Occurrence Of Asthma Symptoms Research Articles

Electronic cigarette use and respiratory symptoms in the French population-based Constances cohort

BackgroundKnowledge about the consequences of electronic cigarette (EC) use on respiratory health is still limited. We aimed to assess whether EC use is associated with the occurrence of asthma symptoms and chronic bronchitis among the French adult population, with a specific focus on never combustible cigarettes (CC) smokers. We further investigated whether the association differed in men and women. MethodsConstances is a population-based cohort of adults aged 18–69 years at inception. We analyzed baseline data collected in 136,276 participants recruited in 2015–2019. Associations of current and former EC use with respiratory symptoms (asthma symptom score and chronic bronchitis) were assessed, controlling for CC smoking, cannabis use, demographics, education and body mass index (BMI). ResultsIncreased frequencies of respiratory symptoms were observed in both current and former EC users (for the asthma symptom score, adjusted mean score ratio (aMSR): 1.34 [95 % confidence interval: 1.28−1.41] and 1.39 [1.33−1.45], respectively; for chronic bronchitis, adjusted prevalence ratio (aPR): 1.27 [1.19−1.36] and 1.40 [1.32−1.48], respectively). Among never CC smokers, ever EC use was associated with an increased asthma symptom score in both men and women (aMSR = 1.44 [1.09−1.90] and 1.36 [1.01−1.83], respectively), and with a higher prevalence of chronic bronchitis only in women (aPR = 1.97 [1.27−3.05]). ConclusionEC use is associated with symptoms of asthma and chronic bronchitis, independently of CC smoking and cannabis use. The fact that these associations are observed among individuals who have never smoked tobacco adds further evidence of the deleterious effects of EC on respiratory health.

Association between prenatal and neonatal factors and occurrence of asthma symptoms in six-year-old children.

The objective was to estimate association between prenatal and neonatal factors and asthma symptoms in children at six years of age. A cross-sectional study using secondary data from a cohort study with a sample of 578 children was carried out. Data were analyzed using three levels hierarchical Poisson Regression. Of the 578 children included in the study, 43.4% (95% CI 39.4; 47.4) had asthma symptoms. The variables with significantly higher prevalence of symptoms and asthma at six years of age were: male gender, with 5% higher prevalence (PR = 1.05 95% CI 1.01; 1.11) (p = 0.043); children of pregnant women presenting infectious diseases with 7% higher prevalence (PR = 1.07; 95% CI 1.02; 1.13) (p = 0.011); children who were not breastfed, with a 12% higher prevalence (PR = 1.12; 95% CI 1.02; 1.24) (p = 0.022) and children with respiratory problems in the first month of life, with a 14% higher prevalence (PR = 1.14; 95% CI 1.01; 1.29) (p = 0.033). It could be concluded that male gender, time-independent breastfeeding deprivation and respiratory problems in the first month of life were independently associated with asthma symptoms at six years of age. The occurrence of infectious diseases during pregnancy was the only factor with intrauterine physiology that was associated with the occurrence of asthma symptoms at six years of age.

Occurrence of infectious diseases during the first two years and symptoms of asthma in six-year-old children

Objective: To observe possible association between the occurrence of infectious diseases during the first two years of life and the occurrence of asthma symptoms in six-year-old children. Methods: Cross-sectional study involving 956 six-year-old schoolchildren. Asthma symptoms were assessed through International Study of Asthma and Allergies in Childhood questionnaires. Socio-demographic data, mother-reported infectious diseases during the child's first two years of life, family history of asthma and breastfeeding were included. Multivariate analysis was performed with all significant variables and those with a p-value <0.20 using Poisson Regression with a robust estimator. Results: The reported wheezing or whistling in the chest in the past 12 months prevalence was 18.7%. There was found a 9% higher prevalence of asthma at six years of age in children who had had respiratory infections in the first two years of life. Children with a family history of asthma had a 7% higher and independent prevalence of asthma at six years of age and those breastfed presented 6% lower independent prevalence of asthma at six years of age. Conclusions: Higher prevalence of asthma reports at six years of age was found in children whose mothers reported infectious respiratory diseases during the first two years and with family history of asthma. Lower prevalence was observed in breastfed children in the first two years of life.

