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Semin Respir Crit Care Med 2018; 39(01): 012-018
DOI: 10.1055/s-0037-1606219
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Environmental Causes of Asthma

Donald W. Cockcroft
1   Division of Respiratory, Critical Care and Sleep Medicine, Department of Medicine, University of Saskatchewan, Saskatoon, Canada
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Publication History

Publication Date:
10 February 2018 (online)

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Abstract

Environmental factors which cause asthma are those that induce airway inflammation with eosinophils (more common) or neutrophils along with airway hyperresponsiveness (AHR). The most common of these (indeed the most common cause of asthma) are IgE-mediated inhalant allergen exposures. Allergen-induced AHR and inflammation are both associated with the allergen-induced late asthmatic response (LAR). Although allergens were previously recognized only as causes of symptoms and bronchoconstriction in asthmatics, we now appreciate them as causes of the fundamental pathophysiologic features of asthma. Low-molecular-weight chemical sensitizers, causes of occupational asthma, also cause asthma in a manner analogous to allergen. Acute irritant-induced asthma (reactive airways dysfunction syndrome) following a very heavy irritant exposure and chronic irritant-induced asthma following repeated high exposures can also induce persistent or permanent changes (inflammation and AHR) consistent with asthma. Textile dust exposure produces a different form of airway disease (byssinosis) which is less frequently observed currently. Environmental exposure to tobacco smoke facilitates the development of asthma in children. Personal smoking and environmental air pollution have an inconsistent and likely generally small effect in causing asthma.

Keywords

inhaled irritant - LMW chemical sensitizer - occupational asthma - RADS - irritant-induced asthma - byssinosis - cigarette smoking - air pollution
 

  • References

  • 1 Ring J. Erstbeschreibung einer “atopischen Familienanamnese” im Julisch-Claudischen Kaiserhaus: Augustus, Claudius, Britannicus. [1st description of an “atopic family anamnesis” in the Julio-Claudian imperial house: Augustus, Claudius, Britcannicus] Hautarzt 1985; 36 (08) 470-471
    PubMedGoogle Scholar
  • 2 Simons FER. , ed. Ancestors of Allergy. New York: Global Medical Communications Ltd.; 1994: 78-80
    Google Scholar
  • 3 Bostock J. Case of a periodical affection of the eyes and chest. Med Chir Trans 1819; 10 (Pt 1): 161-165
    PubMedGoogle Scholar
  • 4 Salter HH. Asthma: Its Pathology and Treatment, 3rd ed. New York: William Wood and Company; 1882
    Google Scholar
  • 5 Wyman M. Autumnal Catarrh (Hay Fever). New York: Hurd and Houghton; 1872
    Google Scholar
  • 6 Blackley C. Catarrhus Æstivus (Hay-Fever or Hay-Asthma). London: Baillière, Tindall & Cox; 1873
    Google Scholar
  • 7 Dunbar WP. The present state of our knowledge of hay fever. J Hyg (Lond) 1913; 13 (02) 105-148
    CrossrefPubMedGoogle Scholar
  • 8 Noon L. Prophylactic inoculation against hay fever. Lancet 1911; 1: 1572
    PubMedGoogle Scholar
  • 9 Prausnitz C, Kustner H. Studien uber die Ueberempfindlichkeit. Centralblatt fur Bakteriologie. Parasitenkunde und Infektionskrankeiten 1921; 86: 160-169
