Urbanisation but not biomass fuel smoke exposure is associated with asthma prevalence in four resource-limited settings

CRONICAS Cohort Study Group

Research output: Contribution to journalArticle

Abstract

Background: Urbanisation is an important contributor to the prevalence of asthma worldwide, and the burden of this effect in low-income and middle-income countries undergoing rapid industrialisation appears to be growing. We sought to characterise adult asthma prevalence across four geographically diverse settings in Peru and identify both individual and environmental risk factors associated with adult asthma. Methods: We collected sociodemographics, clinical history and spirometry in adults aged ≥35 years. We defined asthma as meeting one of the three criteria: physician diagnosis, self-report of wheezing attack or use of asthma medications. We used multivariable logistic regression to assess individual and environmental factors associated with adult asthma. Results: We analysed data from 2953 participants (mean age 55 years; 49% male). Overall asthma prevalence was 7.1%, which varied with urbanisation: highest in Lima (14.5%), followed by urban Puno (4.0%), semiurban Tumbes (3.8%) and rural Puno (1.8%). In multivariable analysis, being male (OR=0.60, 95% CI 0.39 to 0.93) and living at high altitude (OR=0.26, 95% CI 0.16 to 0.42) were associated with lower odds of having asthma, whereas living in an urban setting (OR=4.72, 95% CI 3.15 to 7.23) and family history of asthma (OR=1.83, 95% CI 1.19 to 2.73) were associated with higher odds. Current daily exposure to biomass fuel smoke (OR=1.18, 95% CI 0.70 to 1.91) and smoking (OR=0.99, 95% CI 0.73 to 1.22) were not associated with asthma. Conclusions: These findings confirm that urbanisation is an environmental risk factor of asthma, questions biomass fuel smoke exposure as an important risk factor and proposes high altitude as possibly protective against the development of asthma.

Original languageEnglish (US)
Pages (from-to)154-160
Number of pages7
JournalThorax
Volume71
Issue number2
DOIs
StatePublished - Feb 1 2016

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Urbanization
Smoke
Biomass
Asthma
Peru
Spirometry
Respiratory Sounds
Self Report
Logistic Models
Smoking

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

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Urbanisation but not biomass fuel smoke exposure is associated with asthma prevalence in four resource-limited settings. / CRONICAS Cohort Study Group.

In: Thorax, Vol. 71, No. 2, 01.02.2016, p. 154-160.

Research output: Contribution to journalArticle

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title = "Urbanisation but not biomass fuel smoke exposure is associated with asthma prevalence in four resource-limited settings",
abstract = "Background: Urbanisation is an important contributor to the prevalence of asthma worldwide, and the burden of this effect in low-income and middle-income countries undergoing rapid industrialisation appears to be growing. We sought to characterise adult asthma prevalence across four geographically diverse settings in Peru and identify both individual and environmental risk factors associated with adult asthma. Methods: We collected sociodemographics, clinical history and spirometry in adults aged ≥35 years. We defined asthma as meeting one of the three criteria: physician diagnosis, self-report of wheezing attack or use of asthma medications. We used multivariable logistic regression to assess individual and environmental factors associated with adult asthma. Results: We analysed data from 2953 participants (mean age 55 years; 49{\%} male). Overall asthma prevalence was 7.1{\%}, which varied with urbanisation: highest in Lima (14.5{\%}), followed by urban Puno (4.0{\%}), semiurban Tumbes (3.8{\%}) and rural Puno (1.8{\%}). In multivariable analysis, being male (OR=0.60, 95{\%} CI 0.39 to 0.93) and living at high altitude (OR=0.26, 95{\%} CI 0.16 to 0.42) were associated with lower odds of having asthma, whereas living in an urban setting (OR=4.72, 95{\%} CI 3.15 to 7.23) and family history of asthma (OR=1.83, 95{\%} CI 1.19 to 2.73) were associated with higher odds. Current daily exposure to biomass fuel smoke (OR=1.18, 95{\%} CI 0.70 to 1.91) and smoking (OR=0.99, 95{\%} CI 0.73 to 1.22) were not associated with asthma. Conclusions: These findings confirm that urbanisation is an environmental risk factor of asthma, questions biomass fuel smoke exposure as an important risk factor and proposes high altitude as possibly protective against the development of asthma.",
author = "{CRONICAS Cohort Study Group} and Chelsea Gaviola and Miele, {Catherine H.} and Wise, {Robert A} and Gilman, {Robert H} and Devan Jaganath and Miranda, {J. Jaime} and Antonio Bernabe-Ortiz and Nadia Hansel and William Checkley and Casas, {Juan P.} and Smith, {George Davey} and Shah Ebrahim and Garc{\'i}a, {H{\'e}ctor H.} and Luis Huicho and Germ{\'a}n M{\'a}laga and Montori, {V{\'i}ctor M.} and Liam Smeeth and Diette, {Gregory B} and Fabiola Le{\'o}n-Velarde and Mar{\'i}a Rivera and Katherine Sacksteder",
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T1 - Urbanisation but not biomass fuel smoke exposure is associated with asthma prevalence in four resource-limited settings

AU - CRONICAS Cohort Study Group

AU - Gaviola, Chelsea

AU - Miele, Catherine H.

