ChiroACCESS Clinical Review



Asthma: Prevention

This information is provided to you for use in conjunction with your clinical judgment and the specific needs of the patient.

Lead Author(s): 

Dwain M. Daniel, D.C.

  

How this evidence was rated:

Strength of Recommendation Taxonomy (SORT)



Published on

December 10, 2008

Text Size:     

Unlike many conditions there is a wealth of information relating to risk factors and prevention strategies for asthma.  The difficulty is in choosing an appropriate strategy for your unique patient.  Asthma is a multifactorial disease that is not well understood and can have a variety of risk factors.  In the United States it affects over 22 million people, results in 4000 deaths annually  (1) and is responsible for 200,000 hospitalizations annually (2).  Of additional concern is the observation that the number of asthma cases has doubled in the United States since 1980 (3).  Considering the fact that standard asthma treatment protocols only address symptom reduction and do not resolve the condition, prevention is the most viable treatment option.    The risk factors outlined below may play a role in the etiology of the condition as well as exacerbate the condition when already present.

It is important to note the conclusions made by Saglani and Bush review of the origins of asthma.  It was stated that “the roots of asthma are to be found in the first three years of life…By age 3, the die is cast and lung function tracks lifelong “(4). 

The strength of the recommendation given below is for identification of risk factors.  There is significantly less evidence relating to actual prevention strategies, which in some cases the evidence is conflicting.


AttentionIn order to view the full content of this review, which includes information broken down by topic, you must be a registered user of ChiroACCESS. The primary mission of ChiroACCESS is to disseminate accurate user-friendly information to practicing chiropractors, faculty and students of chiropractic in order to ensure the best possible patient care.

Please click on the following link in order to register at ChiroACCESS and view the full detail of this clinical review.

If you already have an account, you may log in at this time.



References

1. 

Balkissoon R. Asthma overview. Prim Care 2008 Mar;35(1):41-60, vi.



2. 

Michael MA. Scope and impact of pediatric asthma. Nurse Pract 2002 Jun;Suppl:3-6.



3. 

Redd SC. Asthma in the United States: burden and current theories. Environ Health Perspect 2002 Aug;110 Suppl 4:557-60.



4. 

Saglani S, Bush A. The early-life origins of asthma. Curr Opin Allergy Clin Immunol 2007 Feb;7(1):83-90.



5. 

Arbes SJ, Gergen PJ, Vaughn B, Zeldin DC. Asthma cases attributable to atopy:results from the third national Health and Nutritional examination survey. J Allergy Clin Immunol 2007;120:1139-45.



6. 

Simpson A, Custovic A. Allergen avoidance in the primary prevention of asthma. Curr Opin Allergy Clin Immunol 2004 Feb;4(1):45-51.



7. 

Arruda LK, Sole D, Baena-Cagnani CE, Naspitz CK. Risk factors for asthma and atopy. Curr Opin Allergy Clin Immunol 2005 Apr;5(2):153-9.



8. 

Gold MS, Kemp AS. Atopic disease in childhood. Med J Aust 2005 Mar 21;182(6):298-304.



9. 

Platts-Mills TA, Blumenthal K, Perzanowski M, Woodfolk JA. Determinants of clinical allergic disease. The relevance of indoor allergens to the increase in asthma. Am J Respir Crit Care Med 2000 Sep;162(3 Pt 2):S128-S133.



10. 

National Academy of sciences. Clearing the Air. National Academy of Sciences 2000 [cited 2008 Nov 4];



11. 

Wood RA. House dust mite and cockroach exposure: risk factors for asthma. J Aerosol Med 2004;17(2):165-8.



12. 

Liu AH. Something old, something new: indoor endotoxin, allergens and asthma. Paediatr Respir Rev 2004;5 Suppl A:S65-S71.



13. 

Bacharier LB, Dawson C, Bloomberg gr, Bender B, Wilson L, Strunk LC. Hospitalization for asthma: atopic, pulmonary function, psychological correlates among children in the Childhood Asthma Management program. Pediatrics 2003;112:e85-e92.



14. 

Seltzer JM, Fedoruk MJ. Health effects of mold in children. Pediatr Clin North Am 2007 Apr;54(2):309-ix.



15. 

Taylor PE, Jacobson KW, House JM, Glovsky MM. Links between pollen, atopy and the asthma epidemic. Int Arch Allergy Immunol 2007;144(2):162-70.



