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      Prevalence of asthma and other allergic conditions in adults in Khuzestan, southwest Iran, 2018

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          Abstract

          Background

          Health information on the dimensions of asthma and allergic conditions in Khuzestan Province, as a major industrial and polluted area in Iran as and the Middle East, is inadequate. This study was performed to measure the prevalence of asthma and other allergic conditions in adults in Khuzestan Province.

          Methods

          This population-based cross-sectional study was carried out in 17 villages and 27 cities of Khuzestan Province during the years 2017–2018 on 20 to 65 year old respondents. Two-stage cluster sampling was used. The ECRHS (European Community Respiratory Health Survey) questionnaire was completed for individuals with additional questions regarding other allergic conditions.

          Results

          In the study, 5720 questionnaires were distributed of which 5708 were returned. The prevalence of current asthma was 8.5% and that of asthma-like symptoms was 19.0%. The most common symptoms of asthma were nocturnal cough (13.6%), chest tightness (12.3%) and wheezing (13.1%). The prevalence of allergic rhinitis (AR), eczema and airway hyperresponsiveness were 27.2, 10.7, and 38.7%, respectively. The prevalence of current asthma was strongly correlated with age, current location (city, village), and the smoking status of respondents ( p < 0.05).

          Conclusion

          The prevalence of current asthma and asthma-like symptoms in Khuzestan Province is almost twice as high as in Iran. Given the high prevalence of symptoms of airway hyperresponsiveness in the entire province, it is necessary to take environmental measures to mitigate the emergence of new cases of asthma among the residents. In addition, surveillance studies are necessary to monitor the trends in the prevalence of asthma in this province.

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          Most cited references30

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          Effects of marijuana smoking on pulmonary function and respiratory complications: a systematic review.

          The relationship between marijuana smoking and pulmonary function or respiratory complications is poorly understood; therefore, we conducted a systematic review of the impact of marijuana smoking on pulmonary function and respiratory complications. Studies that evaluated the effect of marijuana smoking on pulmonary function and respiratory complications were selected from the MEDLINE, PsychINFO, and EMBASE databases according to predefined criteria from January 1, 1966, to October 28, 2005. Two independent reviewers extracted data and evaluated study quality based on established criteria. Study results were critically appraised for clinical applicability and research methods. Thirty-four publications met selection criteria. Reports were classified as challenge studies if they examined the association between short-term marijuana use and airway response; other reports were classified as studies of long-term marijuana smoking and pulmonary function or respiratory complications. Eleven of 12 challenge studies found an association between short-term marijuana administration and bronchodilation (eg, increases of 0.15-0.25 L in forced expiratory volume in 1 second). No consistent association was found between long-term marijuana smoking and airflow obstruction measures. All 14 studies that assessed long-term marijuana smoking and respiratory complications noted an association with increased respiratory symptoms, including cough, phlegm, and wheeze (eg, odds ratio, 2.00; 95% confidence interval, 1.32-3.01, for the association between marijuana smoking and cough). Studies were variable in their overall quality (eg, controlling for confounders, including tobacco smoking). Short-term exposure to marijuana is associated with bronchodilation. Physiologic data were inconclusive regarding an association between long-term marijuana smoking and airflow obstruction measures. Long-term marijuana smoking is associated with increased respiratory symptoms suggestive of obstructive lung disease.
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            The role of air pollution in asthma and other pediatric morbidities.

            A growing body of research supports the role of outdoor air pollutants in acutely aggravating chronic diseases in children, and suggests that the pollutants may have a role in the development of these diseases. This article reviews the biologic basis of children's unique vulnerability to highly prevalent outdoor air pollutants, with a special focus on ozone, respirable particulate matter (PM 2.5 [<2.5 microm in diameter] and PM 10 [<10 microm in diameter]), lead, sulfur dioxide, carbon monoxide, and nitrogen oxides. We also summarize understanding regarding health effects and molecular mechanisms of action. Practitioners can significantly reduce morbidity in children and other vulnerable populations by advising families to minimize pollutant exposures to children with asthma, or at a broader level by educating policymakers about the need to act to reduce pollutant emissions. Management of children with asthma must expand beyond preventing exposures to agents that directly cause allergic reactions (and therefore can be diagnosed by means of skin tests) and must focus more attention on agents that cause a broad spectrum of nonspecific, generalized inflammation, such as air pollution.
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              An economic evaluation of asthma in the United States.

