Asthma: Prevention [Clinical Review]

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.