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Indoor air pollution and asthma in hospitalized children in a tropical environment
B H Azizi1, H I Zulkifli, S Kasim
1Department of Paediatrics, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur.
Insights
Indoor air pollution from smoking and mosquito coils significantly increases asthma risk in young children in Kuala Lumpur. Reducing exposure to these indoor pollutants can help prevent childhood asthma.
Area of Science:
- Environmental Health
- Pediatric Respiratory Medicine
- Epidemiology
Background:
- Childhood asthma is a growing public health concern, particularly in urban environments.
- Indoor air quality is increasingly recognized as a significant environmental factor influencing respiratory health in children.
- Kuala Lumpur, a tropical urban center, presents a unique setting to study indoor air pollution and childhood asthma.
Purpose of the Study:
- To investigate the association between specific indoor air pollutants and the incidence of acute asthma in young children.
- To identify modifiable indoor environmental risk factors for childhood asthma in a tropical urban setting.
- To provide evidence for public health interventions aimed at reducing childhood asthma morbidity.
Main Methods:
- A hospital-based case-control study was conducted in Kuala Lumpur.
- Cases comprised 158 children (1 month-5 years) hospitalized for their first asthma episode.
- Controls were 201 children hospitalized for non-respiratory conditions, matched by age.
Main Results:
- Sharing a bedroom with an adult smoker (OR=1.91) and exposure to mosquito coil smoke (OR=1.73) were independently associated with increased asthma risk.
- Previous allergy history, family history of asthma, low birth weight, and a coughing sibling were also risk factors.
- No association was found between asthma and kerosene stoves, wood stoves, aerosol repellents, housing type, or crowding.
Conclusions:
- Indoor air pollution, specifically from tobacco smoke and mosquito coils, is a significant and avoidable risk factor for acute asthma in young children.
- Interventions targeting indoor air quality improvements can play a crucial role in managing and preventing childhood asthma in tropical urban areas.
- Further research into specific pollutant components and long-term effects is warranted.
Abstract:
We performed a hospital-based study to examine a hypothesis that indoor air pollution was associated with acute asthma in young children living in Kuala Lumpur City. A total of 158 children aged 1 month to 5 years hospitalized for the first time for asthma were recruited as cases. Controls were 201 children of the same age group who were hospitalized for causes other than a respiratory illness. Information was obtained from mothers using a standardized questionnaire. Univariate analysis identified two indoor pollution variables as significant factors. Sharing a bedroom with an adult smoker and exposure to mosquito coil smoke at least three nights in a week were both associated with increased risk for asthma. Logistic regression analysis confirmed that sharing a bedroom with an adult smoker (OR = 1.91, 95% CI 1.13, 3.21) and exposure to mosquito coil smoke (OR = 1.73, 95% CI 1.02, 2.93) were independent risk factors. Other factors independently associated with acute asthma were previous history of allergy, history of asthma in first-degree relatives, low birth weight, and the presence of a coughing sibling. There was no association between asthma and exposure to kerosene stove, wood stove, aerosol mosquito repellent, type of housing, or crowding. We conclude that indoor air pollution is an avoidable factor in the increasing morbidity due to asthma in children in a tropical environment.