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What Causes Asthma?

Updated on May 03, 2021
Medically reviewed by
Allen J. Blaivas, D.O.
Article written by
Kelly Crumrin

The cause of asthma is not well understood, and it may vary for different people with asthma. Most researchers believe the development of asthma is due to a combination of genetic and environmental risk factors. Asthma is often an allergic reaction related to an overreaction by the immune system in response to a substance that enters the lungs.

In people with asthma, the small airways of the lungs narrow, obstructing the flow of air and causing symptoms such as wheezing, chest tightness, shortness of breath, and coughing. Symptoms of asthma can range from mild and intermittent to severe and persistent and even life-threatening.

Risk Factors for Asthma

It is important to note that while science is good at finding correlations, or apparent relationships, between factors and disease, correlation does not prove the factor causes the disease. Many risk factors for asthma have been identified and are being studied, but none have been pinpointed as the cause of asthma.

Age

Asthma can affect all age groups, but it often starts in childhood — usually before age 4. Different types of asthma tend to develop at different ages. Asthma in young children is usually allergic asthma, while asthma that develops in older adults is more likely to be nonallergic.

Hereditary Factors

Asthma runs in families. If one of your parents has asthma, you are more likely (but not guaranteed) to develop it. Some studies suggest having one parent with asthma presents a 25 percent risk of a child having asthma too. If both parents have asthma, the risk may rise to 50 percent. However, some research indicates that having a mother with asthma — especially when the asthma is not well controlled during pregnancy — raises the risk more than having a father with asthma. Genes inherited from parents contribute differently to the risk for developing different types of asthma.

Researchers have identified eight genes so far that are related to asthma risk, with more than 100 other genes still under study. Some of these genes may influence how the body responds to vitamin D levels or respiratory infections. Others may influence allergic responses or the production of mucus.

Sex

Among children, boys are more likely than girls to have asthma. During adolescence and adulthood, more women have asthma than men.

Asthma and Race

In the United States, asthma disproportionately affects racial and ethnic minorities. People with Black and Puerto Rican heritage are more likely to have asthma, and children with these backgrounds are more likely to die from asthma than white children. Research by the Asthma and Allergy Foundation of America shows that in the U.S.:

  • Puerto Ricans have the highest rate of asthma prevalence.
  • Black people are nearly three times more likely to die from asthma than white people.
  • Black people make five times more trips to the emergency room for asthma than white people.

The reasons for these disparities involve complex associations between economic, social, biological, and behavioral factors. Research to understand these factors and improve health outcomes is ongoing.

Environmental Factors

Risk factors that are not related to inherited genes are known as environmental factors. There are many environmental risk factors that lead to an increased risk for developing asthma. These include:

Occupational Factors

People working in certain industries are more likely to develop occupational asthma, potentially caused by substances they encounter in the workplace. Those who work in the following fields are more likely to be diagnosed with occupational asthma:

  • Agricultural workers, such as farmers or those who work in grain elevators
  • Bakers and millers
  • Manufacturers of detergents or pharmaceuticals
  • Laboratory workers, especially where animals are involved
  • Those who work with metal, plastic, or wood

Other Health Conditions

People with other health conditions — including allergies, obesity, and viral respiratory infections — are more likely to have asthma. There is a strong connection between asthma, allergies, and eczema (also known as atopic dermatitis) that extends to a family history of these conditions. Other lung diseases, including chronic obstructive pulmonary disease (COPD), can make asthma symptoms worse. Read more about conditions related to asthma.

Triggers for Asthma Attacks

Once someone has developed asthma, certain irritants and situations may trigger asthma attacks. Asthma triggers differ from person to person. Common asthma triggers include:

  • Tobacco smoke
  • Furry pets
  • Allergens, such as dust mites, mold, or pollen
  • Air pollution
  • Pests, such as cockroaches or mice
  • Fumes from detergents, cleaning products, or disinfectants
  • Exercise or physical activity
  • Viral infections
  • Strong emotions
  • Certain foods
  • Acid reflux
  • Cold air and changes in weather
  • Certain drugs, such as beta blockers and migraine medications
  • Food additives, including sulfites

Can Asthma Be Prevented?

Unfortunately, there is no way to prevent asthma from developing. Some risk factors, such as inherited genes, are beyond anyone’s control. However, researchers have identified a few factors associated with a lower risk for asthma that may have a protective effect. Potentially protective aspects include:

  • Attending day care during the first six months of life
  • Growing up on a farm
  • Mothers taking vitamin D or fish oil supplements during pregnancy
  • Mothers with asthma keeping their condition well-controlled with asthma treatments during pregnancy

Around the world, some countries have conducted programs or clinical trials aimed at preventing asthma. Smoking-cessation campaigns and bans on public smoking are often prompted in part by an effort to prevent asthma. Some clinical trials have been designed to identify babies or pregnant mothers with a high risk for asthma and supplement their diets with vitamin D or fish oil. Other trials are aimed at modulating the microbiome — the community of bacteria and other microorganisms living in the human body — with vaccinations or probiotic supplements. So far, results are mixed. Researchers are hopeful that one day it may be possible to prevent asthma.

If you are worried about your risk or your child’s risk for developing asthma, you may be able to lower your risk. Consider taking steps to change these environmental factors:

  • Quit smoking and avoid secondhand smoke.
  • Use air purifiers in the home, such as these products certified “asthma and allergy friendly” by the Asthma and Allergy Foundation of America.
  • Avoid allergen triggers.
  • Use protective equipment, such as respirators, if your job involves airborne particles.

Talk to your allergist or health care team about what you can do to reduce your risk factors for asthma.

Condition Guide

References

  1. Asthma — National Heart, Lung, and Blood Institute
  2. Overview of Changes to Asthma Guidelines: Diagnosis and Screening — American Family Physician
  3. Genetics and Asthma — World Health Organization (WHO)
  4. What Causes or Triggers Asthma? — Asthma and Allergy Foundation of America
  5. Asthma Disparities in America: A Roadmap to Reducing Burden on Racial and Ethnic Minorities — Asthma and Allergy Foundation of America
  6. Common Asthma Triggers — Centers for Disease Control and Prevention (CDC)
  7. Occupational asthma — MedlinePlus
  8. What Causes Asthma? — American College of Allergy, Asthma and Immunology
  9. Primary prevention of asthma: from risk and protective factors to targeted strategies for prevention — The Lancet
  10. Antibiotic use in the first year of life as a risk factor for asthma symptoms. What is new in the association? — World Allergy Organization Journal
  11. Asthma epidemiology and risk factors — Seminars in Immunopathology
  12. What Causes Asthma? — American Lung Association
  13. Genetics of asthma: an introduction for the clinician — European clinical respiratory journal
  14. Inflammatory mechanisms linking maternal and childhood asthma — Journal of Leukocyte Biology
  15. Asthma in Children and Adults — What Are the Differences and What Can They Tell us About Asthma? — Frontiers in Pediatrics
  16. Eczema, Atopic Dermatitis and Allergies: What Is The Connection? — National Eczema Association
Allen J. Blaivas, D.O. is certified by the American Board of Internal Medicine in Critical Care Medicine, Pulmonary Disease, and Sleep Medicine. Review provided by VeriMed Healthcare Network. Learn more about him here.
Kelly Crumrin leads the creation of content that educates and empowers people with chronic illnesses. Learn more about her here.

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