    PubMedGoogle Scholar
  • 10 Coca AF, Cooke RA. On the classification of the phenomena of hypersensitiveness. J Immunol 1923; 8: 163-182
    PubMedGoogle Scholar
  • 11 Ishizaka K, Ishizaka T. Identification of gamma-E-antibodies as a carrier of reaginic activity. J Immunol 1967; 99 (06) 1187-1198
    PubMedGoogle Scholar
  • 12 Johansson SG, Bennich H. Immunological studies of an atypical (myeloma) immunoglobulin. Immunology 1967; 13 (04) 381-394
    PubMedGoogle Scholar
  • 13 Rackemann FM. A clinical study of one hundred and fifty cases of bronchial asthma. Arch Intern Med 1918; 22 (04) 517-552
    PubMedGoogle Scholar
  • 14 Lichtenstein LM. An evaluation of the role of immunotherapy in asthma. Am Rev Respir Dis 1978; 117 (02) 191-197
    PubMedGoogle Scholar
  • 15 Hargreave FE, Woolcock AJ. , eds. Airway Responsiveness: Measurement and Interpretation. Ontario, Canada: Astra Pharmaceuticals Canada Ltd.; 1985
    Google Scholar
  • 16 Tiffeneau R, Beauvallet M. Epreuve de bronchoconstriction et de bronchodilation par aerosols. Bull Acad de Med 1945; 129: 165-168
    PubMedGoogle Scholar
  • 17 Altounyan RE. Variation of drug action on airway obstruction in man. Thorax 1964; 19: 406-415
    CrossrefPubMedGoogle Scholar
  • 18 Cockcroft DW, Ruffin RE, Dolovich J, Hargreave FE. Allergen-induced increase in non-allergic bronchial reactivity. Clin Allergy 1977; 7 (06) 503-513
    CrossrefPubMedGoogle Scholar
  • 19 Cartier A, Thomson NC, Frith PA, Roberts R, Hargreave FE. Allergen-induced increase in bronchial responsiveness to histamine: relationship to the late asthmatic response and change in airway caliber. J Allergy Clin Immunol 1982; 70 (03) 170-177
    CrossrefPubMedGoogle Scholar
  • 20 Boulet L-P, Cartier A, Thomson NC, Roberts RS, Dolovich J, Hargreave FE. Asthma and increases in nonallergic bronchial responsiveness from seasonal pollen exposure. J Allergy Clin Immunol 1983; 71 (04) 399-406
    CrossrefPubMedGoogle Scholar
  • 21 Cockcroft DW. Mechanism of perennial allergic asthma. Lancet 1983; 2 (8344): 253-256
    PubMedGoogle Scholar
  • 22 Cockcroft DW, Davis BE. Mechanisms of airway hyperresponsiveness. J Allergy Clin Immunol 2006; 118 (03) 551-559 , quiz 560–561
    CrossrefPubMedGoogle Scholar
  • 23 Leckie MJ, ten Brinke A, Khan J. , et al. Effects of an interleukin-5 blocking monoclonal antibody on eosinophils, airway hyper-responsiveness, and the late asthmatic response. Lancet 2000; 356 (9248): 2144-2148
    CrossrefPubMedGoogle Scholar
  • 24 Crockcroft DW, Murdock KY, Berscheid BA. Relationship between atopy and bronchial responsiveness to histamine in a random population. Ann Allergy 1984; 53 (01) 26-29
    PubMedGoogle Scholar
  • 25 Witt C, Stuckey MS, Woolcock AJ, Dawkins RL. Positive allergy prick tests associated with bronchial histamine responsiveness in an unselected population. J Allergy Clin Immunol 1986; 77 (05) 698-702
    CrossrefPubMedGoogle Scholar
  • 26 Peat JK, Britton WJ, Salome CM, Woolcock AJ. Bronchial hyperresponsiveness in two populations of Australian schoolchildren. III. Effect of exposure to environmental allergens. Clin Allergy 1987; 17 (04) 291-300
    CrossrefPubMedGoogle Scholar
  • 27 Burney PG, Britton JR, Chinn S. , et al. Descriptive epidemiology of bronchial reactivity in an adult population: results from a community study. Thorax 1987; 42 (01) 38-44
