Asthma and indoor environment in Nepal

Background-The development of asthma seems to be influenced by the adoption of a Western lifestyle. A study was undertaken to assess the importance of indoor environmental factors in Nepal where the lifestyle and home environ ment differ from that in the West. Methods-The home environment of 121 schoolchildren with asthma and 126 cont rols aged 11-17 years was studied. The homes of all participants were inves tigated and the children and their mothers were interviewed using a standar dised questionnaire. Cases and controls were identified from an ISAAC (Inte rnational Study of Asthma and Allergy in Childhood) based population study of 2330 schoolchildren in Kathmandu, Nepal. Results-Keeping cattle inside the house during the night was related to a l ower risk for having asthma (adjusted odds ratio (OR) 0.2 (95% CI 0.1 to 0. 5)) while there was no association between asthma and cattle kept outside. Asthma was associated with cigarette smoking by two or more family members (OR 1.9 (95% CI 1.0 to 3.9)) and with the domestic use of smoky fuels (OR 2 .2 (95% CI 1.0 to 4.5)). In analyses stratified by sex, passive smoking and the use of smoky fuels were significantly associated with asthma only in b oys. Conclusions-The risk of asthma in Nepalese children was lower in subjects e xposed to cattle kept inside the house and higher in subjects exposed to pa ssive smoking and indoor use of smoky fuels. Childhood exposure to microorg anisms or allergens from cattle may protect against the development of atop ic disease.