16. 

Platts-Mills T, Vaughan J, Squillace S, Woodfolk J, Sporik R. Sensitisation, asthma, and a modified Th2 response in children exposed to cat allergen: a population-based cross-sectional study. Lancet 2001 Mar 10;357(9258):752-6.



17. 

Johnson CC, Alford SH. Do animals on the farm and in the home reduce the risk of pediatric atopy? Curr Opin Allergy Clin Immunol 2002 Apr;2(2):133-9.



18. 

Apelberg BJ, Aoki Y, Jaakkola JJ. Systematic review: Exposure to pets and risk of asthma and asthma-like symptoms. J Allergy Clin Immunol 2001 Mar;107(3):455-60.



19. 

Prescott SL. Maternal allergen exposure as a risk factor for childhood asthma. Curr Allergy Asthma Rep 2006 Feb;6(1):75-80.



20. 

Lau S, Illi S, Sommerfeld C, Niggermann B, Bergmann R, E von Mutius, et al. Allergen exposure and the development of asthma. Thorax 2001;56 (Suppl II):ii58-ii63.



21. 

Kilburn S, Lasserson TJ, McKean M. Pet allergen control measures for allergic asthma in children and adults. Cochrane Database Syst Rev 2003;(1):CD002989.



22. 

Campbell F, Jones K. Feather vs. non-feather bedding for asthma. Cochrane Database Syst Rev 2000;(4):CD002154.



23. 

Siebers R, Fitzharris P, Crane J. Feather bedding and allergic disease in children: a cover story? Clin Exp Allergy 2002 Aug;32(8):1119-23.



24. 

Phipatanakul W. Environmental factors and childhood asthma. Pediatr Ann 2006 Sep;35(9):646-56.



25. 

Ly NP, Celedon JC. Family history, environmental exposures in early life, and childhood asthma. J Allergy Clin Immunol 2007 Aug;120(2):271-2.



26. 

Peat JK, Mellis CM. Early predictors of asthma. Curr Opin Allergy Clin Immunol 2002 Jun;2(3):167-73.



27. 

Taussig LM, Wright AL, Holberg CJ, Halonen M, Morgan WJ, Martinez FD. Tucson Children's Respiratory Study: 1980 to present. J Allergy Clin Immunol 2003 Apr;111(4):661-75.



28. 

Meurer JR, Lustig JV, Jacob HJ. Genetic aspects of the etiology and treatment of asthma. Pediatr Clin North Am 2006 Aug;53(4):715-25.



29. 

Donfack J, Schneider DH, Tan Z, Kurz T, Dubchak I, Frazer KA, et al. Variation in conserved non-coding sequences on chromosome 5q and susceptibility to asthma and atopy. Respir Res 2005;6:145.



30. 

LeSouef P. Genetics of asthma: what do we need to know? Pediatr Pulmonol Suppl 1997 Sep;15:3-8.



31. 

Bleecker ER, Postma DS, Meyers DA. Evidence for multiple genetic susceptibility loci for asthma. Am J Respir Crit Care Med 1997 Oct;156(4 Pt 2):S113-S116.



32. 

Ozol D, Mete E. Asthma and food allergy. Curr Opin Pulm Med 2008 Jan;14(1):9-12.



33. 

James JM. Respiratory manifestations of food allergy. Pediatrics 2003 Jun;111(6 Pt 3):1625-30.



34. 

Agarkhedkar SR, Bapat HB, Bapat BN. Avoidance of food allergens in childhood asthma. Indian Pediatr 2005 Apr;42(4):362-6.



35. 

Simpson AB, Glutting J, Yousef E. Food allergy and asthma morbidity in children. Pediatr Pulmonol 2007 Jun;42(6):489-95.



36. 

Berns SH, Halm EA, Sampson HA, Sicherer SH, Busse PJ, Wisnivesky JP. Food allergy as a risk factor for asthma morbidity in adults. J Asthma 2007 Jun;44(5):377-81.



37. 

Oddy WH. A review of the effects of breastfeeding on respiratory infections, atopy, and childhood asthma. J Asthma 2004 Sep;41(6):605-21.



38. 

Kemp A, Kakakios A. Asthma prevention: breast is best? J Paediatr Child Health 2004 Jul;40(7):337-9.



