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ORIGINAL ARTICLES  ASTHMA


Panminerva Medica 2004 Giugno;46(2):97-110

lingua: Inglese

Risk factors for asthma incidence. A review of recent prospective evidence

King M. E. 1, Mannino D. M. 2, Holguin F. 1

1 Air Pollution and Respiratory Health Branch Centers for Disease Control and Prevention, Atlanta, GA, USA
2 Division of Polmonary and Critical Care Medicine, University of Kentucky, Lexington, KT


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Aim. The aim of ­this ­study is to deter­mine ­what fac­tors ­have ­been ­shown, in pros­pec­tive stud­ies, to pre­dict the inci­dence of asth­ma.
Methods. We per­formed a system­at­ic ­review of ­peer-­reviewed lit­er­a­ture ­from 1994 to 2004 to deter­mine ­what fac­tors pre­dict the devel­op­ment of asth­ma in ­both chil­dren and ­adults. This ­search strat­e­gy yield­ed 40 stud­ies, ­with 36 pro­vid­ing ­some esti­mate of asth­ma inci­dence for the ­total sam­ple and or a spe­cif­ic sub­group.
Results. Annual esti­mat­ed inci­dence of phy­si­cian-diag­nosed asth­ma ­ranged ­from 0.6 to 29.5 per 1000 per­sons. Risk fac­tors for inci­dent asth­ma ­among chil­dren includ­ed: ­male sex, atop­ic sen­si­ti­za­tion, paren­tal his­to­ry of asth­ma, ear­ly-­life stres­sors and infec­tions, obes­ity, and expo­sure to ­indoor aller­gens, tobac­co ­smoke and out­door pol­lu­tants. Risk fac­tors for ­adult-­onset asth­ma includ­ed ­female sex, air­way hyper­res­pon­sive­ness, life­style fac­tors, and ­work-relat­ed expo­sures.
Conclusion. Risk fac­tors for asth­ma ­include ­both mod­i­fi­able and non­mod­i­fi­able ­ones, and ­they ­vary ­between chil­dren and ­adults. This review of prospective evidence supports tobacco and smoke avoidance as an intervention for the primary prevention of childhood asthma. During ado­les­cence and adult­hood, tar­get­ing life­style fac­tors ­like obes­ity and smok­ing or reduc­ing occu­pa­tion­al expo­sures are the ­best oppor­tu­nities for asth­ma pre­ven­tion. Before specific public health recommendations can be made, however, additional longitudinal research is needed to better characterize target populations and identify appropriate settings for multifaceted asthma interventions.

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