    CrossrefPubMedGoogle Scholar
  • 28 van der Heide S, de Monchy JG, de Vries K, Bruggink TM, Kauffman HF. Seasonal variation in airway hyperresponsiveness and natural exposure to house dust mite allergens in patients with asthma. J Allergy Clin Immunol 1994; 93 (02) 470-475
    CrossrefPubMedGoogle Scholar
  • 29 Platts-Mills TA, Tovey ER, Mitchell EB, Moszoro H, Nock P, Wilkins SR. Reduction of bronchial hyperreactivity during prolonged allergen avoidance. Lancet 1982; 2 (8300): 675-678
    PubMedGoogle Scholar
  • 30 Peroni DG, Boner AL, Vallone G, Antolini I, Warner JO. Effective allergen avoidance at high altitude reduces allergen-induced bronchial hyperresponsiveness. Am J Respir Crit Care Med 1994; 149 (06) 1442-1446
    CrossrefPubMedGoogle Scholar
  • 31 van Velzen E, van den Bos JW, Benckhuijsen JA, van Essel T, de Bruijn R, Aalbers R. Effect of allergen avoidance at high altitude on direct and indirect bronchial hyperresponsiveness and markers of inflammation in children with allergic asthma. Thorax 1996; 51 (06) 582-584
    CrossrefPubMedGoogle Scholar
  • 32 Shirai T, Matsui T, Suzuki K, Chida K. Effect of pet removal on pet allergic asthma. Chest 2005; 127 (05) 1565-1571
    CrossrefPubMedGoogle Scholar
  • 33 De Monchy JG, Kauffman HF, Venge P. , et al. Bronchoalveolar eosinophilia during allergen-induced late asthmatic reactions. Am Rev Respir Dis 1985; 131 (03) 373-376
    PubMedGoogle Scholar
  • 34 Pin I, Freitag AP, O'Byrne PM. , et al. Changes in the cellular profile of induced sputum after allergen-induced asthmatic responses. Am Rev Respir Dis 1992; 145 (06) 1265-1269
    CrossrefPubMedGoogle Scholar
  • 35 Gauvreau GM, Watson RM, O'Byrne PM. Kinetics of allergen-induced airway eosinophilic cytokine production and airway inflammation. Am J Respir Crit Care Med 1999; 160 (02) 640-647
    CrossrefPubMedGoogle Scholar
  • 36 Cockcroft DW, Hargreave FE, O'Byrne PM, Boulet LP. Understanding allergic asthma from allergen inhalation tests. Can Respir J 2007; 14 (07) 414-418
    PubMedGoogle Scholar
  • 37 Johnson JR, Wiley RE, Fattouh R. , et al. Continuous exposure to house dust mite elicits chronic airway inflammation and structural remodeling. Am J Respir Crit Care Med 2004; 169 (03) 378-385
    CrossrefPubMedGoogle Scholar
  • 38 Leigh R, Ellis R, Wattie J. , et al. Dysfunction and remodeling of the mouse airway persist after resolution of acute allergen-induced airway inflammation. Am J Respir Cell Mol Biol 2002; 27 (05) 526-535
    CrossrefPubMedGoogle Scholar
  • 39 Cockcroft DW, Jokic R, Marciniuk DD, Fitzpatrick MF. The current dilemma with spirometric inclusion criteria for asthma drug trials. Ann Allergy Asthma Immunol 1997; 79 (03) 226-228
    CrossrefPubMedGoogle Scholar
  • 40 Pearce N, Pekkanen J, Beasley R. How much asthma is really attributable to atopy?. Thorax 1999; 54 (03) 268-272
    CrossrefPubMedGoogle Scholar
  • 41 Tarlo SM, Lemiere C. Occupational asthma. N Engl J Med 2014; 370 (07) 640-649
    CrossrefPubMedGoogle Scholar
  • 42 Torén K, Blanc PD. Asthma caused by occupational exposures is common - a systematic analysis of estimates of the population-attributable fraction. BMC Pulm Med 2009; 9: 7
    CrossrefPubMedGoogle Scholar
  • 43 Banks DE, Jalloul A. Occupational asthma, work-related asthma and reactive airways dysfunction syndrome. Curr Opin Pulm Med 2007; 13 (02) 131-136
