Arabian Incense Exposure and Its Effect on Asthma Symptoms in Children

Abstract

Background:

Bronchial asthma is a major worldwide health problem. The prevalence of bronchial asthma in Saudi children ranges from 8 to 25% depends on the region. Arabian incense (bakhour) burning is a very popular activity in religious ceremonies and aromatizing homes. It’s slow and partial combustion, continuous smoke contains high concentrations of fine and ultrafine airborne particulates and gaseous pollutants such as carbon monoxide, nitric oxide, and volatile organic compounds. Children spend most of their time indoors and exposure to smoking incense can cause several health effects. The aim of this study was to determine whether exposure to bakhour increases the risk of developing asthma and/or exacerbates its symptoms in children from various regions of Saudi Arabia.

Methods:

A cross-sectional survey was conducted among parents who have children of age between 3 to 16 years. The survey used Arabic version of ISAAC Phase II questionnaires with the addition of questions concerning the use and effect of Arabian incense on asthma symptoms. Current asthma was defined as positive response to wheeze in the past 12 months or positive response to "ever had asthma" together with a positive response to exercise wheeze or night cough in the past 12 months. Simple and multivariable logistic regression analyses were performed to estimate the effect of bakhour exposure and other variables on current asthma diagnosis and parents' response to the question.

Results:

A cross-sectional survey was conducted among parents who have children of age between 3 to 16 years. The survey used Arabic version of ISAAC Phase II questionnaires with the addition of questions concerning the use and effect of Arabian incense on asthma symptoms. Current asthma was defined as positive response to wheeze in the past 12 months or positive response to ever had asthma together with a positive response to exercise wheeze or night cough in the past 12 months. Simple and multivariable logistic regression analyses were performed to estimate the effect of bakhour exposure and other variables on current asthma diagnosis and parents' response to the question.

Conclusions:

Out of 821 attended the survey, 26.1 % had current asthma with regional distribution of 28.5% southern, 27.4% western, 20.5% central,13% eastern, 10.6% northern. Bakhour use more than two times per week had increased effect on asthma symptoms compared to no bakhour use (adjusted OD 1.89;95% CI 1.03-2.01). There was no significant association between bakhour use and the prevalence of current asthma. The use of bakhour was at home was equally common in all regions of Saudi Arabia. However, its use more than twice per week was significantly higher in northern region.