              Asthma is a common chronic illness. Recently, increases in morbidity and mortality due to this disease have been reported. We studied the distribution of health care resources used for asthma in order to lay the groundwork for further policy decisions aimed at reducing the economic burden of this disorder. Estimates of direct medical expenditures and indirect costs (in 1985 dollars) were derived from data available from the National Center for Health Statistics. These cost estimates were projected to 1990 dollars. The cost of illness related to asthma in 1990 was estimated to be $6.2 billion. Inpatient hospital services represented the largest single direct medical expenditure for this chronic condition, approaching $1.6 billion. The value of reduced productivity due to loss of school days represented the largest single indirect cost, approaching $1 billion in 1990. Although asthma is often considered to be a mild chronic illness treatable with ambulatory care, we found that 43 percent of its economic impact was associated with emergency room use, hospitalization, and death. Nearly two thirds of the visits for ambulatory care were to physicians in three primary care specialties--pediatrics, family medicine or general practice, and internal medicine. Potential reductions in the costs related to asthma in the United States may be identified through a closer examination of the effectiveness of care associated with each category of cost. Future health policy efforts to improve the effectiveness of primary care interventions for asthma in the ambulatory setting may reduce the costs of this common illness.
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                Author and article information

                Contributors
                esmaileidani@gmail.com
                dr.raji.h@gmail.com
                madadizadehfarzan@gmail.com
                cheraghian2000@yahoo.com
                m.haddadzadeh_sh@yahoo.com
                +98 61 333 6754 , dastoorpoor-m@ajums.ac.ir
                Journal
                BMC Public Health
                BMC Public Health
                BMC Public Health
                BioMed Central (London )
                1471-2458
                13 March 2019
                13 March 2019
                2019
                : 19
                : 303
                Affiliations
                [1 ]ISNI 0000 0000 9296 6873, GRID grid.411230.5, Air Pollution and Respiratory Diseases Research Center, , Ahvaz Jundishapur University of Medical Sciences, ; Ahvaz, Iran
                [2 ]ISNI 0000 0004 0612 5912, GRID grid.412505.7, Research Center of Prevention and Epidemiology of Non-Communicable Disease, Department of Biostatistics and Epidemiology, , School of Public Health, Shahid Sadoughi University of Medical Sciences, ; Yazd, Iran
                [3 ]ISNI 0000 0001 0166 0922, GRID grid.411705.6, Department of Epidemiology and Biostatistics, , School of Public Health, Tehran University of Medical Sciences, ; Tehran, Iran
                [4 ]ISNI 0000 0000 9296 6873, GRID grid.411230.5, Department of Epidemiology and Biostatistics, , School of Public Health, Ahvaz Jundishapur University of Medical Sciences, ; Ahvaz, Iran
                [5 ]ISNI 0000 0000 9296 6873, GRID grid.411230.5, Department of Epidemiology and Biostatistics, Air Pollution and Respiratory Diseases Research Center, , Ahvaz Jundishapur University of Medical Sciences, ; Ahvaz, Iran
                Article
                6491
                10.1186/s12889-019-6491-0
                6417254
                30866869
                7e704846-808b-449e-a4bf-388056252020
                © The Author(s). 2019

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 24 October 2018
                : 29 January 2019
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100005001, Ahvaz Jundishapur University of Medical Sciences;
                Award ID: APRD-9504
                Award Recipient :
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2019

                Public health
                prevalence,asthma,rhinitis,allergic,eczema,adults
                Public health
                prevalence, asthma, rhinitis, allergic, eczema, adults

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