    CrossrefPubMedGoogle Scholar
  • 44 Cullinan P, Newman Taylor AJ. Inferences from occupational asthma. Ciba Found Symp 1997; 206: 160-168 , discussion 168–172
    PubMedGoogle Scholar
  • 45 Gandevia B. Studies of ventilatory capacity and histamine response during exposure to isocyanate vapour in polyurethane foam manufacture. Br J Ind Med 1963; 20: 204-209
    PubMedGoogle Scholar
  • 46 Chan-Yeung M, Barton GM, MacLean L, Grzybowski S. Occupational asthma and rhinitis due to Western red cedar (Thuja plicata). Am Rev Respir Dis 1973; 108 (05) 1094-1102
    PubMedGoogle Scholar
  • 47 O'Brien IM, Harries MG, Burge PS, Pepys J. Toluene di-isocyanate-induced asthma. I. Reactions to TDI, MDI, HDI and histamine. Clin Allergy 1979; 9 (01) 1-6
    CrossrefPubMedGoogle Scholar
  • 48 O'Brien IM, Newman-Taylor AJ, Burge PS, Harries MG, Fawcett IW, Pepys J. Toluene di-isocyanate-induced asthma. II. Inhalation challenge tests and bronchial reactivity studies. Clin Allergy 1979; 9 (01) 7-15
    CrossrefPubMedGoogle Scholar
  • 49 Cockcroft DW. Occupational asthma: assessment. In: Dosman JA, Cockcroft DW. , eds. Handbook of Health and Safety in Agriculture. Boca Raton, Florida: CRC Press; 1989: 162-163
    Google Scholar
  • 50 Lam S, Wong R, Yeung M. Nonspecific bronchial reactivity in occupational asthma. J Allergy Clin Immunol 1979; 63 (01) 28-34
    CrossrefPubMedGoogle Scholar
  • 51 Mapp CE, Di Giacomo GR, Omini C, Broseghini C, Fabbri LM. Late, but not early, asthmatic reactions induced by toluene-diisocyanate are associated with increased airway responsiveness to methacholine. Eur J Respir Dis 1986; 69 (04) 276-284
    PubMedGoogle Scholar
  • 52 Mapp CE, Polato R, Maestrelli P, Hendrick DJ, Fabbri LM. Time course of the increase in airway responsiveness associated with late asthmatic reactions to toluene diisocyanate in sensitized subjects. J Allergy Clin Immunol 1985; 75 (05) 568-572
    CrossrefPubMedGoogle Scholar
  • 53 Boschetto P, Zocca E, Bruchi O. , et al. Importance of airway inflammation for late asthmatic reactions induced by toluene diisocyanate in sensitized subjects. Adv Prostaglandin Thromboxane Leukot Res 1987; 17B: 1080-1084
    PubMedGoogle Scholar
  • 54 Lemière C, Chaboillez S, Malo JL, Cartier A. Changes in sputum cell counts after exposure to occupational agents: what do they mean?. J Allergy Clin Immunol 2001; 107 (06) 1063-1068
    CrossrefPubMedGoogle Scholar
  • 55 Fabbri LM, Boschetto P, Zocca E. , et al. Bronchoalveolar neutrophilia during late asthmatic reactions induced by toluene diisocyanate. Am Rev Respir Dis 1987; 136 (01) 36-42
    CrossrefPubMedGoogle Scholar
  • 56 Cartier A, L'Archevêque J, Malo JL. Exposure to a sensitizing occupational agent can cause a long-lasting increase in bronchial responsiveness to histamine in the absence of significant changes in airway caliber. J Allergy Clin Immunol 1986; 78 (06) 1185-1189
    CrossrefPubMedGoogle Scholar
  • 57 Chan-Yeung M, Lam S, Koener S. Clinical features and natural history of occupational asthma due to western red cedar (Thuja plicata). Am J Med 1982; 72 (03) 411-415
    CrossrefPubMedGoogle Scholar
  • 58 Padoan M, Pozzato V, Simoni M. , et al. Long-term follow-up of toluene diisocyanate-induced asthma. Eur Respir J 2003; 21 (04) 637-640
    CrossrefPubMedGoogle Scholar
  • 59 Cockcroft DW, Mink JT. Isocyanate-induced asthma in an automobile spray painter. Can Med Assoc J 1979; 121 (05) 602-604