Health literacy among asthma patients and treatment expectations: results of a Belgian survey

ABSTRACTObjectives: Non-adherence to asthma medication can lead to lower disease control and asthma exacerbations that may be fatal. This survey assessed the attitude and expectations of Belgian asthma patients towards their treatment.Methods: This cross-sectional survey was conducted between June 2015 and February 2016 in 70 Belgian pharmacies. Participants completing the survey had to be ≥15 years, diagnosed with asthma, and on inhaled corticosteroid-based treatment. The analysis included 80 completed questionnaires.Results: Participants comprehended well that controller drugs are intended to prevent the occurrence of asthma symptoms and complications, and their long-term daily use should be maintained. Twenty seven percent of participants indicated fear of side effects concerning long-term daily use of a controller inhaler. Participants had a good understanding that quick-relief drugs are intended to (quickly) relieve asthma symptoms and do not need to be used on a systematic, daily basis. Out of 73 participants on long-term controller drugs, 33 (45%) were ‘non-adherent’ (used less frequently than prescribed). Suboptimal adherence to maintenance treatment appeared to increase nightly awakenings and the risk of restrictions in activities due to asthma. Out of 54 participants with available quick-relief drug adherence data, 18 (33%) were non-adherent (used their quick-relief drug more frequently than prescribed).Discussion: This survey confirms suboptimal adherence to maintenance controller therapy and overuse of short-acting reliever medications among Belgian patients, which affects asthma control and quality of life. A substantial proportion of patients expressed fear about their chronic therapy, indicating the need for patient education about their disease and its management.

Paths of causal influence from prenatal inflammation and preterm gestation to childhood asthma symptoms

Introduction: Long-lasting respiratory symptoms have a huge impact on the quality of life in prematurely born children. The aim was to investigate paths of assumed causality leading from foetal inflammatory response syndrome (FIRS) to asthma symptoms in preterms. Methods: Demographic, antenatal, delivery and outcome data were collected from 262 infants with less than 32 completed weeks of gestational age over a 10-year period in a prospective cohort study. The presence of symptoms of asthma beyond the age of 5 years was the primary outcome measure. The causal effect of FIRS on childhood asthma was tested with three different logistic regression models and two structural equation models (SEM). Results: FIRS (OR = 4.7) and subsequent chronic lung disease of prematurity (OR = 7.7) and early childhood wheezing (OR = 9.5) are the most important risk factors for development of asthma symptoms in children born with less than 32 weeks of gestational age. The path analysis showed that FIRS has a large direct (0.59), medium indirect (0.11) and large overall (0.70) effect on CLD; large negative direct effect on ECW (−0.34) and a large positive indirect effect (0.74), mediated by CLD. On the occurrence of asthma symptoms, FIRS has a medium negative direct effect (−0.18) and a medium positive indirect effect (0.26), mediated by CLD and ECW. Conclusion: Prenatal inflammation plays an important role in the development of chronic respiratory disturbances in preterm infants. This influence is mainly related to structural and developmental lung abnormalities initiated in utero as consequences of FIRS, resulting in CLD of prematurity, and overcoming the protective mechanisms of chorioamnionitis.

Asthma control and cold weather-related respiratory symptoms

BackgroundIn the northern hemisphere people are exposed recurrently to cold air and asthmatics experience more respiratory symptoms. We hypothesized that subjects with poor asthma control are more prone to experience cold weather-related respiratory symptoms than those with good asthma control. MethodsA population-based cross-sectional study of 1995 adult asthmatics (response rate 40.4%) living in the Northern Finland was conducted using a questionnaire where cold weather-related respiratory symptoms as well as questions related to asthma control were inquired. The Asthma Control Test (ACT) was defined based on five questions (disadvantage and occurrence of asthma symptoms, waking up because of asthma symptoms, use of rescue medication and self-assessment of asthma control during the past 4 weeks), and was divided into quartiles. ResultsCold weather-related respiratory symptoms were more frequent among asthmatics with poorly controlled asthma (ACT Q1 vs. ACT Q4); adjusted prevalence ratio (PR) for shortness of breath (men 1.47, 95% confidence interval 1.22–1.77; women 1.18, 1.07–1.30), cough (men 1.10, 0.91–1.34; women 1.18, 1.08–1.30), wheezing (men 1.91, 1.31–2.78; women 1.48, 1.17–1.87), phlegm production (men 1.51, 1.06–2.14; women 1.62, 1.27–2.08) and chest pain (men 4.47, 1.89–10.56; women 2.60, 1.64–4.12). The relations between asthma control and symptom occurrence seemed stronger among smokers than never smokers and subjects with body mass index (BMI) below and above 25–30. ConclusionsOur study provides new evidence that subjects whose asthma is poorly controlled are more prone to experience cold weather-related respiratory symptoms and even a slight worsening of asthma control increases symptom prevalences.

