The Effects of Allergens and Other Environmental Factors on Childhood Asthma

Asthma is a respiratory disease that affects a multitude of people. It has been said that by

exposing kids to allergens at an early age, they are more likely to have asthma. However, over

the years the number of asthma cases has increased making this theory questionable. Even when

parents keep their children’s environment as clean as possible, many children still get the disease.

There could be multiple factors influencing the development of asthma but, the cause has not yet

been defined. As societies develop, the amounts of microbes and bacteria decreases especially in

places with higher economic status where sanitation is common (Zeyrek et al., 2006). For

example, in our schools, it has become a routine to clean the school everyday after classes. It is

also known that our bodies become weaker in fighting against pathogens and diseases when we

are not exposed to outside germs and allergens. I believe it is important to know if we are doing

our children any good by keeping the environment they live in so sanitized. This topic is

interesting to me because I have many friends that are athletes and I have observed an asthma

attack before and noted how frightening it can be. I also want to pursue a career in pediatric

nursing and I am interested in learning if there is a way that I can establish prevention methods

and provide care for children who suffer from this disease.

Asthma is a disease that causes a person’s airways to swell, become inflamed, and

produce extra mucus, making it hard to breathe (AAAAI, 2017). An asthma attack occurs when

these symptoms suddenly worsen and the muscles around the airways contract. The most

common causes of these attacks in children are exposure to allergens (such as pollen, dust or

animal dander), strong smells, and changes in weather. This disease affects more children than

adults around the world. More than half (57%) of people with asthma are children (AAAAI,
2017). There are a number of reasons why children develop asthma, “even as infants”. Some of

these include: underweight birth, presence of tobacco before and after birth, allergies and

genetics (WebMD, 2017). Asthma can affect many aspects of a person’s everyday life. It

becomes difficult to participate in physical activities or to simply go out a for a walk during the

summer. Many researchers have conducted studies in the attempt to find the causes of asthma but

the answer is still unclear. There have been a few studies though, that have sparked ideas of what

those causes may be.

In one study, researchers from New England conducted two large-scale studies on

children. One was done in a predominantly rural community, and the other in a city area. There

were a total of 933 children recruited for analysis. Of those, 489 were farm-living children and

444 lived in the city (Ege et al., 2011). First, researchers used questionnaires to ask about each

child's respiratory and allergic symptoms. Then, collected dust samples from living rooms and

bedrooms to analyze the amounts of bacteria and fungi in each sample. Bacterial and fungal

results were shown as colony-forming units per dust collector (Ege et al., 2011). Each sample

was sent to a lab for culture in order to determine the type of microbe, since it cannot be

determined with a small sample (Ege et al., 2011). It was concluded that there was a larger

variety of microbes found in the homes of the children who lived on farms. As stated by the

researcher, “The findings indicate that indoor microbial exposure is much more common and

diverse in the farming environment than in the non farming environment” (Ege et al., 2011, p.

705). This is because farm animals live in environments where they are exposed to millions of

microbes thus exposing a farmers to those microbes as well. It was also discovered that the kids

living in the farms had lower risk of asthma because the farm environment had strengthened their
immune systems (Ege et al., 2011). This could mean that there is a correlation between the

amount of microbes one is exposed to and prevalence of asthma. However, the results could

differ, considering that different cultures and locations may conclude different results. For

example, children living in England are not exposed to the same bacteria and fungi as children

living in the United States. If the study was done in different environments, these outcomes could

be verified.

Another study suggests that sanitation could be the cause of asthma. Sanitation is a big

part of our society and it has become an important thing to do in places like hospitals, schools,

workplaces and even in homes. A group of researchers conducted an investigation in different

areas of Sanliurfa, Turkey. A total of 1108 children were selected for the study, 535 of them lived

urban areas with higher economic status and 573 lived in poor communities (Zeyrek et al., 2006).

Questionnaires were used to determine economic status and previous asthma symptoms and

allergies. It was determined that areas that were considered to be better sanitized had higher

numbers of children with asthma. The article stated, “According to the ISAAC questionnaire

results the prevalence rates of all atopic diseases overall was 5.6% (n =32/573) in children

attending schools in slum areas while it was 11.8% (n = 63/535) in those attending central

schools” (Zeyrek et al., 2006, p. 292). This means that there could be some relationship between

the immune system and asthma risks. Since the children living in more urban areas were not

exposed to many pathogens, they became more prone to getting not only asthma, but other

diseases as well. Also, there were no signs found that indicated pet/pest allergens may have been

the cause of the results which meant the immune system solely played a role in the outcomes

(Zeyrek et al., 2006). Nevertheless, there was only a 6.2% difference between the results but still
adds valuable information to asthma research. This article could help future researchers look

deeper into the association between the immune system and asthma.

