Environment and asthma in adults

doi:10.1016/j.lpm.2013.06.010

La Presse Médicale

Volume 42, Issue 9, Part 2, September 2013, Pages e317-e333

https://doi.org/10.1016/j.lpm.2013.06.010 Get rights and content

Summary

The present review addresses recent advances and especially challenging aspects regarding the role of environmental risk factors in adult-onset asthma, for which the causes are poorly established. In the first part of the review, we discuss aspects regarding some environmental risk factors for adult-onset asthma: air pollution, occupational exposures with a focus on an emerging risk represented by exposure to cleaning agents (both at home and in the workplace), and lifestyle and nutrition. The second part is focused on perspectives and challenges, regarding relevant topics on which research is needed to improve the understanding of the role of environmental factors in asthma. Aspects of exposure assessment, the complexity of multiple exposures, the interrelationships of the environment with behavioral characteristics and the importance of studying biological markers and gene–environment interactions to identify the role of the environment in asthma are discussed. We conclude that environmental and lifestyle exposures play an important role in asthma or related phenotypes. The changes in lifestyle and the environment in recent decades have modified the specific risk factors in asthma even for well-recognized risks such as occupational exposures. To better understand the role of the environment in asthma, the use of objective (quantitative measurement of exposures) or modern tools (bar code, GPS) and the development of multidisciplinary collaboration would be very promising. A better understanding of the complex interrelationships between socio-economic, nutritional, lifestyle and environmental conditions might help to study their joint and independent roles in asthma.

Section snippets

Outdoor air pollution

Air pollution epidemiology started in the 1970s by studying the short-term effects of air pollution on mortality and hospitalization and by focusing on respiratory causes including those related to asthma exacerbations. Since then, many studies have assessed the association between air pollution and asthma phenotypes, going from time-series or panel studies, that assess the short-term exposure to air pollution on acute manifestations of the disease [31], [32], [33], [34], [35], [36], [37], [38]

Occupational exposures

Occupational exposure was recognized to cause asthma at the end of the 1970s [5], [28], [55], [56]. Work-related asthma is now the most common occupational lung disease in industrial countries [57], [58]. The number of established asthmagenic agents (specific dusts, gases or fumes known to induce asthma) identified in occupational asthma increased regularly from more than 150 at the end of the 1990s [55], [59] to more than 400 known asthmagens in 2012 [60]. The burden of occupational diseases

Cleaning agents: an emerging public health issue, occupational and indoor exposures

Many people are regularly exposed to disinfectant or cleaning agents worldwide and there is growing evidence that health-care workers and cleaners are commonly and highly exposed to these agents [71], [72]. Evidence of an adverse effect of cleaning products or disinfectants in asthma mostly comes from studies on occupational risk factors, but a deleterious role of domestic cleaning exposure has also been observed [73] (table II). This exposure may represent an important public health issue,

Lifestyle and nutrition

Changes in dietary habits (less fruits/vegetables, more ready to eat meals), the obesity epidemic, and the decrease in physical activity, have been suggested to play a role in the increase of asthma worldwide [15], [17], [29]. Regarding obesity, a large number of papers have been published on the topic over the last 10 years, showing that obesity precedes asthma [104], and that obesity-related asthma is a distinct asthma phenotype [10]. Despite a general consensus defining obesity as a risk

Research needed to improve understanding of environmental factors

The complex relationships between various socio-economic, environmental and lifestyle conditions, genetic pathways and the clinical expression of asthma are illustrated in figure 1. The following section discussed exposure assessment and the interrelationships between environmental and lifestyle factors for which research is needed to improve understanding of the role of environmental factors in asthma. The importance of studying genetic pathways, biological markers and gene-environment

Conclusion

Environmental and lifestyle exposures may play an important role in asthma or related phenotypes. The lung is a key organ in relation with the environment as it is an open door to the environment. The changes in lifestyle and environment during recent decades have modified the specific risk factors in asthma even for long-standing recognized risks such as occupational exposures such as latex gloves, although preventive measures have been taken in this regard. To better understand the role of

Disclosure of interest

the authors declare that they have no conflicts of interest concerning this article.

