Beyond Smoking: Environmental Determinants of Asthma Prevalence in Western Nepal

Abstract

Background. Asthma is widely prevalent in Nepal, but the causes are not well known aside from some general associations with ambient air pollution and microbial exposures. Information on the wide-ranging determinants of asthma prevalence among the population at risk can help policy makers to reduce risk. Objective. The present study is a preliminary investigation of the environmental, socioeconomic and behavioral determinants of asthma prevalence in western Nepal. Methods. A survey was conducted among 420 randomly selected households in western Nepal. A cross-sectional analytical study design was employed with the primary data using econometric tools of probit and logistic regression. Results. Environmental variables such as extreme cold winter, deteriorating river water quality and air pollution were associated with an increase in asthma prevalence. However, individual or household characteristics such as advancing age of household head, use of pesticides in the home for the control of pests, piped drinking water with old pipes and lack of participation in awareness programs were associated with an increase in asthma prevalence. Discussion. Among environmental factors, decreasing river water quality, increasing air pollution, and extremely cold winters are more likely to contribute to asthma prevalence. In light of the effects of environmental factors on the prevalence of asthma in Nepal, the high public and private costs of asthma could further impoverish the rural poor. Conclusions. Environmental health policy makers should design adaptation strategies along with additional community programs addressing asthma-instigating factors. Programs to reduce environmental pollution can reduce morbidity due to asthma. Participant Consent. Obtained Ethics Approval. This study was approved by the Ethical Committee of the Nepal Health Research Council. Competing Interests. The authors declare no competing financial interests.

Keywords

• nepal
• asthma
• environment
• household characteristics
• probit model