Asthmatic symptoms and air pollution: a panel study on children living in the Italian Po Valley.

The Po Valley (Northern Italy) has elevated levels of air-pollution due to various sources of pollution and adverse weather conditions. This study evaluates the short-term effects of exposure to particulate matter with a diameter of 10 microns or less (PM10) on asthma symptoms in school-aged children. An initial cross-sectional survey was conducted in the area to estimate asthma prevalence in children. Out of a total of 250 asthmatic children identified by the study, 69 agreed to participate in a panel study. The PM10 exposure assessment was based on a combination of geographic and environmental measurements leading to a focus on three different areas, each characterised by its own daily PM10 level. Participants were monitored daily for respiratory symptoms for eight weeks (January-March 2006). We assessed the relationship between daily PM10 exposure and occurrence of asthma symptoms with a generalised linear model based on a total of 3864 person-days of observation. Exposure to PM10 per m³ was found to be particularly associated with cough (OR=1.03, CI 95% 0.99; 1.08) and phlegm (OR=1.05, CI 95% 1.00; 1.10). In the most polluted area, exposure to PM10 was also associated with wheezing (OR=1.18, CI 95% 1.02; 1.37).

Influence of heredity on asthma continues to adulthood

Influence of heredity on asthma continues to adulthood

Roles of pollution in the prevalence and exacerbations of allergic diseases in Asia

The prevalence of asthma and allergic diseases has been found to be increasingly rapidly, especially in developing countries. Environmental factors have been found to be important contributors to the manifestations of allergic diseases. Air pollution has been extensively studied in different regions of the world. The levels of ambient air pollutants in many Asian countries are very high when compared with those in developed Western countries. However, the prevalence of asthma was relatively low across many Asian countries. Many studies have clearly documented that environmental air pollution is an important factor resulting in exacerbations of asthma. In particular, levels of traffic-related pollutants are increasing rapidly across many Asian countries in parallel with the level of urbanization and economic development. The loss of protective factors associated with a rural environment will further contribute to the adverse effect on patients with allergic diseases such as asthma. In this review the roles of air pollution were examined in relation to the inception and exacerbations of allergic diseases in Asia.

SP1-60 Community violence and the prevalence of asthma in the peripheral areas of Salvador

IntroductionAsthma and violence are two complex, multi-factorial phenomena strongly present in Latin America and Brazil. Studies about asthma demonstrate that there are a number of risk factors for the development...

Impact of Asthma 101 Training on Level of Nursing Students’ Knowledge

The Asthma 101 training, developed by the American Lung Association, was offered in 2009 to 93 senior bachelor of science in nursing (BSN) students. It was offered again in 2010 to 65 senior BSN students enrolled at the University of Texas Pan American in Edinburg, Texas. The training included both a pretest and posttest to evaluate changes in level of knowledge. Nursing students who were trained in 2009 participated in an asthma study offering asthma education to local elementary and middle schools students and their parents. The goal of Asthma 101 training was to educate nursing students so that they could provide general information about asthma to elementary school children and their parents, which could be done in a variety of settings such as health fairs and in classrooms. Test results for those who received the 2009 training showed an improvement in their knowledge about asthma. More than 95% of participants were very or somewhat satisfied with the Asthma 101 training. Test results in 2010 showed a significant improvement in participants’ knowledge in 2 areas: taking asthma medications to prevent an asthma episode ( P = .001) and occurrence of asthma symptoms ( P = .016). Two questions of statistical significance related to the use of medications and asthma episode demonstrated that nursing students had increased their knowledge in these areas. These findings suggest that health professionals can acquire additional knowledge from a brief yet focused training, such as the Asthma 101 training outlined in this article.