39. 

Greer FR, Sicherer SH, Burks AW. Effects of early nutritional interventions on the development of atopic disease in infants and children: the role of maternal dietary restriction, breastfeeding, timing of introduction of complementary foods, and hydrolyzed formulas. Pediatrics 2008 Jan;121(1):183-91.



40. 

Weichenthal S, Dufresne A, Infante-Rivard C. Indoor ultrafine particles and childhood asthma: exploring a potential public health concern. Indoor Air 2007 Apr;17(2):81-91.



41. 

Krone CA, Klingner TD. Isocyanates, polyurethane and childhood asthma. Pediatr Allergy Immunol 2005 Aug;16(5):368-79.



42. 

Bello D, Herrick CA, Smith TJ, Woskie SR, Streicher RP, Cullen MR, et al. Skin exposure to isocyanates: reasons for concern. Environ Health Perspect 2007 Mar;115(3):328-35.



43. 

Mendell MJ. Indoor residential chemical emissions as risk factors for respiratory and allergic effects in children: a review. Indoor Air 2007 Aug;17(4):259-77.



44. 

Mirabelli MC, Zock JP, Plana E, Anto JM, Benke G, Blanc PD, et al. Occupational risk factors for asthma among nurses and related healthcare professionals in an international study. Occup Environ Med 2007 Jul;64(7):474-9.



45. 

D'Amato G, Liccardi G, D'Amato M, Holgate S. Environmental risk factors and allergic bronchial asthma. Clin Exp Allergy 2005 Sep;35(9):1113-24.



46. 

Nightingale JA, Rogers DF, Barnes PJ. Effect of inhaled ozone on exhaled nitric oxide, pulmonary function, and induced sputum in normal and asthmatic subjects. Thorax 1999 Dec;54(12):1061-9.



47. 

Mortimer KM, Tager IB, Dockery DW, Neas LM, Redline S. The effect of ozone on inner-city children with asthma: identification of susceptible subgroups. Am J Respir Crit Care Med 2000 Nov;162(5):1838-45.



48. 

Sarnat JA, Holguin F. Asthma and air quality. Curr Opin Pulm Med 2007 Jan;13(1):63-6.



49. 

Schildcrout JS, Sheppard L, Lumley T, Slaughter JC, Koenig JQ, Shapiro GG. Ambient air pollution and asthma exacerbations in children: an eight-city analysis. Am J Epidemiol 2006 Sep 15;164(6):505-17.



50. 

Thomson NC. The role of environmental tobacco smoke in the origins and progression of asthma. Curr Allergy Asthma Rep 2007 Jul;7(4):303-9.



51. 

Pandya RJ, Solomon G, Kinner A, Balmes JR. Diesel exhaust and asthma: hypotheses and molecular mechanisms of action. Environ Health Perspect 2002 Feb;110 Suppl 1:103-12.



52. 

Gilmour MI, Jaakkola MS, London SJ, Nel AE, Rogers CA. How exposure to environmental tobacco smoke, outdoor air pollutants, and increased pollen burdens influences the incidence of asthma. Environ Health Perspect 2006 Apr;114(4):627-33.



53. 

Rundell KW, Jenkinson DM. Exercise-induced bronchospasm in the elite athlete. Sports Med 2002;32(9):583-600.



54. 

Tan RA, Spector SL. Exercise-induced asthma. Sports Med 1998 Jan;25(1):1-6.



55. 

Stensrud T, Berntsen S, Carlsen KH. Exercise capacity and exercise-induced bronchoconstriction (EIB) in a cold environment. Respir Med 2007 Jul;101(7):1529-36.



56. 

Fanelli A, Cabral AL, Neder JA, Martins MA, Carvalho CR. Exercise training on disease control and quality of life in asthmatic children. Med Sci Sports Exerc 2007 Sep;39(9):1474-80.



57. 

Basaran S, Guler-Uysal F, Ergen N, Seydaoglu G, Bingol-Karakoc G, Ufuk AD. Effects of physical exercise on quality of life, exercise capacity and pulmonary function in children with asthma. J Rehabil Med 2006 Mar;38(2):130-5.



58. 

Weisgerber MC, Guill M, Weisgerber JM, Butler H. Benefits of swimming in asthma: effect of a session of swimming lessons on symptoms and PFTs with review of the literature. J Asthma 2003;40(5):453-64.



