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Your Environment. Your Health.

Asthma

Introduction

mom watching son while he uses asthma inhaler

Asthma

Lower allergen levels in your home

  • Vacuum carpets and upholstered furniture every week
  • Wash sheets and blankets weekly in hot water
  • Use special allergen-proof covers on mattresses and pillows
  • Lower humidity levels indoors to 50%
  • Limit pets' access to bedrooms
  • Seal doors and windows
  • Eliminate pests

Asthma is a chronic lung disease. Common symptoms are wheezing, coughing, chest tightness, and shortness of breath. During an asthma attack, the sides of the airways in lungs swell and the airways shrink, making it harder to breathe. Once considered rare, asthma is now a common disease in childhood. In the United States, more than 26 million people have asthma, of which 6 million are children.1

Asthma is a major cause of missed time from school and work. Severe asthma attacks may require emergency room visits and hospitalizations, and they can be fatal. Asthma affects people of all races, sexes, and ages across every region of the U.S.

Asthma can be triggered by substances in the environment called allergens. Indoor allergens from dust mites, cockroaches, dogs, cats, rodents and molds are among the most important environmental triggers for asthma.2

What is NIEHS Doing?

NIEHS conducts and supports asthma research from basic studies in laboratories to human clinical trials. This research focuses on complex relationships among the environment and people’s genetics and immune system. Projects include:

  • Development of sensors that measure personal environmental triggers of asthma.
  • Clinical trials that examine if reduced indoor air pollution can improve asthma symptoms.
  • Data science methods that combine environmental data gathered across the United States. 

Asthma triggers in schools – NIEHS research demonstrates the importance of healthy school environments for reducing asthma risk. A study of inner-city students linked airborne mouse allergens in schools to increased asthma symptoms and decreased lung function in children.3 This study suggests schools can take steps to improve air quality and help children who have asthma.

Indoor air pollution makes asthma worse – Indoor air pollutants are a major concern for lung health. NIEHS-funded research has shown that obese inner-city children living in homes with high levels of indoor air pollution may have worse asthma symptoms if they are also deficient in vitamin D.4

Visit the Join an NIEHS Study Website

Join an asthma study!

The goal of the Natural History of Asthma with Longitudinal Environmental Sampling (NHALES) study is to help scientists understand how bacteria and other factors in the environment affect people who have moderate to severe asthma.

Who can participate?

  • Moderate to severe asthmatics.
  • Males and females, aged 18-60.
  • Females should not be pregnant or breastfeeding at the start of the study, but may still participate if they become pregnant during the study.
  • Nonsmokers who are also not around significant amounts of secondhand smoke.
  • No history of chronic obstructive pulmonary disease, emphysema, cystic fibrosis (CF), pulmonary fibrosis, non-CF bronchiectasis, sarcoidosis, unstable angina, or pulmonary hypertension.
  • Not allergic to methacholine.
  • Able to provide your own transportation to clinic visits on the NIEHS campus in North Carolina.

    For more information about this study:
    NHALES: Asthma Study
    Tel 855-MYNIEHS (855-696-4347)
    nhales@mail.nih.gov

Outside triggers of asthma – NIEHS-funded researchers found babies who breathe high levels of traffic-related air pollution were more likely to have persistent wheezing during childhood, and children exposed to high levels of traffic-related air pollution through age 7 were more likely to develop asthma.5 Another NIEHS-funded study found that adolescents exposed to nitrogen dioxide, an indicator of traffic-related pollution, experienced shifts in hormone levels that affect their response to stress, suggesting a way that air pollution might make asthma worse.6

Asthma and a changing climate – Climate can also affect the severity of asthma. Research has shown that natural disasters and extreme weather events can create conditions that may worsen asthma in several ways.7 For example, heat and drought make wildfires more widespread and severe, leading to large spikes in air pollution. More intense rainfall and flooding can lead to mold growth in homes and commercial buildings. Prolonged drought can worsen dust storms in dry areas.

The genetics of asthma – Asthma often runs in families, which suggests that genetics plays a role in disease development. NIEHS researchers have shown that asthma patients with a specific genetic makeup who live close to a highway are more likely to have intense symptoms.8 Another NIEHS study finds that certain indicators within DNA may predict a newborn’s risk of asthma.9 This information may help researchers identify which children may develop asthma and how to develop a treatment for preventing the disease.