Funding: French Agency of health safety, environment and work: AFSSET-EST-09-15 (NETA), ANSES-PNR-EST 2012-2-166 (SESAP). The French National Research Agency: ANR-2010-PRSP-003 (IAGO).

Glossary

25(OH)D: serum 25-hydroxyvitamin D
AHSMOG: ADVENTIST Health and Smog Study
APMoSPHERE: Air Pollution Modeling for Support to Policy on Health and Environmental Risk in Europe
COPD: Chronic Obstructive Pulmonary Disease
ECRHS: European Community Respiratory Health Survey
EGEA: Epidemiological study on the genetics and environment of asthma
GIS: Geographical Information System
GPS: Global Positioning System
GxE: Gene by environment interaction
GWAS: a genome-wide association study
IgE: Immunoglobulin E
NHANES study: The National

References (210)

S.S. Braman
The global burden of asthma
Chest
(2006)
R. Beasley
The burden of asthma with specific reference to the United States
J Allergy Clin Immunol
(2002)
E. von Mutius
Gene-environment interactions in asthma
J Allergy Clin Immunol
(2009)
Y. Jie et al.
Do indoor environments influence asthma and asthma-related symptoms among adults in homes? A review of the literature
J Formos Med Assoc
(2011)
D.B. Peden et al.
Advances in environmental and occupational disorders in 2012
J Allergy Clin Immunol
(2013)
S.E. Wenzel
Asthma defining of the persistent adult phenotypes
Lancet
(2006)
D. Peden et al.
Environmental and occupational allergies
J Allergy Clin Immunol
(2010)
D.B. Peden et al.
Advances in environmental and occupational respiratory diseases in 2009
J Allergy Clin Immunol
(2010)
J. Ciencewicki et al.
Oxidants and the pathogenesis of lung diseases
J Allergy Clin Immunol
(2008)
W.F. McDonnell et al.
Long-term ambient ozone concentration and the incidence of asthma in nonsmoking adults: the AHSMOG Study
Environ Res
(1999)

J.L. Malo et al.

Natural history of occupational asthma: relevance of type of agent and other factors in the rate of development of symptoms in affected subjects

J Allergy Clin Immunol

(1992)

C. Lemiere et al.

Occupational asthma: new deleterious agents at the workplace

Clin Chest Med

(2012)

C.T. Cowl

Occupational asthma: review of assessment, treatment, and compensation

Chest

(2011)

P. Maestrelli et al.

Mechanisms of occupational asthma

J Allergy Clin Immunol

(2009)

O. Dumas et al.

Asthma and exposures to cleaning products [Asthme et expositions aux produits de nettoyage]

Arch Mal Prof

(2013)

M. Kogevinas et al.

Exposure to substances in the workplace and new-onset asthma: an international prospective population-based study (ECRHS-II)

Lancet

(2007)

J. Bousquet et al.

Prioritised research agenda for prevention and control of chronic respiratory diseases

Eur Respir J

(2010)

W. Eder et al.

The asthma epidemic

N Engl J Med

(2006)

M.R. Becklake et al.

Environmental factors

Lancet

(1997)

G. Devereux

The increase in the prevalence of asthma and allergy: food for thought

Nat Rev Immunol

(2006)

S.E. Wenzel

Asthma phenotypes: the evolution from clinical to molecular approaches

Nat Med

(2012)

National Asthma Education Prevention Program

N. Expert Panel Report 3 (EPR-3): guidelines for the diagnosis and management of asthma. National Heart, Lung, and Blood Institute, National Institutes of Health

(2007)

G. Wlasiuk et al.

The farm effect, or: when, what and how a farming environment protects from asthma and allergic disease

Curr Opin Allergy Clin Immunol

(2012)

R. Varraso et al.

Farming in childhood, diet in adulthood and asthma history

Eur Respir J

(2012)

J.M. Anto

Recent advances in the epidemiologic investigation of risk factors for asthma: a review of the 2011 literature

Curr Allergy Asthma Rep

(2012)

J. Bousquet et al.

Exposure to environmental tobacco smoke and adult asthma

Allergy

(2001)

M.K. Selgrade et al.

