Environmental Determinants of Bronchial Asthma among Saudi School Children in Southwestern Saudi Arabia
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Target Population
2.2. Sample Size Determination and Sampling
2.3. Questionnaire Interview
2.4. Skin Prick Tests
2.5. Statistical Analysis
3. Results
3.1. Description of the Study Sample
3.2. Prevalence of Asthma and Severe Asthma
3.3. Determinants of Asthma and Severe Asthma
3.3.1. Personal and Environmental Outdoor and Indoor Pollution Factors
3.3.2. Dietary Factors
3.3.3. Allergens Sensitization Factors
4. Discussion
5. Conclusions
Acknowledgments
Author Contributions
Conflicts of Interest
References
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Personal and Environmental Factors | No-Asthma Group 1 N = 1096 | Ever (Diagnosed) Asthma N = 468 | 12-Month Nocturnal Cough N = 353 |
---|---|---|---|
Age 13–20 in years: No (%) | 471 (43.0%) | 196 (41.9%) | 138 (39.1%) |
cOR 2 (95% CI) | - | 0.96 (0.77–1.19) | 0.85 (0.67–1.09) |
aOR 3 (95% CI) | - | 1.00 (0.79–1.27) | 0.87 (0.66–1.14) |
Sex: Male: No (%) | 498 (45.4%) | 275 (58.8%) | 220 (62.3%) |
cOR (95% CI) | - | 1.71 (1.37–2.13) | 1.98 (1.55–2.54) |
aOR (95% CI) | - | 1.75 (1.35–2.27) | 1.93 (1.45–2.58) |
Having dogs: No (%) | 68 (6.2%) | 53 (11.3%) | 33 (9.3%) |
cOR (95% CI) | - | 1.93 (1.32–2.81) | 1.56 (1.01–2.40) |
aOR (95% CI) | - | 2.78 (1.79–4.31) | 2.48 (1.50–4.10) |
Having cats: No (%) | 478 (43.6%) | 186 (39.7%) | 132 (37.4%) |
cOR (95% CI) | - | 0.85 (0.68–1.06) | 0.77 (0.60–0.98) |
aOR (95% CI) | - | 0.77 (0.60–1.00) | 0.75 (0.56–1.01) |
Dense truck traffic: No (%) | 879 (80.2%) | 417 (89.1%) | 319 (90.4%) |
cOR (95% CI) | - | 2.02 (1.45–2.80) | 2.32 (1.58–3.40) |
aOR (95% CI) | - | 2.13 (1.48–3.06) | 2.47 (1.61–3.80) |
Wood as cooking fuel: No (%) | 11 (1.0%) | 7 (1.5%) | 7 (2.0%) |
cOR (95% CI) | - | 1.50 (0.57–3.88) | 1.99 (0.77–5.18) |
aOR (95% CI) | - | 3.01 (1.02–9.77) | 4.16 (1.06–16.33) |
Wood as heating fuel: No (%) | 124 (11.3%) | 64 (13.7%) | 37 (10.5%) |
cOR (95% CI) | - | 1.24 (0.89–1.72) | 0.92 (0.62–1.35) |
aOR (95% CI) | - | 1.30 (0.90–1.89) | 1.19 (0.77–1.84) |
Family member smoking: No (%) | 79 (7.2%) | 48 (10.3%) | 45 (12.7%) |
cOR (95% CI) | - | 1.47 (0.99–2.17) | 1.88 (1.25–2.81) |
aOR (95% CI) | - | 1.31 (0.97–1.99) | 1.75 (1.11–2.13) |
Vigorous exercise: No (%) | 470 (42.9%) | 235 (50.2%) | 192 (54.4%) |
cOR (95% CI) | - | 1.34 (1.08–1.67) | 1.59 (1.23–2.02) |
aOR (95% CI) | 1.37 (1.07–1.75) | 1.87 (1.41–2.48) | |
Paracetamol use: No (%) | 778 (71.3%) | 310 (66.5%) | 262 (74.6%) |
cOR (95% CI) | - | 0.80 (063–1.01) | 1.18 (0.90–1.56) |
