Exacerbation of asthma among adults in relation to the home environment in multi-family buildings in Sweden

OBJECTIVE: To study the association between the home environment and asthma medication and exacerbation of asthma among adults with physician-diagnosed asthma.

METHODS: Adults aged 18 years in a stratified sample of multi-family buildings throughout Sweden were invited to respond to a postal questionnaire (the BETSI Study). A total of 639 adults (11.5%) with physician-diagnosed asthma were included.

RESULTS: Of the 639 adults, 62.0% were females, 10.8% were current smokers, 62.6% had pollen or furry pet allergy, 61.7% were on current asthma medication and 48.6% had experienced an asthma exacerbation in the past year. Logistic regression models were applied to study the association between the home environment and asthma medication and asthma exacerbation, adjusting for sex, age and smoking status. Asthma medication was more commonly prescribed for those who kept dogs as pets (OR 2.66, 95%CI 1.05–6.75) and in homes with mouldy odour (OR 5.72, 95%CI 1.29–25.4). Asthma exacerbation was more frequent among those living in buildings constructed in 1961–1975 (OR 2.56, 95%CI 1.22–5.34), in areas with a high population density (OR 4.69, 95%CI 1.42–15.5), in rented apartments (OR 1.77, 95%CI 1.12–2.78) and in homes with a greater degree of window opening (OR 1.47, 95%CI 1.12–1.94).

CONCLUSIONS: Factors in the home environment were associated with exacerbation of asthma in adults. Certain construction periods (1961–1975), rented apartments, mould, having dogs as pets and living in urban areas were associated with asthma exacerbations.