Another article found that children with smoking parents were at high risk of asthma.

Researchers chose 39,306 women who were delivering between 1989 and 2006 at Kuopio

University Hospital, Finland (Harju et al., 2016). Each mother gave record of their smoking

habits previous to pregnancy and after delivery. They followed up with each baby for a mean of

4.2 years and kept record of asthma symptoms. After analyzing all the records, researchers

discovered that children with smoking parents had a significantly higher risks of asthma. The

main finding at the hospital was that, “parental smoking, and especially paternal smoking

regardless of maternal smoking, increased the risk of asthma among offspring” (Harju et al.,

2016, p. 428). Mothers who quit smoking during pregnancy still contributed to their child’s risk

of asthma, but the risk was slightly lower. The risk of asthma was reduced from 7.7 % to 7.2 %

when the mother quit smoking after her pregnancy (Harju et al., 2016, p. 432). The results also

tied into socioeconomic status since smoking has been known to be common among poorer

families (Harju et al., 2016). Although the results were fairly accurate, these findings may have

been different because the parents in the study tended to reduce smoking after the child was born.

The true effect of parental smoking may have not been exactly reflected on the results.

Overall, each study gave good results that can help conclude that there really are multiple

causes of asthma. The first article showed us that being exposed to wider variety of microbes can

actually protect us against asthma by strengthening our defense system. The second article

revealed that too much sanitation could be causing our immune system to weaken. Children

living in “cleaner” environments were at higher risk of asthma. We also learned from the last
article that children who had parents, especially mothers, who smoked were a lot more likely to

get the disease. Each article seemed to have no bias, for there were mainly results and statistics

displayed as well as an explanation for their meaning. Gathering all this information together, it

can be concluded that it is mainly environmental factors that contribute to the frequency of

asthma in our children. Toxins and chemicals, like those found in cigarettes, can be said to be the

leading cause of the disease, followed by weak immune systems. Socioeconomic status also

played in the results especially when studying the effects of parental smoking. People in the U.S.,

especially, who are living at or below poverty level, have higher rates of smoking (Centers for

Disease Control and Prevention, 2017)

Asthma is a disease that has affected children from all around the world and it only gets

worse as the days go by. It is hard for these children to do everyday things like running around

and playing like a child should. As proved by the articles, it is important to keep our children

away from harmful things like toxins and chemicals but to also not worry if we let them go

outside during pollen season. As a child, it is important to let kids explore the world around them

and become exposed to different microbes, harmful or not, since it is a critical time period for the

immune system to build up. Nonetheless, the articles have left me with a few questions. To what

extent could children be exposed to allergens and not get a disease like asthma? Why is asthma

most common in children? Why does asthma come and go in some people? Will finding the

cause of asthma help us prevent the disease or help us find a possible cure? Researching about

this topic has definitely increased my passion for pediatric nursing. As a future health

professional, this research will help me teach people, especially parents, about the effects asthma

can have on children and their lives.

 References

American Academy of Allergy, Asthma & Immunology (AAAAI). (2017). Asthma statistics.

Retrieved from http://www.aaaai.org/about-aaaai/newsroom/asthma-statistics

WebMD. (2017). Asthma in children: Symptoms and risk factors. Retrieved from

https://www.webmd.com/asthma/children#1

Centers for Disease Control and Prevention. (2017). Cigarette smoking and tobacco use among

people of low socioeconomic status. Retrieved from

https://www.cdc.gov/tobacco/disparities/low-ses/index.htm

Ege, M., Mayer, M., Normand, A., Genuneit, J., Cookson, W., Phil, D., … Braun-Fahrländer, C.

(2011). Exposure to environmental microorganisms and childhood asthma. The New

England Journal of Medicine, 364, 701-709. doi: 10.1056/NEJMoa1007302

Harju, M., Keski-Nisula, L., Georgiadis, L. & Heinonen, S. (2016). Parental smoking and

cessation during pregnancy and the risk of childhood asthma. BMC Public Health, 16,

doi:10.1186/s12889-016-3029-6

Zeyrek, C.D., Zeyrek, F., Sevinc, E., Demir, E. (2006). Prevalence of asthma and allergic

diseases in Sanliurfa, Turkey, and the relation to environmental and socioeconomic

factors: Is the hygiene hypothesis enough?. Journal of Investigational Allergology and

Clinical Immunology, 16, 290-295.