Clinical profile and environmental risk factors of asthma in children at a tertiary care teaching hospital in the sub-Himalayan belt of Northern India

OBJECTIVES: To describe the clinical profile of patient with bronchial asthma, to determine the presence of environmental risk factors among them and to determine the relationship between environmental risk factors to the severity of asthma. METHODS: It was a descriptive observational study done at a tertiary care teaching hospital in sub-Himalyan belt of Northern India. Children aged 1-18 years,who presented to hospital with diagnosis of asthma were included in the study after obtaining informed consent. RESULTS: Prevalence of asthma in children age 0-18 years was 1.6 % in this study.Mean age was 8.60±4.40 years with male preponderance. Majority of patients (68.3%) had onset of symptoms before 5 years of age. Fifty nine percent were malnourished and 53% had history of atopy. Majority of children were born vaginally (81.5%) with 91.5% of them were born at term with normal birthweight (90%) Asthma was more common in 2nd order birth (50.7%) and majority (60.7%) were bottle fed in first 6 months of life. Family history of atopy or asthma was present in 86% of the ptients. Eighty percent of patients had history of exacerbations episode after exposure to dust, 81.8% had seasonal variation of asthma with 52.3% exacerbations in winter. Seventy five percent had history of exacerbations during crop harvesting time.Seventy two percent had history of smoke producing fuel at home.Sixty percent had history of exposure to cigarette or other tobacco product smoke and 21.5% of pts had pets at home.Strong relationship was found between use of power and perfumes and exacerbations and exacerbation after exposure to cold air with uncontrolled asthma. CONCLUSIONS: Male gender, malnourished and bottle fed children are prone for developing asthma. Presence of atopy, most commonly allergic rhinitis in early life predisposes children to asthma later in life. Exposure to cold air, dust during harvesting season and use of powder and perfumes are important risk factors for development of asthma.