Induction of asthma and the environment: what we know and need to know

Environ Health Perspect

(2006)

W.J. Crinnion

Do environmental toxicants contribute to allergy and asthma?

Altern Med Rev

(2012)

J.A. Sarnat et al.

Asthma and air quality

Curr Opin Pulm Med

(2007)

M.T. Salam et al.

Recent evidence for adverse effects of residential proximity to traffic sources on asthma

Curr Opin Pulm Med

(2008)

M. Jerrett et al.

Traffic-related air pollution and asthma onset in children: a prospective cohort study with individual exposure measurement

Environ Health Perspect

(2008)

B. Jacquemin et al.

The role of air pollution in adult-onset asthma: a review of the current evidence

Semin Respir Crit Care Med

(2012)

J.M. Anto et al.

Risk factors of new-onset asthma in adults: a population-based international cohort study

Allergy

(2010)

E.C. Matsui

Role of environmental control in the management of asthma and allergy

J Allergy Clin Immunol

(2012)

B. Ramazzini et al.

Des maladies du travail. Translation of “De morbis artificum diatriba. Mutinae: Typis Antonii Capponi; 1713” by Antoine de Fourcroy in 1777, Ayssenes

(1990)

J. Pepys et al.

R. Varraso

Nutrition and asthma

Curr Allergy Asthma Rep

(2012)

S. Accordini et al.

The role of smoking in allergy and asthma: lessons from the ECRHS

Curr Allergy Asthma Rep

(2012)

S. Boutin-Forzano et al.

Visits to the emergency room for asthma attacks and short-term variations in air pollution. A case-crossover study

Respiration

(2004)

C.H. Chen et al.

Seasonality in adult asthma admissions, air pollutant levels, and climate: a population-based study

J Asthma

(2006)

R. de Marco et al.

The impact of climate and traffic-related NO₂ on the prevalence of asthma and allergic rhinitis in Italy

Clin Exp Allergy

(2002)

D. Diaz-Sanchez et al.

Diesel effects on human health: a question of stress?

Am J Physiol Lung Cell Mol Physiol

(2005)

G. Emenius et al.

NO2, as a marker of air pollution, and recurrent wheezing in children: a nested case-control study within the BAMSE birth cohort

Occup Environ Med

(2003)

D. Fusco et al.

Air pollution and hospital admissions for respiratory conditions in Rome, Italy

Eur Respir J

(2001)

S. Hajat et al.

Association of air pollution with daily GP consultations for asthma and other lower respiratory conditions in London

Thorax

(1999)

J. Sunyer et al.

Urban air pollution and emergency admissions for asthma in four European cities: the APHEA Project

Thorax

(1997)

E. Rage et al.

Air pollution and asthma severity in adults

Occup Environ Med

(2009)

B. Jacquemin et al.

Air pollution and asthma control in the Epidemiological Study on the Genetics and Environment of Asthma

J Epidemiol Community Health

(2012)

R. Anderson et al.

Long-term exposure to air pollution and the incidence of asthma: meta-analysis of cohort studies

Air Qual Atmos Health

(2011)

R. Anderson et al.

Long-term exposure to air pollution and the prevalence of asthma: meta-analysis of multi-community prevalence of asthma

Air Qual Atmos Health

(2013)

