Home environment and asthma in Kenyan schoolchildren: a case-control study.

Mohamed, Nashila; Ng’ang’a, Lucy; Odhiambo, Joseph; Nyamwaya, J.; Menzies, R.

doi:10.1136/thx.50.1.74

Cited by 80 publications

(55 citation statements)

References 20 publications

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“…In a large study from Nepal (N73000) adjusted odds ratios of up to six were found for some of the asthma symptoms when comparing households using only gas for cooking to only open fires (Schei et al, 2004). A case-control study of schoolchildren in Nairobi found increased exposure to wood smoke in asthmatics (Mohammed et al, 1995). Two other studies from Turkey and Jordan found similar results, but did not adjust for confounding (Gharaibeh 1996;Guneser et al, 1994).…”

Section: Biomass-smoke Exposurementioning

confidence: 88%

Childhood asthma and indoor woodsmoke from cooking in Guatemala

Schei

Hessen

Smith

et al. 2004

J Expo Sci Environ Epidemiol

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We estimated the prevalence and severity of asthma, and the association with cooking on open wood fires, as preparation for a large-scale randomized field trial on effects of indoor air pollution and child health. This is one of the first systematic studies of asthma and indoor wood-smoke pollution and to our knowledge the first asthma study in a purely indigeneous population in Latin America. The mothers of 1058 children aged 4-6 years were interviewed, using the standardized ISAAC (International Study of Asthma and Allergies in Childhood) procedures and questionnaire. The study population is a Mam-speaking (Maya), indigenous group living at relatively high altitude (2000 m) in Western Guatemalan Highlands. We found that asthma prevalence is low among indigenous children in Gautemala, compared to other populations in Latin America. Only 3.3% of the children reported wheezing symptoms in the last 12 months, and 72% wheezing symptoms ever. The majority of the current wheezers had at least one of the criteria for severe asthma. The prevalence of all the symptoms of asthma was higher in children from households that used open fires compared to improved stoves with chimneys. In a logistic regression model, use of open fire for cooking was a significant risk factor for a number of asthma symptoms, with odds ratios varying from 2.0 to 3.5. Among the different cooking technologies (1Fimproved stove with chimney, 2Fmixture of gas and open fire, 3Fopen fire) trends of higher prevalence with more pollution was found for some of the symptoms. Hence use of open fire for cooking, may be an important risk factor for asthma symptoms and severity.

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Section: Biomass-smoke Exposurementioning

confidence: 88%

Childhood asthma and indoor woodsmoke from cooking in Guatemala

Schei

Hessen

Smith

et al. 2004

J Expo Sci Environ Epidemiol

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“…The most accepted explanation for this phenomenon is that early exposure to endotoxins enhances Th1 immunity, which in turn inhibits Th2 immunity, which is involved in allergic disease (McGuirk and Mills, 2002). It has been found that the prevalence of asthma is lower in developing than in industrialized countries (Cookson, 1987), and it is associated with several factors in the home environment (Mohamed et al, 1995).…”

Section: Discussionmentioning

confidence: 99%

Heterogeneity in microbial exposure in schools in Sweden, Poland and Jordan revealed by analysis of chemical markers

Wady

Shehabi

Szponar

et al. 2004

J Expo Sci Environ Epidemiol

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We used gas chromatography-tandem mass spectrometry to analyze microbial components in 85 samples of airborne dust from schools in Jordan, Sweden, and Poland. To collect the samples, we allowed dust to settle on plexiglass plates hanging in the breathing zone in school buildings during both summer and winter. In each of the three countries, we conducted such sampling in two schools: one in an urban environment and the other in rural surroundings. The microbial marker profiles differed significantly between the schools and seasons. For example, samples from Jordan contained remarkably low levels of ergosterol (marker of fungal biomass) and high levels of 3-hydroxy acids (markers of lipopolysaccharide) of 10, 12, and 14 carbon chain lengths relative to such acids of 16 and 18 carbons in comparison with samples from Sweden and Poland. This dissimilarity in 3-hydroxy fatty acid distribution indicates significant differences in the populations of Gram-negative bacteria. We also noted that muramic acid (marker of bacterial biomass) exhibited the smallest variation between schools and seasons. In summary, our results demonstrate that exposure to microorganisms in indoor air in school buildings may differ markedly between countries, between seasons, and between urban and rural environments.

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“…4 A positive significant effect of biomass fuel use on asthma is also consistent with previous research linking cooking smoke to asthma. [57][58][59][60] Both the amount of body fat and its distribution are important in determining health risks associated with overweight conditions. In Asian populations, abdominal or central obesity is more common than obesity defined by BMI, 61 and health risks associated with overweight and obesity occur at lower levels of BMI than in North America or Europe.…”

Section: Discussionmentioning

confidence: 99%

Effect of obesity on asthma among adult Indian women

Mishra

2004

Int J Obes

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OBJECTIVE: Both obesity and asthma are on the rise worldwide. This study examined the association between obesity and asthma prevalence in adult women in India. METHODS: The analysis used information on 82 464 nonpregnant, ever-married women aged 15À49 y, included in India's 1998À99 National Family Health Survey. The effects of measured Body Mass Index (BMI) on reported asthma were estimated using logistic regression, after adjusting for tobacco smoking (active and passive), cooking smoke, age, education, work status, media habits, food habits, house type, separate kitchen, indoor crowding, religion, caste/tribe, household living standard, urban/rural residence, and geographic region. RESULTS: Obese women (BMIZ30.0 kg/m 2 ) were about twice as likely as those with a normal BMI (18.5À25.0 kg/m 2 ) to report suffering from asthma (OR ¼ 1.92; 95% CI: 1.40À2.65). The association between obesity and asthma remained strong and statistically significant even when the effects of other selected risk factors and potential confounders were controlled (OR ¼ 1.85; 95% CI: 1.30À2.63). Overweight women (25.0rBMIo30.0 kg/m 2 ) also reported significantly higher adjusted asthma prevalence than those with a normal BMI (OR ¼ 1.32; 95% CI: 1.07À1.63). Results hold in separate analysis for younger (15À29 y) and older (30À49 y) women. CONCLUSION: The study finds a strong positive association between obesity and asthma among adult Indian women. To validate this relationship and to establish causality, prospective epidemiological studies, with better measures of overweight conditions and clinical measures of asthma, are needed in developing-country settings.

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Home environment and asthma in Kenyan schoolchildren: a case-control study.

Cited by 80 publications

References 20 publications

Childhood asthma and indoor woodsmoke from cooking in Guatemala

Childhood asthma and indoor woodsmoke from cooking in Guatemala

Heterogeneity in microbial exposure in schools in Sweden, Poland and Jordan revealed by analysis of chemical markers

Effect of obesity on asthma among adult Indian women

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