Asthma and the immune system – Although exposure to many microbes can benefit the immune system, exposures to others can be harmful. An NIEHS-funded study showed that children who live on traditional Amish farms, which use animals rather than machines, were less likely to have asthma. The researchers suggest that the rich microbial environment on Amish farms may help build a stronger immune response in those children.10

Although exposure to some bacteria and similar microbes can benefit the immune system, exposure to others can be harmful. Scientists funded by NIEHS showed that children who were exposed to high levels of molds were more likely to have asthma at age 7.11 For children with allergies, the association was especially strong.

Further Reading

Stories from the Environmental Factor (NIEHS Newsletter)

Press Releases

Fact Sheets

Asthma and Its Environmental Triggers

Community Action Against Asthma Fact Sheet on "Particulate Matter" (English)

Community Action Against Asthma Fact Sheet on "Particulate Matter" (Spanish)

Environment and Health A to Z

Preventing Asthma: A Landlord’s Guide to Property Maintenance for Healthy Homes

Thinking About Asthma: A Developer's Guide to Building a Healthy Home

Podcasts

Additional Resources

  • CDC Asthma Webpage – Information from the U.S. Centers for Disease Control and Prevention
  • EPA Asthma Webpage – Information from the U.S. Environmental Protection Agency
  • NHLBI Asthma Webpage – Information from the National Heart, Lung, and Blood Institute, part of the National Institutes of Health
Content courtesy of the Centers for Disease Control and Prevention (CDC)