aOR (95% CI) | - | 0.86 (0.66–1.12) | 1.14 (0.84–1.54) |
Dietary Factors | No-Asthma Group 1 N = 1096 | Ever (Diagnosed) Asthma N = 468 | 12-Month Nocturnal Cough N = 353 |
---|---|---|---|
Seafoods intake: No (%) | 49 (4.5%) | 8 (1.7%) | 4 (1.1%) |
cOR 2 (95% CI) | - | 0.37 (0.17–0.79) | 0.24 (0.09–0.68) |
aOR 3 (95% CI) | - | 0.39 (0.17–0.88) | 0.41 (0.16–0.95) |
Fruit intake: No (%) | 507 (46.3%) | 197 (42.1%) | 138 (39.1%) |
cOR (95% CI) | - | 0.84 (0.68–1.05) | 0.74 (0.58–0.95) |
aOR (95% CI) | - | 0.72 (0.54–0.96) | 0.56 (0.40–0.79) |
Vegetable intake: No (%) | 485 (44.3%) | 218 (46.6%) | 171 (48.4%) |
cOR (95% CI) | - | 1.10 (0.88–1.36) | 1.18 (0.93–1.50) |
aOR (95% CI) | - | 1.58 (1.18–2.11) | 2.17 (1.57–3.02) |
Legume consumption: No (%) | 188 (17.2%) | 105 (22.4%) | 64 (18.1%) |
cOR (95% CI) | - | 1.40 (1.07–1.82) | 1.07 (0.78–1.46) |
aOR (95% CI) | - | 1.35 (0.95–1.91) | 0.85 (0.57–1.26) |
Grain intake: No (%) | 794 (72.4%) | 344 (73.5%) | 268 (75.9%) |
cOR (95% CI) | - | 1.05 (0.82–1.35) | 1.20 (0.91–1.58) |
aOR (95% CI) | - | 1.04 (0.76–1.41) | 1.25 (0.88–1.76) |
Nut intake: No (%) | 225 (20.5%) | 85 (18.3%) | 50 (14.3%) |
cOR (95% CI) | - | 0.87 (0.65–1.14) | 0.64 (0.46–0.90) |
aOR (95% CI) | - | 0.71 (0.48–1.03) | 0.67 (0.44–1.03) |
Dairy product intake: No (%) | 599 (54.7%) | 226 (48.3%) | 156 (44.2%) |
cOR (95% CI) | - | 0.77 (0.62–0.96) | 0.66 (0.51–0.84) |
aOR (95% CI) | - | 0.53 (0.40–0.71) | 0.38 (0.28–0.53) |
Egg intake: No (%) | 338 (30.8%) | 185 (39.5%) | 132 (37.4%) |
cOR (95% CI) | - | 1.46 (1.17–1.84) | 1.34 (1.04–1.72) |
aOR (95% CI) | - | 1.47 (1.11–1.95) | 1.60 (1.17–2.19) |
Fast Food consumption: No (%) | 156 (14.2%) | 67 (14.3%) | 45 (12.7%) |
cOR (95% CI) | - | 1.01 (0.74–1.37) | 0.88 (0.62–1.25) |
aOR (95% CI) | - | 0.92 (0.64–1.33) | 0.73 (0.47–1.12) |
Meat consumption: No (%) | 563 (51.40%) | 237 (50.6%) | 191 (54.1%) |
cOR (95% CI) | - | 0.97 (0.78–1.21) | 1.11 (0.88–1.42) |
aOR (95% CI) | - | 0.85 (0.65–1.10) | 1.21 (0.90–1.62) |
Allergens | No-Asthma Group 1 N = 1096 | Ever (Diagnosed) Asthma N = 468 | 12-Month Nocturnal Cough N = 353 |
---|---|---|---|
Indoor Allergens | |||
D. pteronyssinus: No (%) | 79 (7.2%) | 20 (4.3%) | 16 (4.5%) |
cOR 2 (95% CI) | - | 0.57 (0.35–0.95) | 0.61 (0.35–1.06) |
aOR 3 (95% CI) | - | 0.87 (0.46–1.63) | 1.20 (0.57–2.55) |
D. farina: No (%) | 50 (4.6%) | 16 (3.4%) | 20 (5.7%) |
cOR (95% CI) | - | 0.74 (0.42–1.31) | 1.25 (0.73–2.14) |
aOR (95% CI) | - | 0.52 (0.23–1.19) | 0.86 (0.37–1.96) |
Dog hair: No (%) | 7 (0.6%) | 12 (2.6%) | 7 (2.0%) |
cOR (95% CI) | - | 4.09 (1.60–10.46) | 3.14 (1.10–9.04) |