    PubMedGoogle Scholar
  • 60 Cockcroft DW. Acquired persistent increase in nonspecific bronchial, reactivity associated with isocyanate exposure. Ann Allergy 1982; 48 (02) 93-95
    PubMedGoogle Scholar
  • 61 Brooks SM, Weiss MA, Bernstein IL. Reactive airways dysfunction syndrome (RADS). Persistent asthma syndrome after high level irritant exposures. Chest 1985; 88 (03) 376-384
    CrossrefPubMedGoogle Scholar
  • 62 Moisan TC. Prolonged asthma after smoke inhalation: a report of three cases and a review of previous reports. J Occup Med 1991; 33 (04) 458-461
    PubMedGoogle Scholar
  • 63 Kennedy SM, Enarson DA, Janssen RG, Chan-Yeung M. Lung health consequences of reported accidental chlorine gas exposures among pulp mill workers. Am Rev Respir Dis 1991; 143 (01) 74-79
    CrossrefPubMedGoogle Scholar
  • 64 Axford AT, McKerrow CB, Jones AP, Le Quesne PM. Accidental exposure to isocyanate fumes in a group of firemen. Br J Ind Med 1976; 33 (02) 65-71
    PubMedGoogle Scholar
  • 65 Prezant DJ, Weiden M, Banauch GI. , et al. Cough and bronchial responsiveness in firefighters at the World Trade Center site. N Engl J Med 2002; 347 (11) 806-815
    CrossrefPubMedGoogle Scholar
  • 66 Banauch GI, Alleyne D, Sanchez R. , et al. Persistent hyperreactivity and reactive airway dysfunction in firefighters at the World Trade Center. Am J Respir Crit Care Med 2003; 168 (01) 54-62
    CrossrefPubMedGoogle Scholar
  • 67 Henneberger PK, Derk SJ, Davis L. , et al. Work-related reactive airways dysfunction syndrome cases from surveillance in selected US states. J Occup Environ Med 2003; 45 (04) 360-368
    CrossrefPubMedGoogle Scholar
  • 68 Brooks SM, Hammad Y, Richards I, Giovinco-Barbas J, Jenkins K. The spectrum of irritant-induced asthma: sudden and not-so-sudden onset and the role of allergy. Chest 1998; 113 (01) 42-49
    CrossrefPubMedGoogle Scholar
  • 69 Bhérer L, Cushman R, Courteau JP. , et al. Survey of construction workers repeatedly exposed to chlorine over a three to six month period in a pulp mill: II. Follow up of affected workers by questionnaire, spirometry, and assessment of bronchial responsiveness 18 to 24 months after exposure ended. Occup Environ Med 1994; 51 (04) 225-228
    CrossrefPubMedGoogle Scholar
  • 70 McL Niven R, Pickering CA. Byssinosis: a review. Thorax 1996; 51 (06) 632-637
    CrossrefPubMedGoogle Scholar
  • 71 Wang XR, Zhang HX, Sun BX. , et al. A 20-year follow-up study on chronic respiratory effects of exposure to cotton dust. Eur Respir J 2005; 26 (05) 881-886
    CrossrefPubMedGoogle Scholar
  • 72 Schachter EN, Zuskin E, Buck M. , et al. Airway responses to the inhalation of cotton dust and cotton bract extracts. Respiration 2006; 73 (01) 41-47
    CrossrefPubMedGoogle Scholar
  • 73 Khan AJ, Nanchal R. Cotton dust lung diseases. Curr Opin Pulm Med 2007; 13 (02) 137-141
    CrossrefPubMedGoogle Scholar
  • 74 den Dekker HT, Voort AMMS, de Jongste JC. , et al. Tobacco smoke exposure, airway resistance, and asthma in school-age children: The Generation R Study. Chest 2015; 148 (03) 607-617
    CrossrefPubMedGoogle Scholar
  • 75 Singh S, Sharma BB, Sharma SK, Sabir M, Singh V. ; ISAAC collaborating investigators. Prevalence and severity of asthma among Indian school children aged between 6 and 14 years: associations with parental smoking and traffic pollution. J Asthma 2016; 53 (03) 238-244