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Indoor air and respiratory health: Volatile organic compounds and cleaning products
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Various indoor irritants and allergens may be associated with asthma. Some volatile and semivolatile organic compounds (VOCs and SVOCs) in indoor environments are respiratory irritants that may increase the risk of asthma and respiratory symptoms. Indoor VOCs are originated from multiple sources, including cleaning products. Results of studies focusing on the occupational use of cleaning products provide strong evidence of their adverse respiratory health effects. More recent studies show that domestic use of cleaning products is also a risk factor for asthma and asthma symptoms, not only among active users (adults) but also among children. This chapter summarizes methods for exposure assessment used in epidemiology and provides an overview of the respiratory health effects of nonoccupational exposure to chemicals occurring in indoor environments, focusing on the exposure to VOCs and SVOCs and the domestic use of cleaning products.
Laundry detergents and detergent residue after rinsing directly disrupt tight junction barrier integrity in human bronchial epithelial cells
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Defects in the epithelial barrier have recently been associated with asthma and other allergies. The influence of laundry detergents on human bronchial epithelial cells (HBECs) and their barrier function remain unknown.
We investigated the effects of laundry detergents on cytotoxicity, barrier function, the transcriptome, and the epigenome in HBECs.
Air-liquid interface cultures of primary HBECs from healthy control subjects, patients with asthma, and patients with chronic obstructive pulmonary disease were exposed to laundry detergents and detergent residue after rinsing. Cytotoxicity and epithelial barrier function were evaluated. RNA sequencing, Assay for Transposase Accessible Chromatin with high-throughput sequencing, and DNA methylation arrays were used for checking the transcriptome and epigenome.
Laundry detergents and rinse residue showed dose-dependent toxic effects on HBECs, with irregular cell shape and leakage of lactate dehydrogenase after 24 hours of exposure. A disrupted epithelial barrier function was found with decreased transepithelial electrical resistance, increased paracellular flux, and stratified tight junction (TJ) immunostaining in HBECs exposed to laundry detergent at 1:25,000 dilutions or rinse residue at further 1:10 dilutions. RNA sequencing analysis showed that lipid metabolism, apoptosis progress, and epithelially derived alarmin-related gene expression were upregulated, whereas cell adhesion–related gene expression was downregulated by laundry detergent at 1:50,000 dilutions after 24 hours of exposure without substantially affecting chromatin accessibility and DNA methylation.
Our data demonstrate that laundry detergents, even at a very high dilution, and rinse residue show significant cell-toxic and directly disruptive effects on the TJ barrier integrity of HBECs without affecting the epigenome and TJ gene expression.
Environmental risk factors for asthma developement
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La prévalence de l’asthme a augmenté de façon très marquée depuis le début des années 1970, et seules des modifications de l’exposition à certains facteurs d’environnement, indissociables des modifications du mode de vie, peuvent expliquer une augmentation aussi rapide.
L’exposition aux allergènes est un facteur de risque de sensibilisation allergique et la sensibilisation allergique un facteur de risque de l’asthme allergique. Toutefois, en dehors de l’exposition aux moisissures vis-à-vis de l’asthme de l’enfant, il est difficile d’établir des liens de causalité entre l’exposition aux différents allergènes et le développement de l’asthme.
Un nouveau défi pour la recherche est d’analyser la multitude de données issues de la caractérisation métagénomique du microbiome environnemental et humain, pour comprendre le rôle des interactions entre virus, bactéries et allergènes dans le développement de l’asthme.
Il est admis que l’exposition prénatale et postnatale à la pollution de l’air et au tabagisme de la mère augmentent le risque de développer un asthme chez l’enfant. Chez l’adulte, les données sont plus rares et les résultats restent controversés quant au rôle de ces expositions sur l’incidence de l’asthme.
Des recherches doivent être développées sur le rôle de l’exposition aux phénols, phtalates et composés perfluorés, largement répandus dans notre environnement, et qui pourraient être associés à l’asthme, notamment chez l’enfant.
L’utilisation fréquente des produits de nettoyage pour le ménage à domicile, notamment sous forme de sprays ; — pratique très répandue dans la population — est un facteur de risque du développement de l’asthme de l’adulte, et peut être aussi pour l’asthme de l’enfant exposé à domicile. Les substances chimiques en cause restent mal connues.