aOR (95% CI) | - | 6.38 (1.80–22.53) | 1.40 (0.39–4.94) |
Cat fur: No (%) | 176 (16.1%) | 109 (23.3%) | 76 (21.5%) |
cOR (95% CI) | - | 1.58 (1.21–2.07) | 1.43 (1.06–1.93) |
aOR (95% CI) | - | 1.21 (0.88–1.67) | 0.81 (0.55–1.19) |
Horse hair: No (%) | 47 (4.3%) | 19 (4.1%) | 25 (7.1%) |
cOR (95% CI) | - | 0.94 (0.54–1.62) | 1.70 (1.03–2.80) |
aOR (95% CI) | - | 0.89 (0.48–1.64) | 1.31 (0.72–2.39) |
Cladosporium: No (%) | 64 (5.8%) | 41 (8.8%) | 25 (7.1%) |
cOR (95% CI) | - | 1.55 (1.03–2.33) | 1.23 (0.76–1.98) |
aOR (95% CI) | - | 1.72 (1.06–2.78) | 1.25 (0.71–2.21) |
Outdoor Allergens | |||
Mugwort (Artimisia): No (%) | 3 (0.3%) | 3 (0.6%) | 3 (0.8%) |
cOR (95% CI) | - | 2.35 (0.47–11.68) | 3.20 (0.63–15.42) |
aOR (95% CI) | - | - | - |
Chenopodium album | 8 (0.7%) | 7 (1.5%) | 0 (0.0%) |
cOR (95% CI) | - | 2.06 (0.74–5.72) | - |
aOR (95% CI) | - | 1.18 (0.26–5.32) | - |
Pigweed (Amaranthus retroflexus): No (%) | 8 (0.7%) | 15 (3.2%) | 7 (2.0%) |
cOR (95% CI) | - | 4.50 (1.89–10.69) | 2.75 (0.99–7.64) |
aOR (95% CI) | - | 3.18 (1.03–9.83) | 7.76 (1.79–33.56) |
Timothy grass (Phleum pretense): No (%) | 71 (6.5%) | 24 (5.1%) | 37 (10.5%) |
cOR (95% CI) | - | 0.78 (0.48–1.25) | 1.69 (1.11–2.56) |
aOR (95% CI) | - | 0.39 (0.21–0.71) | 0.76 (0.44–1.32) |
Bermuda grass (Cynodon dactylon): No (%) | 158 (14.4%) | 115 (24.6%) | 98 (27.8%) |
cOR (95% CI) | - | 1.93 (1.477–2.53) | 2.28 (1.71–3.04) |
aOR (95% CI) | - | 1.66 (1.17–2.35) | 2.55 (1.71–3.79) |
Ragweed (Ambrosia): No (%) | 25 (2.3%) | 19 (4.1%) | 19 (5.4%) |
cOR (95% CI) | - | 1.813 (0.99–3.32) | 2.44 (1.32–4.48) |
aOR (95% CI) | - | 1.32 (0.63–2.77) | 1.42 (0.68–2.98) |
Candida albicans: No (%) | 27 (2.5%) | 0.00% | 4 (1.1%) |
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Alqahtani, J.M.; Asaad, A.M.; Awadalla, N.J.; Mahfouz, A.A. Environmental Determinants of Bronchial Asthma among Saudi School Children in Southwestern Saudi Arabia. Int. J. Environ. Res. Public Health 2017, 14, 22. https://doi.org/10.3390/ijerph14010022
Alqahtani JM, Asaad AM, Awadalla NJ, Mahfouz AA. Environmental Determinants of Bronchial Asthma among Saudi School Children in Southwestern Saudi Arabia. International Journal of Environmental Research and Public Health. 2017; 14(1):22. https://doi.org/10.3390/ijerph14010022
Chicago/Turabian StyleAlqahtani, Jobran M., Ahmed M. Asaad, Nabil J. Awadalla, and Ahmed A. Mahfouz. 2017. "Environmental Determinants of Bronchial Asthma among Saudi School Children in Southwestern Saudi Arabia" International Journal of Environmental Research and Public Health 14, no. 1: 22. https://doi.org/10.3390/ijerph14010022