Triggers of Childhood Asthma - Baz - World Allergy Organization

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Triggers of Childhood Asthma - Baz - World Allergy Organization

Zeina E. Baz MDSt George Hospital University Medical CenterBeirut, Lebanon


Objectives:To provide an understanding of the regional triggersand risk factors of childhood asthma


•Aeroallergens•Sandstorms•Petrochemical pollution•Habits of smoking•Consanguinity


Per cent %181614121086420Prevalence of asthma in childrenAge 6-14 yrs16.815.413.612.4UAE Kuwait Jordan UKBener et al Eur J Epidem 1994;10:271Awadh Behbehani et al Ann Allergy 2000;85:58Abuekteish et al Ann Trop Pead 1996;16:227


Asthma in the desert: spectrum of the sensitizingaeroallergensC. I. Ezeamuzie 1 , M. S. Thomson 1 S. Al‐Ali 2 , A. Dowaisan 2 , M. Khan 2 Z. Hijazi 3


Kuwait (2) Saudi Arabia (3) United ArabEmirates (1)Prosopis Juliflora 62.7% 80% 45%Chenopodium album 70.7% 50% 19.6%Bermuda grass 62.9% 60% 31.3%Chenopodium weedProsopis treeBermuda grass1. An analysis of skin prick test reactions in asthmatics in a hot climate and desert environmentBener A, Safa W, Abdulhalik S, Lestringant GG2. Asthma in the desert: spectrum of the sensitizing aeroallergensC. I. Ezeamuzie 1 , M. S. Thomson 1 S. Al‐Ali 2 , A. Dowaisan 2 , M. Khan 2 Z. Hijazi 33. Aerallergens and allergy in Saudi ArabiaAlmogren et al, 2009


Z. E. Baz, M. Nader, F. Zaitoun, R. Dana, C. Irani, A. Hejjaoui, E. Kairallah, B. Abi Salloum, S. AbiDib Antoun, S. Chreiteh, H. Maatouk, B. AndaryFebruary 2010 , Vol. 125, Issue 2Pollen %Cupressaceae 55.4Oleaceae 7.6Urticaceae 3.7Poaceae 1


Meteorological factors, aeroallergens and asthmarelatedvisits in Kuwait : A 12‐month retrospective studyJafar A Qasem 1 , Hassan Nasrallah 2 , Bader N Al‐Khalaf 2 , Faysal Al‐Sharifi 2 , Ahmed Al‐Sherayfee 1 , Samirah A Almathkouri 1 , Hussein Al‐Saraf 3 Year : 2008 | Volume : 28 | Issue : 6 | Page : 435‐441Climatic factors and fungal spore counts, and emergency department visitsto Al‐Sabah Hospital over 12 months


SANDSTORM IN THE ARABIAN GULF


Alternaria alternata, Aspergillus fumigatus, A. niger, A. thomii,Cladosporium cladosporioides, Penicillium chrysogen, P. griseoroseum


Bener A, Safa W, Abdulhalik S, Lestringant GGUnited ArabEmiratesAllerg Immunol (Paris). 2002 Oct ; 34(8)Sensitization % of allergic patients with respiratory diseases ,dermatologic and ophtalmologic diseasesMesquite 45.5%Grass mix 40.7%Cottonwood 33.1%Bermuda grass 31.3%Kochi 25.8%Acacia 25.6%Alfalfa 22.9%Chenopodium 19.6%Date palm 13.2%Cockroach 14.7%Dust Mite 9.5%


Table I. House dust mite, cat, dog and cockroach allergens in dust samples from homes (µg/g fine dust)Lounge floorMattressBelowdetection limitMedian(interquartilerange) [range]Belowdetection limitMedian(interquartilerange) [range]Der p 1382/383(99.7%)NA [0.05‐0.16]378/379(99.7%)NA [0.05‐0.10]Der f 1381/383(99.5%)NA [0.05‐10.70]368/375(98.1%)NA [0.05‐11.00]


Al Mousawi et al 2001Public placeFel d 1 Median(range)Can f 1 Median(range)Bla g 2 Median(range)Mosques 0.26 (0.09–0.74) 0.12 (0.08–0.46) 0.35 (0.08–1.6)Restaurants 0.25 (0.17–0.75) N/A 0.41 (0.2–0.75)Schools 0.12 (0.06–0.58) N/A 0.14 (0.08–0.48)Cinemas 0.47 (0.06–1.62) 0.07 (0.04–0.09) 0.37 (0.06–1.6)


Petrochemical Plants


The Relation between mother smoking and the subsequentdevelopment of asthma


Challenge with environmental tobacco smoke exacerbates allergic airwaydisease in human beingsThe Journal of Allergy and ClinicalImmunology` David Diaz Sanchez et al August 2006Fig 1 ETS interacts with allergen to enhance allergen specific IgE and IgG4 levels. Subjects were challenged with ragweed allergenafter ETS (black bars) or clean air (white bars) exposure. The mean ± 1 SE ragweed IgE (A) or IgG4 (B) levels in nasal washes for 19subjects is shown. P < .01 vs challenge with clean air/ragweed.


Clean air (n = 10) ETS (n = 10)Clean air/ragweed(n = 19)ETS/ragweed (n =19)IL‐4 (pg/mL) ND ND ND 2.54 (1.24)IL‐5 (pg/mL) ND ND 0.31 (0.30) 4.82 (0.51)IL‐13 (pg/mL) ND ND 0.14 (0.09) 1.06 (0.49)IFN‐γ (pg/mL) 1.22 (0.45) 0.89 (0.34) 0.91 (0.22) 0.45 (0.08)


31 May 2010Tobacco smoke among school girlsThe Region has the second highest rate (9%) in the world of girls’ use of tobaccoproducts other than cigarettes, including shisha and smokeless tobacco, with ratesexceeding 30% in Lebanon and 20% in Jordan, Syrian Arab Republic, United ArabEmirates and occupied Palestinian territory (West Bank).


Joseph M et al, Journal of Asthma 2009The prevalence of childhood asthma was higher among children inconsanguineous families (43.3%) compared to non‐consanguineous (22.6%, p< 0.001).A significant correlation between the degree of consanguinity and thenumber of asthmatic children per family (p = 0.0002).Paternal asthma in consanguineous families increased asthma risk for both boysand girls (p = 0.021 for boys, p < 0.001 for girls),


Asthma in childhood is a frequent problem in countries of the Gulf and the Near East•Mold allergy in the desert is an important trigger for asthma in children•Cat sensitization and ownership in the desert is another risk factor•Exposure to pollutants from petrochemical plants puts children at high risk for asthmaprevalence and exacerbation•The habit of smoking especially among school girls in the Arab countries is becoming amajor risk for asthma in children•Paternal asthma in consanguineous families increases the asthma risk for both boys andgirls


Zeina E. Baz MDSt George Hospital University Medical CenterBeirut, Lebanon

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