L’asthme professionnel est un phénotype spécifique majeur de l’asthme de l’adulte. L’exposition professionnelle aux produits de nettoyage pourrait être impliquée.
Des relations ont été montrées entre l’alimentation pendant la grossesse ou dans l’enfance et le risque de développer un asthme chez l’enfant, mais les données chez l’adulte sont insuffisantes. Au-delà des facteurs génétiques, la composition corporelle est influencée par les choix alimentaires et par le niveau d’activité physique. Des recherches doivent être développées pour clarifier le rôle des interrelations complexes entre ces facteurs nutritionnels dans le développement de l’asthme.
Le nouveau défi pour la recherche est de décrypter, par une approche holistique, le rôle de l’ensemble des facteurs d’environnement auxquels l’individu est exposé depuis sa conception (« exposome ») dans le développement de l’asthme.
The prevalence of asthma has increased rapidly since the early 1970s, and only changes in exposure to environmental factors; which go together with changes in lifestyle, are likely to explain such a rapid increase.
Exposure to allergens is a risk factor for allergic sensitization, and allergic sensitization is a risk factor for allergic asthma. However, apart from indoor mold exposure as a risk factor for childhood asthma, there is insufficient evidence to conclude that the associations between allergen exposure and asthma development are causal.
A new challenge for research is to analyze the huge amount of data derived from the metagenomic characterization of the environmental and human microbiome, to understand the role of interactions between viruses, bacteria and allergens in the development of asthma.
It is recognized that prenatal and postnatal exposure to air pollution and maternal smoking increase the risk of developing asthma in children. In adults, the data are scarce and the results remain controversial as regards these exposures and asthma incidence.
Further research is needed to appraise the effect of exposure to phenols, phthalates and perfluorinated compounds, which are widespread in the environment and may be associated with asthma, especially in children.
Frequent use of chemicals for home cleaning especially in the form of sprays — which is a common practice at the population level — is a risk factor for the development of adult asthma. The domestic use of cleaning products might also be a risk factor for asthma in children exposed at home. The chemicals involved in these relationships are still to be identified.
Occupational asthma is a major phenotype of adult asthma. A significant part of these asthma cases might relate to occupational exposure to cleaning products.
While there is evidence of associations between diet during pregnancy or during childhood and the risk of developing asthma in children, the data in adults are insufficient. Beyond genetic factors, body composition is influenced by dietary choices and physical activity. Further research is needed to clarify the complex interplay between these nutritional factors and asthma development.
The new challenge for research is to decipher the role of all the environmental factors to which the individual is exposed since conception (“exposome”) in the development of asthma, using a holistic approach.
Analysis of exposure to ambient air pollution: Case study of the link between environmental exposure and children’s school performance in Memphis, TN
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Publications link various health outcomes and several elements of the physical environment, including environmental exposures such as air pollution, built-up environment, as well as social environment. The local neighborhood context is important in studies on health impacts. For example, associations have been found between neighborhood physical and social environments and diabetes. Since the physical environment is an element of the neighborhood’s overall environment, the focus of the chapter is on environmental exposure. Specifically, the present chapter focuses primarily on one important environmental hazard, air pollution, by examining the links between an outside and inside environment and health, as well as the extent that socioeconomic factors play in the association between exposure to air pollution and health outcomes. The chapter concludes with an empirical case study, which considers the links between air pollution exposure from stationary facilities and children’s performance in schools.
Traffic-related air pollution exposure is associated with allergic sensitization, asthma, and poor lung function in middle age
2017, Journal of Allergy and Clinical Immunology
Citation Excerpt :
None of these studies looked at interactions with GSTs. Australia is a country with low levels of air pollution3 and in our study the mean annual residential NO2 level was 5.1± 2.6 ppb, which was substantially lower than the National Air Quality standard (mean annual NO2 = 30 ppb). Nevertheless, we were able to demonstrate that even low levels of TRAP are associated with allergic respiratory diseases.