The Added Burden of Comorbidity in Patients with Asthma

Objective. Compare the prevalence of comorbidities in adults with and without asthma in Canada and investigate the association between comorbidities in patients with asthma and the occurrence of asthma symptoms or attacks. Methods. Survey data from the 2005 Canadian Community Health Survey (CCHS) were analyzed. A total of 132,221 Canadians participated in the national survey; 10,089 adult respondents from 10 Canadian provinces and 3 territories reported having asthma. Analyses focused on 11 major chronic comorbidities. Results. Respondents with asthma were more likely to have comorbidities except cancer; 31% of respondents with asthma and comorbidities reported their health status to be fair or poor. For respondents with asthma, non-asthma chronic respiratory disease, mental illness, and allergy were significantly associated with having asthma symptoms or attacks. Conclusions. Many Canadians with asthma report a high comorbidity burden. These patients will likely require more health services and more complex health management strategies. Comorbid conditions should be clearly identified with particular emphasis on management of mood disorders and anxiety because these conditions are likely to increase asthma symptomatology and may be unrecognized by clinicians.

Relationship between African dust carried in the Atlantic trade winds and surges in pediatric asthma attendances in the Caribbean

Asthma is epidemic in developed and developing countries including those in the Caribbean where it is widely believed that African dust, transported in high concentrations in the Trade Winds every year, is a major causative factor. The link between asthma and dust in the Caribbean is based largely on anecdotal evidence that associates sharp increases in the occurrence of asthma symptoms with hazy conditions often caused by dust. Here we report on a 2-year study of the relationship between the daily concentrations of dust measured in on-shore Trade Winds at Barbados and pediatric asthma attendance rates at Queen Elizabeth Hospital (QEH). We looked for large increases in QEH daily attendances in relation to daily dust concentrations as previously suggested by anecdotal observations. We could not find any obvious relationship although there may be more subtle linkages between dust and asthma. Our measurements show, however, that the concentration of dust in the size range under 2.5 microm diameter is sufficiently high as to challenge United States Environmental Protection Agency air quality standards for respirable particles. Thus, African dust may constitute a health threat of a different nature, producing symptoms less obvious than those of asthma.

Housing characteristics, home environmental factors and respiratory health in 3945 pre-school children in China

The objective of the study was to assess the effects of housing characteristics and home environmental factors on respiratory symptoms of Chinese children. A cross-sectional study of 3945 children aged 1–6-years-old was conducted at 24 randomly selected kindergartens in Liaoning province, northeast China during April 2007. Information on respiratory symptoms (persistent cough, persistent phlegm, doctor-diagnosed asthma, current asthma, current wheeze and allergic rhinitis) and exposures to home environmental factors was obtained by a standard questionnaire from the American Thoracic Society. We used Chi-square tests, multivariate logistic regression models and adjusted odds ratios (ORs) with 95% confidence intervals (95% CI) for estimates of the risk of respiratory symptoms. Results suggested that the prevalence of asthma-related symptoms was higher for those who lived along the main stem of traffic, and houses near a pollution source. Lower prevalence rates of respiratory morbidity were associated with households with a larger area of residence and more rooms. Pet keeping was associated with doctor-diagnosed asthma (OR = 1.45; 95% CI, 1.03–2.06). Among boys, home decorations significantly increased the risk of doctor-diagnosed asthma (OR = 1.71; 95% CI, 1.21–2.41), current asthma (OR = 1.80; 95% CI, 1.10–2.94) and current wheeze (OR = 1.81; 95% CI, 1.31–2.50). Environmental tobacco smoke, pests and visible mold on walls were associated with the occurrence of asthma symptoms, especially in boys. Based upon the findings of this study, it is concluded that home environmental factors are particularly important for the development of respiratory morbidity among children. Boys may be more susceptible to home environmental factors than girls.

