Chest
Volume 129, Issue 2, February 2006, Pages 300-308
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Original Research
Home Exposures, Parental Atopy, and Occurrence of Asthma Symptoms in Adulthood in Southern Taiwan

https://doi.org/10.1378/chest.129.2.300Get rights and content

Objective

Parental atopy and environmental exposures at home have been recognized risk factors for adulthood asthma. However, the relative contributions of specific risk factors and the overall contributions of heredity or home exposure remain unexplored. The purpose of this study was to identify predictors and estimate the population attributable risk (PAR) of each exposure for typical asthma symptoms among 26- to 50-year-old Taiwanese. We also investigated whether an interactive effect existed between parental atopy and home exposures on the occurrence of asthma symptoms in adulthood.

Design

A cross-sectional study with retrospective components.

Setting

Elementary and middle schools in Southern Taiwan.

Subjects

Between March and October 2004, we conducted a cross-sectional survey among schoolchildren's parents from 94 elementary and middle schools in Southern Taiwan. The main outcome measure was typical asthma-like symptoms occurring within the preceding 5 years. Information on hereditary and home exposures was collected by using a self-administered questionnaire.

Results

After excluding unqualified questionnaires, data from 24,784 subjects were left for analysis. New-onset asthma was reported for 0.83% of male (n = 80 of 9,662) and 1.36% of female subjects (n = 206 of 15,122). Besides parental atopic factors, environmental tobacco smoke or pet avoidance and visible mold on walls at home were independently associated with the occurrence of asthma symptoms. Mutually adjusted models produced statistically significant associations between any home exposure (odds ratio [OR], 1.80; 95% confidence interval [CI], 1.08 to 3.23; PAR, 28.04%), parental atopy (OR, 4.47; 95% CI, 3.47 to 5.75; PAR, 31.38%), and new-onset asthma. However, there was no interaction between parental atopy and home exposures.

Conclusions

Home exposures and parental atopy both increased the risks of new-onset asthma in adulthood but did not show an interactive effect. These two exposure categories approximately contributed equally to the adulthood asthma.

Section snippets

Population and Study Design

Southern Taiwan, the southernmost part of Taiwan Island, comprises five administrative districts: Tainan City, Tainan County, Kaohsiung City, Kaohsiung County, and Pintung County. The overall population and territory of this area in 2002 were 5,501,747 people and 7,914 square kilometers. Between March and October 2004, we conducted a cross-sectional, school-based survey for respiratory diseases and symptoms in middle- and elementary-school children and their parents. Twenty of the 189 middle

Results

Our study surveyed the parents of 35,682 children from 94 elementary and middle schools. A total of 9,990 subjects were excluded from our study due to refusal participation, inadequate demographic information, or missing responses to the key questions. Data from 25,692 subjects remained satisfactory, with an overall response rate of 72.1%. Most of the participants were between 26 and 50 years old. We omitted 908 subjects > 50 years old; 24,784 subjects (9,662 male and 15,122 female) were left

Discussion

Our large cross-sectional questionnaire survey among 26- to 50-year-old adults provides evidence of the effects of hereditary and environmental factors on the occurrence of adulthood asthma in Taiwan. Although our study was cross-sectional, we analyzed data by case-control study method, which was very efficient compared with a cohort study yielding a similar amount of information. Our data corresponded to a follow-up of 24,784 adults for 5 years, and the incidence of typical asthma symptoms was

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  • Cited by (0)

    This study was supported by grant DOH93-HP-1108 from Bureau of Health Promotion, Department of Health, Taiwan.

    Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/misc/reprints.shtml).

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