Traffic-related air pollution (TRAP) exposure is associated with allergic airway diseases and reduced lung function in children, but evidence concerning adults, especially in low-pollution settings, is scarce and inconsistent.
We sought to determine whether exposure to TRAP in middle age is associated with allergic sensitization, current asthma, and reduced lung function in adults, and whether these associations are modified by variants in Glutathione S-Transferase genes.
The study sample comprised the proband 2002 laboratory study of the Tasmanian Longitudinal Health Study. Mean annual residential nitrogen dioxide (NO₂) exposure was estimated for current residential addresses using a validated land-use regression model. Associations between TRAP exposure and allergic sensitization, lung function, current wheeze, and asthma (n = 1405) were investigated using regression models.
Increased mean annual NO₂ exposure was associated with increased risk of atopy (adjusted odds ratio [aOR], 1.14; 95% CI, 1.02-1.28 per 1 interquartile range increase in NO₂ [2.2 ppb]) and current wheeze (aOR, 1.14; 1.02-1.28). Similarly, living less than 200 m from a major road was associated with current wheeze (aOR, 1.38; 95% CI, 1.06-1.80) and atopy (aOR, 1.26; 95% CI, 0.99-1.62), and was also associated with having significantly lower prebronchodilator and postbronchodilator FEV₁ and prebronchodilator forced expiratory flow at 25% to 75% of forced vital capacity. We found evidence of interactions between living less than 200 m from a major road and GSTT1 polymorphism for atopy, asthma, and atopic asthma. Overall, carriers of the GSTT1 null genotype had an increased risk of asthma and allergic outcomes if exposed to TRAP.
Even relatively low TRAP exposures confer an increased risk of adverse respiratory and allergic outcomes in genetically susceptible individuals.
Genetic and environmental factors of asthma and allergy: Results of the EGEA study
2015, Revue des Maladies Respiratoires
L’étude française EGEA (étude épidémiologique des facteurs génétiques et environnementaux de l’asthme, l’hyperactivité bronchique et l’atopie) combine une étude cas-témoins et une étude familiale de cas (n = 2120) avec trois enquêtes sur 20 ans. Cet article de synthèse présente les travaux réalisés depuis 2007 (42 articles) sur la caractérisation phénotypique et l’étude de facteurs environnementaux et génétiques de l’asthme et des phénotypes associés.
Les résultats épidémiologiques et génétiques confirment le caractère hétérogène de l’asthme. L’âge de début, le statut allergique et le niveau d’activité de la maladie jouent un rôle prépondérant dans l’identification des différents phénotypes et des facteurs génétiques sous-jacents. Le rôle néfaste du tabagisme, des expositions à la pollution atmosphérique, aux asthmogènes professionnels et aux produits de nettoyage sur la prévalence et/ou l’activité de l’asthme est étayé. La prise en compte d’interactions gène–environnement a permis d’identifier de nouveaux facteurs génétiques de susceptibilité et de préciser leur mode d’action.
L’étude EGEA participe aux avancées de la recherche en pneumologie au niveau international. Les nouvelles données phénotypiques, environnementales et biologiques permettront de caractériser l’évolution à long terme de l’asthme et les facteurs associés à cette évolution.
The EGEA study (epidemiological study on the genetics and environment of asthma, bronchial hyperresponsiveness and atopy), which combines a case-control and a family-based study of asthma case (n = 2120 subjects) with three surveys over 20 years, aims to identify environmental and genetic factors associated with asthma and asthma-related phenotypes. We summarize the results of the phenotypic characterization and the investigation of environmental and genetic factors of asthma and asthma-related phenotypes obtained since 2007 in the EGEA study (42 articles).
Both epidemiological and genetic results confirm the heterogeneity of asthma. These results strengthen the role of the age of disease onset, the allergic status and the level of disease activity in the identification of the different phenotypes of asthma. The deleterious role of active smoking, exposure to air pollution, occupational asthmogenic agents and cleaning products on the prevalence and/or activity of asthma has been confirmed. Accounting for gene–environment interactions allowed the identification of new genetic factors underlying asthma and asthma-related traits and better understanding of their mode of action.
The EGEA study is contributing to the advances in respiratory research at the international level. The new phenotypic, environmental and biological data available in EGEA study will help characterizing the long-term evolution of asthma and the factors associated to this evolution.