Effects of Housing Characteristics and Home Environmental Factors on Respiratory Symptoms of 10,784 Elementary School Children from Northeast China

Background: Only few studies have assessed the relative impact of housing characteristics and home environmental factors on asthma and asthma-related symptoms in Chinese children, and to our knowledge, few studies have elaborated respiratory symptoms and allergies in this context. Objective: It was the aim of this study to assess the effects of housing characteristics, pet keeping, home decorations and other indoor environmental factors on respiratory health of Chinese children. Methods: We studied 10,784 children (6–13 years old) from 12 districts in Liaoning province, Northeast China. Information on respiratory health, housing characteristics and environmental pollution was obtained by a standard questionnaire from the American Thoracic Society. Results: Prevalence of asthma-related symptoms was higher for those living along the main stem of traffic, and for those with a house nearby a pollution source. Lower prevalence rates of respiratory morbidity were associated with households with a bigger area of residence and more rooms. Pet keeping was associated with doctor-diagnosed asthma (OR = 1.52; 95% CI 1.25–1.84). Home decorations also increased the risk of doctor-diagnosed asthma (OR = 1.72; 95% CI 1.45–2.04) and current asthma (OR = 1.43; 95% CI 1.06–1.93). Environmental tobacco smoke, pests and visible mold on walls were associated with the occurrence of asthma symptoms. Conclusion: Home environmental factors are particularly important for the development of respiratory morbidity among children.

The Dietary Habits of Non-asthmatic Schoolchildren in Lhasa, Tibet

The occurrence of asthma symptoms and food consumption frequencies in 13- to 14-year-old schoolchildren was investigated in Lhasa, Tibet (3,658 meters above sea level). A total of 99.2% of the schoolchildren reported that they had not experienced any wheezing during the prior 12 months. Among these students, more than 50% had consumed rice, meat, fruits, and vegetables at least three times per week in the preceding year. More than 70% of the non-asthmatic students rarely consumed margarine; 50% of these students rarely ate fast food; and 40% only occasionally ate fish during the prior 12 months. The dietary habits of the schoolchildren in Lhasa may have some potential beneficial roles in contributing to the low prevalence of asthma in this high altitude region.

Home Exposures, Parental Atopy, and Occurrence of Asthma Symptoms in Adulthood in Southern Taiwan

Parental atopy and environmental exposures at home have been recognized risk factors for adulthood asthma. However, the relative contributions of specific risk factors and the overall contributions of heredity or home exposure remain unexplored. The purpose of this study was to identify predictors and estimate the population attributable risk (PAR) of each exposure for typical asthma symptoms among 26- to 50-year-old Taiwanese. We also investigated whether an interactive effect existed between parental atopy and home exposures on the occurrence of asthma symptoms in adulthood. A cross-sectional study with retrospective components. Elementary and middle schools in Southern Taiwan. Between March and October 2004, we conducted a cross-sectional survey among schoolchildren's parents from 94 elementary and middle schools in Southern Taiwan. The main outcome measure was typical asthma-like symptoms occurring within the preceding 5 years. Information on hereditary and home exposures was collected by using a self-administered questionnaire. After excluding unqualified questionnaires, data from 24,784 subjects were left for analysis. New-onset asthma was reported for 0.83% of male (n = 80 of 9,662) and 1.36% of female subjects (n = 206 of 15,122). Besides parental atopic factors, environmental tobacco smoke or pet avoidance and visible mold on walls at home were independently associated with the occurrence of asthma symptoms. Mutually adjusted models produced statistically significant associations between any home exposure (odds ratio [OR], 1.80; 95% confidence interval [CI], 1.08 to 3.23; PAR, 28.04%), parental atopy (OR, 4.47; 95% CI, 3.47 to 5.75; PAR, 31.38%), and new-onset asthma. However, there was no interaction between parental atopy and home exposures. Home exposures and parental atopy both increased the risks of new-onset asthma in adulthood but did not show an interactive effect. These two exposure categories approximately contributed equally to the adulthood asthma.

Asthma and allergy in Albania and the UK

In the first phase of the International Study of Asthma and Allergies in Childhood, a large difference in occurrence of asthma symptoms was seen between children in Albania and the UK. We did skin-prick tests with various allergens and measured peak expiratory flow rate in about 1000 children from each country. A large difference in the proportion of exercise-induced bronchial reactivity was evident between children from Albania and the UK (0.8% vs 5.4%, respectively). However, the frequency of allergic sensitisation was closely similar (15.0% vs 17.8%, respectively). These results suggest that large geographical variations in asthma prevalence can arise without differences in frequency of atopy.