Related Health Topics


  1. CDC (U.S. Centers for Disease Control and Prevention). 2018. Most recent national asthma data. [accessed April 17, 2019]. [Available CDC (U.S. Centers for Disease Control and Prevention). 2018. Most recent national asthma data. [accessed April 17, 2019].]
  2. Salo PM, Wilderson J, Rose KM, Cohn RD, Calatroni A, Mitchell HE, Server ML, Gergen PJ, Thorne PS, Zeldin DC. 2018. Bedroom allergen exposures in US households. J Allergy Clin Immunol 141(5):1870-1879. [Abstract Salo PM, Wilderson J, Rose KM, Cohn RD, Calatroni A, Mitchell HE, Server ML, Gergen PJ, Thorne PS, Zeldin DC. 2018. Bedroom allergen exposures in US households. J Allergy Clin Immunol 141(5):1870-1879.]
  3. Sheehan WJ, Permaul P, Petty CR, Coull BA, Baxi SN, Gaffin JM, Lai PS, Gold DR, Phipatanakul W. 2017. Association between allergen exposure in inner-city schools and asthma morbidity among students. JAMA Pediatr 171(1):31–38. [Abstract Sheehan WJ, Permaul P, Petty CR, Coull BA, Baxi SN, Gaffin JM, Lai PS, Gold DR, Phipatanakul W. 2017. Association between allergen exposure in inner-city schools and asthma morbidity among students. JAMA Pediatr 171(1):31–38.]
  4. Bose S, Diette GB, Woo H, Koehler K, Romero K, Rule A, Detrick B, Brigham E, McCormack M, Hansel NN. 2019. Vitamin D status modifies the response to indoor particulate matter in obese urban children with asthma. J Allergy Clin Immunol Pract; doi: https://doi.org/10.1016/j.jaip.2019.01.051 [Online 11 February 2019]. [Abstract Bose S, Diette GB, Woo H, Koehler K, Romero K, Rule A, Detrick B, Brigham E, McCormack M, Hansel NN. 2019. Vitamin D status modifies the response to indoor particulate matter in obese urban children with asthma. J Allergy Clin Immunol Pract; doi: https://doi.org/10.1016/j.jaip.2019.01.051 [Online 11 February 2019].]
  5. Brunst KJ, Ryan PH, Brokamp C, Bernstein D, Reponen T, Lockey J, Khurana Hershey GK, Levin L, Grinshpun SA, LeMasters G. 2015.Timing and duration of traffic-related air pollution exposure and the risk for childhood wheeze and asthma. Am J Respir Crit Care Med 192(4):421-7. [Abstract Brunst KJ, Ryan PH, Brokamp C, Bernstein D, Reponen T, Lockey J, Khurana Hershey GK, Levin L, Grinshpun SA, LeMasters G. 2015.Timing and duration of traffic-related air pollution exposure and the risk for childhood wheeze and asthma. Am J Respir Crit Care Med 192(4):421-7.]
  6. Wing SE, Bandoli G, Telesca D, Su JG, Ritz B. 2018. Chronic exposure to inhaled, traffic-related nitrogen dioxide and a blunted cortisol response in adolescents. Environ Res 163:201-207. [Abstract Wing SE, Bandoli G, Telesca D, Su JG, Ritz B. 2018. Chronic exposure to inhaled, traffic-related nitrogen dioxide and a blunted cortisol response in adolescents. Environ Res 163:201-207.]
  7. NCA (National Climate Assessment). 2018. Fourth National Climate Assessment: Human Health. [accessed April 11, 2019]. [Available NCA (National Climate Assessment). 2018. Fourth National Climate Assessment: Human Health. [accessed April 11, 2019].]
  8. Schurman SH, Bravo MA, Innes CL, Jackson WB 2nd, McGrath JA, Miranda ML, Garantziotis S. 2018. Toll-like receptor 4 pathway polymorphisms interact with pollution to influence asthma diagnosis and severity. Sci Rep 8(1):12713. [Abstract Schurman SH, Bravo MA, Innes CL, Jackson WB 2nd, McGrath JA, Miranda ML, Garantziotis S. 2018. Toll-like receptor 4 pathway polymorphisms interact with pollution to influence asthma diagnosis and severity. Sci Rep 8(1):12713.]
  9. Reese SE, Xu CJ, den Dekker HT, Lee MK, Sikdar S, Ruiz-Arenas C, Merid SK, et. al. 2018. Epigenome-wide meta-analysis of DNA methylation and childhood asthma. J Allergy Clin Immunol; doi:10.1016/j.jaci.2018.11.043 [Online 21 December 2018]. [Abstract Reese SE, Xu CJ, den Dekker HT, Lee MK, Sikdar S, Ruiz-Arenas C, Merid SK, et. al. 2018. Epigenome-wide meta-analysis of DNA methylation and childhood asthma. J Allergy Clin Immunol; doi:10.1016/j.jaci.2018.11.043 [Online 21 December 2018].]
  10. Stein MM, Hrusch CL, Gozdz J, Igartua C, Pivniouk V, Murray SE, Ledford JG, Marques dos Santos M, Anderson RL, Metwali N, Neilson JW, Maier RM, Gilbert JA, Holbreich M, Thorne PS, Martinez FD, von Mutius E, Vercelli D, Ober C, Sperling AI. 2016. Innate immunity and asthma risk in Amish and Hutterite farm children. N Engl J Med 375(5):411–421. [Abstract Stein MM, Hrusch CL, Gozdz J, Igartua C, Pivniouk V, Murray SE, Ledford JG, Marques dos Santos M, Anderson RL, Metwali N, Neilson JW, Maier RM, Gilbert JA, Holbreich M, Thorne PS, Martinez FD, von Mutius E, Vercelli D, Ober C, Sperling AI. 2016. Innate immunity and asthma risk in Amish and Hutterite farm children. N Engl J Med 375(5):411–421.]
  11. Zhang Z, Biagini Myers JM, Brandt EB, Ryan PH, Lindsey M, Mintz-Cole RA, Reponen T, Vesper SJ, Forde F, Ruff B, Bass SA, LeMasters G, Bernstein DI, Lockey J, Budelsky AL, Khurana Hershey GK. 2017. Beta-glucan exacerbates allergic asthma independent of fungal sensitization and promotes steroid-resistant TH2/TH17 responses. J Allergy Clin Immunol. 139(1):54-65. [Abstract Zhang Z, Biagini Myers JM, Brandt EB, Ryan PH, Lindsey M, Mintz-Cole RA, Reponen T, Vesper SJ, Forde F, Ruff B, Bass SA, LeMasters G, Bernstein DI, Lockey J, Budelsky AL, Khurana Hershey GK. 2017. Beta-glucan exacerbates allergic asthma independent of fungal sensitization and promotes steroid-resistant TH2/TH17 responses. J Allergy Clin Immunol. 139(1):54-65.]

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