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Quarterly Medical ReviewEnvironment and asthma in adults

Summary

Section snippets

Outdoor air pollution

Occupational exposures

Cleaning agents: an emerging public health issue, occupational and indoor exposures

Lifestyle and nutrition

Research needed to improve understanding of environmental factors

Conclusion

Disclosure of interest

Glossary

Chest

J Allergy Clin Immunol

J Allergy Clin Immunol

J Formos Med Assoc

J Allergy Clin Immunol

Lancet

J Allergy Clin Immunol

J Allergy Clin Immunol

J Allergy Clin Immunol

Environ Res

J Allergy Clin Immunol

Clin Chest Med

Chest

J Allergy Clin Immunol

Arch Mal Prof

Lancet

Prioritised research agenda for prevention and control of chronic respiratory diseases

Eur Respir J

The asthma epidemic

N Engl J Med

Environmental factors

Lancet

The increase in the prevalence of asthma and allergy: food for thought

Nat Rev Immunol

Asthma phenotypes: the evolution from clinical to molecular approaches

Nat Med

N. Expert Panel Report 3 (EPR-3): guidelines for the diagnosis and management of asthma. National Heart, Lung, and Blood Institute, National Institutes of Health

The farm effect, or: when, what and how a farming environment protects from asthma and allergic disease

Curr Opin Allergy Clin Immunol

Farming in childhood, diet in adulthood and asthma history

Eur Respir J

Recent advances in the epidemiologic investigation of risk factors for asthma: a review of the 2011 literature

Curr Allergy Asthma Rep

Exposure to environmental tobacco smoke and adult asthma

Allergy

Induction of asthma and the environment: what we know and need to know

Environ Health Perspect

Do environmental toxicants contribute to allergy and asthma?

Altern Med Rev

Asthma and air quality

Curr Opin Pulm Med

Recent evidence for adverse effects of residential proximity to traffic sources on asthma

Curr Opin Pulm Med

Traffic-related air pollution and asthma onset in children: a prospective cohort study with individual exposure measurement

Environ Health Perspect

The role of air pollution in adult-onset asthma: a review of the current evidence

Semin Respir Crit Care Med

Risk factors of new-onset asthma in adults: a population-based international cohort study

Allergy

Role of environmental control in the management of asthma and allergy

J Allergy Clin Immunol

Des maladies du travail. Translation of “De morbis artificum diatriba. Mutinae: Typis Antonii Capponi; 1713” by Antoine de Fourcroy in 1777, Ayssenes

Nutrition and asthma

Curr Allergy Asthma Rep

The role of smoking in allergy and asthma: lessons from the ECRHS

Curr Allergy Asthma Rep

Visits to the emergency room for asthma attacks and short-term variations in air pollution. A case-crossover study

Respiration

Seasonality in adult asthma admissions, air pollutant levels, and climate: a population-based study

J Asthma

The impact of climate and traffic-related NO2 on the prevalence of asthma and allergic rhinitis in Italy

Clin Exp Allergy

Diesel effects on human health: a question of stress?

Am J Physiol Lung Cell Mol Physiol

NO2, as a marker of air pollution, and recurrent wheezing in children: a nested case-control study within the BAMSE birth cohort

Occup Environ Med

Air pollution and hospital admissions for respiratory conditions in Rome, Italy

Eur Respir J

Association of air pollution with daily GP consultations for asthma and other lower respiratory conditions in London

Quarterly Medical Review
Environment and asthma in adults

The impact of climate and traffic-related NO₂ on the prevalence of asthma and allergic rhinitis in Italy