    CrossrefPubMedGoogle Scholar
  • 76 Burke H, Leonardi-Bee J, Hashim A. , et al. Prenatal and passive smoke exposure and incidence of asthma and wheeze: systematic review and meta-analysis. Pediatrics 2012; 129 (04) 735-744
    CrossrefPubMedGoogle Scholar
  • 77 Moerloose KB, Robays LJ, Maes T, Brusselle GG, Tournoy KG, Joos GF. Cigarette smoke exposure facilitates allergic sensitization in mice. Respir Res 2006; 7: 49
    CrossrefPubMedGoogle Scholar
  • 78 Siroux V, Pin I, Oryszczyn MP, Le Moual N, Kauffmann F. Relationships of active smoking to asthma and asthma severity in the EGEA study. Epidemiological study on the Genetics and Environment of Asthma. Eur Respir J 2000; 15 (03) 470-477
    CrossrefPubMedGoogle Scholar
  • 79 Underner M, Perriot J, Peiffer G, Meurice JC. Influence of tobacco smoking on the risk of developing asthma [in French]. Rev Mal Respir 2015; 32 (02) 110-137
    CrossrefPubMedGoogle Scholar
  • 80 Senthilselvan A, Chen Y, Dosman JA. Predictors of asthma and wheezing in adults. Grain farming, sex, and smoking. Am Rev Respir Dis 1993; 148 (03) 667-670
    CrossrefPubMedGoogle Scholar
  • 81 Vesterinen E, Kaprio J, Koskenvuo M. Prospective study of asthma in relation to smoking habits among 14,729 adults. Thorax 1988; 43 (07) 534-539
    CrossrefPubMedGoogle Scholar
  • 82 McWhorter WP, Polis MA, Kaslow RA. Occurrence, predictors, and consequences of adult asthma in NHANESI and follow-up survey. Am Rev Respir Dis 1989; 139 (03) 721-724
    CrossrefPubMedGoogle Scholar
  • 83 Verlato G, Nguyen G, Marchetti P. , et al. Smoking and new-onset asthma in a prospective study on Italian adults. Int Arch Allergy Immunol 2016; 170 (03) 149-157
    CrossrefPubMedGoogle Scholar
  • 84 Althuis MD, Sexton M, Prybylski D. Cigarette smoking and asthma symptom severity among adult asthmatics. J Asthma 1999; 36 (03) 257-264
    CrossrefPubMedGoogle Scholar
  • 85 Fuertes E, Standl M, Cyrys J. , et al. A longitudinal analysis of associations between traffic-related air pollution with asthma, allergies and sensitization in the GINIplus and LISAplus birth cohorts. PeerJ 2013; 1: e193
    CrossrefPubMedGoogle Scholar
  • 86 Alexis NE, Carlsten C. Interplay of air pollution and asthma immunopathogenesis: a focused review of diesel exhaust and ozone. Int Immunopharmacol 2014; 23 (01) 347-355
    CrossrefPubMedGoogle Scholar
  • 87 Lazarevic N, Dobson AJ, Barnett AG, Knibbs LD. Long-term ambient air pollution exposure and self-reported morbidity in the Australian Longitudinal Study on Women's Health: a cross-sectional study. BMJ Open 2015; 5 (10) e008714
    CrossrefPubMedGoogle Scholar
  • 88 Burte E, Nadif R, Jacquemin B. Susceptibility factors relevant for the association between long-term air pollution exposure and incident asthma. Curr Environ Health Rep 2016; 3 (01) 23-39
    PubMedGoogle Scholar
  • 89 Cox Jr LA. Socioeconomic and air pollution correlates of adult asthma, heart attack, and stroke risks in the United States, 2010-2013. Environ Res 2017; 155: 92-107
    CrossrefPubMedGoogle Scholar
  • 90 Nel AE, Diaz-Sanchez D, Ng D, Hiura T, Saxon A. Enhancement of allergic inflammation by the interaction between diesel exhaust particles and the immune system. J Allergy Clin Immunol 1998; 102 (4, Pt 1): 539-554
    CrossrefPubMedGoogle Scholar