The ecological relationship of tobacco smoking to the prevalence of symptoms of asthma and other atopic diseases in children: the International Study of Asthma and Allergies in Childhood (ISAAC).

This study examined the relationship between parental smoking and asthma and other atopic diseases at the ecological level. The prevalence of atopic symptoms in 6-7- and 13-14-year old children was assessed in 91 centres (from 38 countries) and 155 centres (from 56 countries) respectively in the International Study of Asthma and Allergy in Childhood (ISAAC). These symptoms were related to prevalence of tobacco smoking for each country by gender as reported by the World Health Organisation. There was a significant negative association between the prevalence of smoking by men and the prevalence of symptoms of asthma and rhinitis, but not eczema in the 13-14-year age group. There was a significant positive relationship between prevalence of smoking by women and prevalence of wheeze in the last 12 months, but not for any other symptoms in the 13-14-year age group. In the 6-7-year age group, there was a significant negative correlation between prevalence of smoking by men and the prevalence of wheeze causing sleep disturbance and a close to significant negative association at the 5% level with the prevalence of wheeze in the last 12 months and rhinitis. Thus, for the countries that are included in this analysis, countries that have high adult male smoking rates have a lower risk of asthma and rhinitis symptoms in children. It should be stressed that this analysis does not involve information on individual exposures and therefore does not contradict the well-established association of active and passive smoking in individuals with the occurrence of asthma symptoms in the same individuals. Rather, it indicates that this well-established individual-level association does not account for the international differences in asthma prevalence, and that other risk factors for asthma must be responsible for the observed international patterns.

Effects of Ambient Air Pollution on Symptoms of Asthma in Seattle-Area Children Enrolled in the CAMP Study

We observed a panel of 133 children (5-13 years of age) with asthma residing in the greater Seattle, Washington, area for an average of 58 days (range 28-112 days) during screening for enrollment in the Childhood Asthma Management Program (CAMP) study. Daily self-reports of asthma symptoms were obtained from study diaries and compared with ambient air pollution levels in marginal repeated measures logistic regression models. We defined days with asthma symptoms as any day a child reported at least one mild asthma episode. All analyses were controlled for subject-specific variables [age, race, sex, baseline height, and FEV(1) PC(20) concentration (methacholine provocative concentration required to produce a 20% decrease in forced expiratory volume in 1 sec)] and potential time-dependent confounders (day of week, season, and temperature). Because of variable observation periods for participants, we estimated both between- and within-subject air pollutant effects. Our primary interest was in the within-subject effects: the effect of air pollutant excursions from typical levels in each child's observation period on the odds of asthma symptoms. In single-pollutant models, the population average estimates indicated a 30% [95% confidence interval (CI), 11-52%] increase for a 1-ppm increment in carbon monoxide lagged 1 day, an 18% (95% CI, 5-33%) increase for a 10-microg/m(3) increment in same-day particulate matter < 1.0 microm (PM(1.0)), and an 11% (95% CI, 3-20%) increase for a 10-microg/m(3) increment in particulate matter < 10 microm (PM(10)) lagged 1 day. Conditional on the previous day's asthma symptoms, we estimated 25% (95% CI, 10-42%), 14% (95% CI, 4-26%), and 10% (95% CI, 3-16%) increases in the odds of asthma symptoms associated with increases in CO, PM(1.0), and PM(10), respectively. We did not find any association between sulfur dioxide (SO(2)) and the odds of asthma symptoms. In multipollutant models, the separate pollutant effects were smaller. The overall effect of an increase in both CO and PM(1. 0) was a 31% (95% CI, 11-55%) increase in the odds of symptoms of asthma. We conclude that there is an association between change in short-term air pollution levels, as indexed by PM and CO, and the occurrence of asthma symptoms among children in Seattle. Although PM effects on asthma have been found in other studies, it is likely that CO is a marker for vehicle exhaust and other combustion by-products that aggravate asthma.