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TIBITS—collected by
JK from Wikipedia:
Its diagnosis is usually made based on the pattern of
symptoms and/or response to therapy over time.[10]
The prevalence of asthma has increased significantly since the 1970s. As of
2010, 300 million people were affected worldwide.[11] In 2009
asthma caused 250,000 deaths globally.[ Some 9% of US children had asthma in 2001,
compared with just 3.6% in 1980. One subject that appears to show a strong
correlation is the development of asthma and obesity. In the
United Kingdom and United States, the rise in asthma prevalence has echoed an
almost epidemic rise in the prevalence of obesity. In Taiwan, symptoms of allergies and airway
hyper-reactivity increased in correlation with each 20% increase in body-mass
index.[54] Maternal tobacco smoking during pregnancy and
after delivery is associated with a greater risk of asthma-like symptoms,
wheezing, and respiratory infections during childhood.[64] The strongest risk factor for
developing asthma is a history of atopic disease;[37]
{hyper allergenic people} this increases one's risk of hay fever by up to 5×
and the risk of
asthma by 3–4×.[38] Asthma prevalence in the US is higher than in
most other countries in the world, but varies drastically between diverse US
populations.[61] In
the US, asthma prevalence is highest in Puerto Ricans, African Americans,
Filipinos, Irish Americans, and Native Hawaiians, and lowest in Mexicans and
Koreans. During the 1930s–50s, asthma
was considered as being one of the 'holy seven' psychosomatic illnesses. Its aetiology was
considered to be psychological, with treatment often based on psychoanalysis
and other 'talking cures'.[171]
As these psychoanalysts interpreted the asthmatic wheeze as the suppressed cry
of the child for its mother, so they considered that the treatment of
depression was especially important for individuals with asthma.[171]
among the first papers in modern medicine, is one that was published in 1873
and this paper tried to explain the pathophysiology
of the disease.[172]
Through the end of 2005, 25 genes had been associated with asthma in six or
more separate populations:[84] The genetic trait, CD14 single nucleotide polymorphism (SNP)
C-159T and exposure to endotoxin (a bacterial product) are a well-replicated
example of a gene-environment interaction that is associated with asthma.
Phthalates
There is a significant association between asthma-like symptoms (wheezing)
among preschool children and the concentration of DEHP (phthalates) in indoor
environment.[79] DEHP
(di-ethylhexyl phthalate) is a plasticizer that is commonly used in building
material. The hydrolysis product of DEHP (di-ethylhexyl phthalate) is MEHP
(Mono-ethylhexyl phthalate) which mimics the prostaglandins and thromboxanes in
the airway leading to symptoms related to asthma.[80] Another
mechanism that has been studied regarding phthalates causation of asthma is
that high phthalates level can "modulate the murine immune response to a
coallergen". Asthma can develop in the adults who come in contact with
heated PVC fumes.[81] Two main
type of phthalates, namely n-butyl benzyl phthalate (BBzP) and di(2-ethylhexyl)
phthalate (DEHP), have been associated between the concentration of polyvinyl
chloride (PVC) used as flooring and the dust concentrations. Water leakage were
associated more with BBzP, and buildings construction were associated with high
concentrations of DEHP.[82] Asthma
has been shown to have a relationship with plaster wall materials and wall-to
wall carpeting. The onset of asthma was also related to the floor–leveling
plaster at home. Therefore, it is important to understand the health aspect of
these materials in the indoor surfaces.[83]
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THE LANCET
The Lancet, Volume
372, Issue 9643, Pages 1039 - 1048, 20 September 2008 doi:10.1016/S0140-6736(08)61445-2
Summary
Background
Exposure to paracetamol during
intrauterine life, childhood, and adult life may increase the risk of
developing asthma. We studied 6—7-year-old children from Phase Three of the
International Study of Asthma and Allergies in Childhood (ISAAC) programme to
investigate the association between paracetamol consumption and asthma.
Methods
As part of Phase Three of ISAAC,
parents or guardians of children aged 6—7 years completed written
questionnaires about symptoms of asthma, rhinoconjunctivitis, and eczema, and
several risk factors, including the use of paracetamol for fever in the child's
first year of life and the frequency of paracetamol use in the past 12 months.
The primary outcome variable was the odds ratio (OR) of asthma symptoms in
these children associated with the use of paracetamol for fever in the first
year of life, as calculated by logistic regression.
Findings
205 487 children aged 6—7 years
from 73 centres in 31 countries were included in the analysis. In the multivariate
analyses, use of paracetamol for fever in the first year of life was associated
with an increased risk of asthma symptoms when aged 6—7 years (OR 1·46 [95% CI
1·36—1·56]). Current use of paracetamol was associated with a dose-dependent
increased risk of asthma symptoms (1·61 [1·46—1·77] and 3·23 [2·91—3·60] for
medium and high use vs no use, respectively). Use of paracetamol was
similarly associated with the risk of severe asthma symptoms, with
population-attributable risks between 22% and 38%. Paracetamol use, both in the
first year of life and in children aged 6—7 years, was also associated with an
increased risk of symptoms of rhinoconjunctivitis and eczema.
Interpretation
Use of paracetamol in the first year
of life and in later childhood, is associated with risk of asthma,
rhinoconjunctivitis, and eczema at age 6 to 7 years. We suggest that exposure
to paracetamol might be a risk factor for the development of asthma in
childhood.
Funding
The BUPA Foundation, the Health
Research Council of New Zealand, the Asthma and Respiratory Foundation of New
Zealand, the Hawke's Bay Medical Research Foundation, the Waikato Medical
Research Foundation, Glaxo Wellcome New Zealand, the New Zealand Lottery Board,
Astra Zeneca New Zealand, and Glaxo Wellcome International Medical Affairs.