59. 

Spector SL. Update on exercise-induced asthma. Ann Allergy 1993 Dec;71(6):571-7.



60. 

Sly RM. History of exercise-induced asthma. Med Sci Sports Exerc 1986 Jun;18(3):314-7.



61. 

Beuther DA, Martin RJ. Efficacy of a heat exchanger mask in cold exercise-induced asthma. Chest 2006 May;129(5):1188-93.



62. 

Illi S, von ME, Lau S, Bergmann R, Niggemann B, Sommerfeld C, et al. Early childhood infectious diseases and the development of asthma up to school age: a birth cohort study. BMJ 2001 Feb 17;322(7283):390-5.



63. 

Dunder T, Tapiainen T, Pokka T, Uhari M. Infections in child day care centers and later development of asthma, allergic rhinitis, and atopic dermatitis: prospective follow-up survey 12 years after controlled randomized hygiene intervention. Arch Pediatr Adolesc Med 2007 Oct;161(10):972-7.



64. 

Proud D, Chow CW. Role of viral infections in asthma and chronic obstructive pulmonary disease. Am J Respir Cell Mol Biol 2006 Nov;35(5):513-8.



65. 

Mallia P, Johnston SL. How viral infections cause exacerbation of airway diseases. Chest 2006 Oct;130(4):1203-10.



66. 

Chinn S. Obesity and asthma: evidence for and against a causal relation. J Asthma 2003 Feb;40(1):1-16.



67. 

Garcia-Marcos L, Canflanca IM, Garrido JB, Varela AL, Garcia-Hernandez G, Guillen GF, et al. Relationship of asthma and rhinoconjunctivitis with obesity, exercise and Mediterranean diet in Spanish schoolchildren. Thorax 2007 Jun;62(6):503-8.



68. 

Eneli IU, Skybo T, Camargo CA, Jr. Weight loss and asthma: a systematic review. Thorax 2008 Aug;63(8):671-6.



69. 

Dixon AE, Shade DM, Cohen RI, Skloot GS, Holbrook JT, Smith LJ, et al. Effect of obesity on clinical presentation and response to treatment in asthma. J Asthma 2006 Sep;43(7):553-8.



70. 

Schachter LM, Peat JK, Salome CM. Asthma and atopy in overweight children. Thorax 2003 Dec;58(12):1031-5.



71. 

Chinn S, Downs SH, Anto JM, Gerbase MW, Leynaert B, de MR, et al. Incidence of asthma and net change in symptoms in relation to changes in obesity. Eur Respir J 2006 Oct;28(4):763-71.



72. 

Westergaard T, Rostgaard K, Wohlfahrt J, Andersen PK, Aaby P, Melbye M. Sibship characteristics and risk of allergic rhinitis and asthma. Am J Epidemiol 2005 Jul 15;162(2):125-32.



73. 

Neto HJ, Rosario NA. Risk factors for wheezing in the first year of life. J Pediatr (Rio J) 2008 Oct 20;84(6).



74. 

Nystad W. Daycare attendance, asthma and atopy. Ann Med 2000 Sep;32(6):390-6.



75. 

Jenkins C, Costello J, Hodge L. Systematic review of prevalence of aspirin induced asthma and its implications for clinical practice. BMJ 2004 Feb 21;328(7437):434.



76. 

Kanabar D, Dale S, Rawat M. A review of ibuprofen and acetaminophen use in febrile children and the occurrence of asthma-related symptoms. Clin Ther 2007 Dec;29(12):2716-23.



77. 

Kanabar D. Ibuprofen and asthma in paediatric populations: clinical concern or clinical reality? J R Soc Med 2007;100 Suppl 48:15-7.



78. 

Body R, Potier K. Best evidence topic report. Non-steroidal anti-inflammatory drugs and exacerbations of asthma in children. Emerg Med J 2004 Nov;21(6):713-4.



79. 

Kauffman RE, Lieh-Lai M. Ibuprofen and increased morbidity in children with asthma: fact or fiction? Paediatr Drugs 2004;6(5):267-72.



80. 

Mickleborough TD, Rundell KW. Dietary polyunsaturated fatty acids in asthma- and exercise-induced bronchoconstriction. Eur J Clin Nutr 2005 Dec;59(12):1335-46.



