Risk factors for asthma across India: Results from global asthma network (GAN) phase I study.

Introduction: This study aimed to assess the risk factors and triggers predisposing to asthma in Indian children and adults.

Methods: The Global Asthma Network Phase I study was a multicentre, international, school, and questionnaire-based cross-sectional study conducted across the world with nine centers in India from 2017-18, the current study being analysis of the Indian data.

Results: There were 20084 children, 25887 adolescents, and 81296 adults from 9 sites across India. The adjusted odds ratio (AOR) and 95% confidence interval (CI) for atopic factors were as follows: parental history of asthma in adults (AOR 2.88, CI 2.21-3.75), hay fever in children (AOR 2.05, CI 1.62-2.58), and hay fever in adolescents (AOR 1.65, CI 1.40-1.94). Environmental triggers such as exposure to damp spots in the home (AOR1.28, CI 1.05-1.55), antibiotics consumption (AOR 1.80, CI 1.30-2.51), paracetamol taken during pregnancy (AOR 1.23, CI1.02-1.49), and laying on a woollen blanket in the first year of life (AOR 1.67, CI1.34-2.03) were the risk factors predisposing to current wheeze in the children. Risk factors for current wheeze in the adolescents included passage of trucks in front of the house (AOR 1.20, CI 1.04-1.39), and pet animal exposure (AOR 1.32, CI 1.14-1.53); and in the adults included damp spots in houses (AOR 1.61, CI 1.47-1.77), and the use of coal or kerosene or cow dung as a cooking fuel (AOR 1.48, CI 1.28-1.71). Personal factors such as the history of pneumonia in the children (AOR 1.71, CI 1.36-2.15); wheezing after exercise (AOR 1.45, CI 1.23-1.69), hospitalization in the past year (AOR 2.85, CI 2.61-3.59) and caesarean birth (AOR 1.28, CI 1.07-1.53) in the adolescents were associated with current wheeze. India-specific triggers included consumption of bananas (AOR 1.34, CI 1.10-1.63), curd (AOR 1.49, CI 1.23-1.82), packed crunchies (AOR 1.23, CI 1.03-1.48), ice-creams (AOR 1.31, CI1.12-1.53) in adolescents and use of mosquito repellents in adults (AOR 1.11, CI 1.01-1.22).

Conclusion: The study identifies genetic, environmental, personal health, and dietary risk factors for asthma in India, underscoring the need for public health measures to improve air quality, promote dietary awareness, and reduce indoor hazards.