Factors associated with asthma and wheezing in children: The role of personal, household, home, environmental, and behavioral characteristics

OBJECTIVES: We assessed factors associated with asthma and wheezing in children using a comprehensive approach encompassing child, perinatal, household, home, and behavioral characteristics. STUDY DESIGN: A cross-sectional study was performed, inviting parents/legal guardians of 2629 children (5-11 years) from 20 public primary schools in Porto, Portugal. METHODS: Data were collected using structured questionnaires completed by parents/legal guardians. Multivariable logistic regression models assessed the adjusted associations between potential factors and ever-asthma, current asthma, and wheezing. RESULTS: Overall, 1145 children completed the questionnaire (response rate: 43.5%). Early-life respiratory illnesses were consistently associated with respiratory outcomes. Pneumonia (OR = 4.69; 95%CI = 2.45-8.99), bronchitis (OR = 1.98; 95% CI = 1.19-3.29), and bronchiolitis (OR = 2.66; 95% CI = 1.73-4.11) were associated with higher odds of ever-asthma, while bronchitis (OR = 3.30; 95%CI = 2.21-4.94) and bronchiolitis (OR = 5.72; 95%CI = 4.28-7.64) were also associated with higher odds of wheezing. Family history of asthma was associated with ever-asthma (OR = 2.20; 95%CI = 1.39-3.49), whereas having siblings was associated with higher odds of wheezing (OR = 1.40; 95%CI = 1.02-1.94). Home renovation or remodeling was associated with lower odds of ever-asthma (OR = 0.43; 95%CI = 0.26-0.69) and wheezing (OR = 0.56; 95%CI = 0.41-0.76), while home mold growth was associated with higher odds of wheezing (OR = 2.37; 95%CI = 1.72-3.26). Living in detached houses was associated with lower odds of current asthma (OR = 0.42; 95%CI = 0.22-0.89), whereas living in flat houses (OR = 1.72; 95%CI = 1.00-2.96) and using a dry cloth for cleaning (OR = 1.36; 95%CI = 1.01-1.83) were associated with higher odds of wheezing. CONCLUSIONS: Despite the inherent limitations in establishing causality, the findings highlight the multifactorial nature of childhood asthma and wheezing and their associations with early-life, household, home, and behavioral factors.