81. 

Simopoulos AP. Importance of the ratio of omega-6/omega-3 essential fatty acids: evolutionary aspects. World Rev Nutr Diet 2003;92:1-22.



82. 

Mickleborough TD, Lindley MR, Ionescu AA, Fly AD. Protective effect of fish oil supplementation on exercise-induced bronchoconstriction in asthma. Chest 2006 Jan;129(1):39-49.



83. 

Laerum BN, Wentzel-Larsen T, Gulsvik A, Omenaas E, Gislason T, Janson C, et al. Relationship of fish and cod oil intake with adult asthma. Clin Exp Allergy 2007 Nov;37(11):1616-23.



84. 

Sienra-Monge JJ, Ramirez-Aguilar M, Moreno-Macias H, Reyes-Ruiz NI, Del Rio-Navarro BE, Ruiz-Navarro MX, et al. Antioxidant supplementation and nasal inflammatory responses among young asthmatics exposed to high levels of ozone. Clin Exp Immunol 2004 Nov;138(2):317-22.



85. 

Tecklenburg SL, Mickleborough TD, Fly AD, Bai Y, Stager JM. Ascorbic acid supplementation attenuates exercise-induced bronchoconstriction in patients with asthma. Respir Med 2007 Aug;101(8):1770-8.



86. 

Mickleborough TD, Fogarty A. Dietary sodium intake and asthma: an epidemiological and clinical review. Int J Clin Pract 2006 Dec;60(12):1616-24.



87. 

Medici TC, Schmid AZ, Hacki M, Vetter W. Are asthmatics salt-sensitive? A preliminary controlled study. Chest 1993 Oct;104(4):1138-43.



88. 

Pogson ZE, Antoniak MD, Pacey SJ, Lewis SA, Britton JR, Fogarty AW. Does a low sodium diet improve asthma control? A randomized controlled trial. Am J Respir Crit Care Med 2008 Jul 15;178(2):132-8.



89. 

Johnson JB, Summer W, Cutler RG, Martin B, Hyun DH, Dixit VD, et al. Alternate day calorie restriction improves clinical findings and reduces markers of oxidative stress and inflammation in overweight adults with moderate asthma. Free Radic Biol Med 2007 Mar 1;42(5):665-74.



90. 

Waser M, Michels KB, Bieli C, Floistrup H, Pershagen G, von ME, et al. Inverse association of farm milk consumption with asthma and allergy in rural and suburban populations across Europe. Clin Exp Allergy 2007 May;37(5):661-70.



91. 

Smith LJ, Holbrook JT, Wise R, Blumenthal M, Dozor AJ, Mastronarde J, et al. Dietary intake of soy genistein is associated with lung function in patients with asthma. J Asthma 2004;41(8):833-43.



92. 

Devereux G. Early life events in asthma--diet. Pediatr Pulmonol 2007 Aug;42(8):663-73.



93. 

Weiss ST, Litonjua AA. Childhood asthma is a fat-soluble vitamin deficiency disease. Clin Exp Allergy 2008 Mar;38(3):385-7.



94. 

Grigg J. Asthma year in review 2006-7. Paediatr Respir Rev 2008 Jun;9(2):134-8.



95. 

Wagner JG, Jiang Q, Harkema JR, Ames BN, Illek B, Roubey RA, et al. Gamma-tocopherol prevents airway eosinophilia and mucous cell hyperplasia in experimentally induced allergic rhinitis and asthma. Clin Exp Allergy 2008 Mar;38(3):501-11.



96. 

Almqvist C, Worm M, Leynaert B. Impact of gender on asthma in childhood and adolescence: a GA2LEN review. Allergy 2008 Jan;63(1):47-57.



97. 

Melgert BN, Ray A, Hylkema MN, Timens W, Postma DS. Are there reasons why adult asthma is more common in females? Curr Allergy Asthma Rep 2007 May;7(2):143-50.



98. 

Gold DR, Wright R. Population disparities in asthma. Annu Rev Public Health 2005;26:89-113.



99. 

Jaakkola JJ, Ahmed P, Ieromnimon A, Goepfert P, Laiou E, Quansah R, et al. Preterm delivery and asthma: a systematic review and meta-analysis. J Allergy Clin Immunol 2006 Oct;118(4):823-30.