AU - Wise, Robert A

AU - Gilman, Robert H

AU - Jaganath, Devan

AU - Miranda, J. Jaime

AU - Bernabe-Ortiz, Antonio

AU - Hansel, Nadia

AU - Checkley, William

AU - Casas, Juan P.

AU - Smith, George Davey

AU - Ebrahim, Shah

AU - García, Héctor H.

AU - Huicho, Luis

AU - Málaga, Germán

AU - Montori, Víctor M.

AU - Smeeth, Liam

AU - Diette, Gregory B

AU - León-Velarde, Fabiola

AU - Rivera, María

AU - Sacksteder, Katherine

PY - 2016/2/1

Y1 - 2016/2/1

N2 - Background: Urbanisation is an important contributor to the prevalence of asthma worldwide, and the burden of this effect in low-income and middle-income countries undergoing rapid industrialisation appears to be growing. We sought to characterise adult asthma prevalence across four geographically diverse settings in Peru and identify both individual and environmental risk factors associated with adult asthma. Methods: We collected sociodemographics, clinical history and spirometry in adults aged ≥35 years. We defined asthma as meeting one of the three criteria: physician diagnosis, self-report of wheezing attack or use of asthma medications. We used multivariable logistic regression to assess individual and environmental factors associated with adult asthma. Results: We analysed data from 2953 participants (mean age 55 years; 49% male). Overall asthma prevalence was 7.1%, which varied with urbanisation: highest in Lima (14.5%), followed by urban Puno (4.0%), semiurban Tumbes (3.8%) and rural Puno (1.8%). In multivariable analysis, being male (OR=0.60, 95% CI 0.39 to 0.93) and living at high altitude (OR=0.26, 95% CI 0.16 to 0.42) were associated with lower odds of having asthma, whereas living in an urban setting (OR=4.72, 95% CI 3.15 to 7.23) and family history of asthma (OR=1.83, 95% CI 1.19 to 2.73) were associated with higher odds. Current daily exposure to biomass fuel smoke (OR=1.18, 95% CI 0.70 to 1.91) and smoking (OR=0.99, 95% CI 0.73 to 1.22) were not associated with asthma. Conclusions: These findings confirm that urbanisation is an environmental risk factor of asthma, questions biomass fuel smoke exposure as an important risk factor and proposes high altitude as possibly protective against the development of asthma.

AB - Background: Urbanisation is an important contributor to the prevalence of asthma worldwide, and the burden of this effect in low-income and middle-income countries undergoing rapid industrialisation appears to be growing. We sought to characterise adult asthma prevalence across four geographically diverse settings in Peru and identify both individual and environmental risk factors associated with adult asthma. Methods: We collected sociodemographics, clinical history and spirometry in adults aged ≥35 years. We defined asthma as meeting one of the three criteria: physician diagnosis, self-report of wheezing attack or use of asthma medications. We used multivariable logistic regression to assess individual and environmental factors associated with adult asthma. Results: We analysed data from 2953 participants (mean age 55 years; 49% male). Overall asthma prevalence was 7.1%, which varied with urbanisation: highest in Lima (14.5%), followed by urban Puno (4.0%), semiurban Tumbes (3.8%) and rural Puno (1.8%). In multivariable analysis, being male (OR=0.60, 95% CI 0.39 to 0.93) and living at high altitude (OR=0.26, 95% CI 0.16 to 0.42) were associated with lower odds of having asthma, whereas living in an urban setting (OR=4.72, 95% CI 3.15 to 7.23) and family history of asthma (OR=1.83, 95% CI 1.19 to 2.73) were associated with higher odds. Current daily exposure to biomass fuel smoke (OR=1.18, 95% CI 0.70 to 1.91) and smoking (OR=0.99, 95% CI 0.73 to 1.22) were not associated with asthma. Conclusions: These findings confirm that urbanisation is an environmental risk factor of asthma, questions biomass fuel smoke exposure as an important risk factor and proposes high altitude as possibly protective against the development of asthma.

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