Indoor environmental risk factors and seasonal variation of childhood asthma

Seasonality of asthma may result from varying exposures. This cross-sectional study was designed to examine the relationship between indoor environmental factors and seasonal childhood asthma. Study subjects were participants from the International Study of Asthma and Allergies in Childhood (ISAAC) in 2004, a population-based surveillance, which included school children aged 6-15 yr in south Taiwan. Cases included 1725 children who experienced asthma symptoms in the past 12 months and the references consisted of 19,646 children who reportedly have no asthma history. By using a moving average and principal component analysis, asthmatic children were grouped into four asthma subtypes: winter, spring, summer/fall, and perennial. Multivariate logistic regression was used to evaluate the effect of indoor environmental factors on seasonality of childhood asthma. For all asthma prevalence, a peak occurred in the winter and a nadir appeared in summer. Contributing factors of asthma for children, regardless of seasonality, included younger age, parental atopy, maternal smoking during pregnancy, breast feeding, and perceived air pollution. After adjusted for salient risk factors, water damage was significantly associated with all subtypes of asthma. Presence of cockroaches was related to the summer/fall asthma (adjusted odds ratio [aOR] = 1.65, 95% confidence interval [CI] = 1.12-2.55). Visible mold on the walls was associated with an increased occurrence of winter and spring asthma (aOR = 1.53, 95% CI = 1.26-1.85 and aOR = 1.34, 95% CI = 1.10-1.62, respectively). Passive smoking was shown to be related to spring and summer/fall asthma. Water damage is a possible risk for childhood asthma year-round. Cockroaches and visible mold on the walls may play essential roles for seasonality of childhood asthma in Taiwan. Plausible mechanisms and allergic effects should be further determined. Elimination of these allergens is necessary to help prevent the development of asthma.