P et al. (1999) Dietary products used in infants for treatment and prevention of food allergy. Joint Statement of the European Society for Paediatric Allergology and Clinical Immunology (ESPACI) Committee on Hypoallergenic Formulas and the European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) Committee on Nutrition. Arch Dis Child 81 (1):80-4. PMID: 10373144

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