Asthma is a chronic public health problem with gradually increasing importance that affects people of all ages [1]. Asthma is a complex inflammatory condition of the airways, which makes breathing difficult due to airflow obstruction, bronchial hyper-responsiveness and an underlying inflammation [2,3]. Its development is seen as an intricate interaction between genetic and environmental factors [4].

Despite the fact that the Saudi Thoracic Society (STS) is committed to a long-term enhancement plan for the best practice in the asthma field by creating asthma guidelines, periodic scientific meetings, frequent asthma courses and educational brochures, but local reports suggest that the prevalence of asthma is increasing in Saudi Arabia, this could be due to environmental changes, beside exposure to indoor and outdoor allergens as well as occupational and industrial exposure [5,6].

Its impact goes beyond the patients to their families as well as to the community as a whole in terms of lost work and school days, poor quality of life, frequent emergency department visits, hospitalizations and death cases may occur [7,8].

The aim of this study was to explore the common risk factors that associated with asthma among Saudi adults in Najran during the period between December 2016 up to October 2017. One hundred eighty four patients who were over 18 years of age and who had a diagnosis of definite asthma (cases), beside another 184 healthy individuals as control group, that matched the cases in terms of age and sex constituted the study sample. A questionnaire as a tool of data collection was completed by cases as well as from controls. It was consisting of data that include personal, familial and indoor environmental factors that could be potential risk factors for asthma.

The results show that the mean ages for cases and controls were 21.3(±16.5) and 21.7 (±16.8) years respectively. Each group consisted of 108 (58.7%) males beside 76(43.3%) females. There were no significant association between asthma occurrence and level of education and indoor plants with P-value >0.05. On the other hand, multivariate logistic regression analysis showed that family history (OR= 5.01, and CI = 2.09 – 8.42), using sprays of insecticides or air fresheners (OR = 8.5, CI= 2.34 – 11.09) were significantly associated with asthma occurrence.

The current study revealed that allergic rhinitis increases the risk for developing asthma, (OR = 4.76, CI= 2.19 – 6.45) which is in consistent with what was concluded by several other studies that shown similar relationship [9-11]. Additionally, active or passive smoking was significantly (P-value = 0.041 and 0.012) associated with asthma among adults. The same results had been reported by Cerveri et al. and Skoner who stated that exposure to tobacco smoke was one of the strongest and most consistent risk factors in regard to development and exacerbation of asthma [12,13].

This study showed that females' cases were slightly higher than males among the total asthmatic cases within the studied sample, which is consistent with other studies that yielded similar results among adults [14,15]. In contrast, Bjerg et al concluded that asthma was observed to be  more in males than females [16]. Very interestingly, a gender variation in asthma had been studied in Nigeria which reported a weak independent association between prevalence of asthma and gender [17].

It was concluded that family history, smoking, allergic rhinitis and smoking among the most risk factors for developing asthma among Saudi adults. Further studies for investigating other factors were recommended. Moreover, health education programs for educating people about the risk factors, preventive measures, early diagnosis and proper management were highly recommended too.

1. World Health Organization (2007) Global surveillance, prevention and control of chronic respiratory diseases: a comprehensive approach.
2. Eder W, Ege MJ, von Mutius E (2006) The Asthma epidemic. N Engl J Med 355: 2226 - 2235.
3. Duksal F, Becerir T, Ergin A, Akcay A, Guler N (2014) The Prevalence of Asthma Diagnosis and Symptoms is Still Increasing in Early Adolescents in Turkey. Allergol Int 63: 189-197.
4. Kumar R (2008) Prenatal factors and the development of asthma. Curr Opin Pediatr 20: 682-687.
5. Ministry of Health of the Kingdom of Saudi Arabia (2007) The asthma Insights and reality in the Kingdom of Saudi Arabia (AIRKSA) study.
6. Al-Moamary MS, Al-Hajjaj MS, Idrees MM, Zeitouni MO, Alanezi MO, et al. (2009) The Saudi Initiative for asthma. Ann Thorac Med 4: 216-233.
7. Georgy V, Fahim H, Gaafary M, Walters S (2006) Prevalence and socioeconomic associations of asthma and allergic rhinitis in Northern Africa. Eur Respir J 28: 756-762.
8. Rosenberg SL, Miller GE, Brehm JM, Celedon JC (2014) Stress and asthma: Novel insights on genetic, epigenetic and immunologic mechanisms. J Allergy Clin Immunol 134: 1009-1015.
9. Zhao TB, Wang HJ, Chen YZ, et al. (2000) Prevalence of childhood asthma, allergic rhinitis and eczema in Urumqi and Beijing; J Paediatr Child Health 36: 128-133.
10. Nayak A (2003) The asthma and allergic rhinitis link. Allergy Asthma Proc 24: 595- 602.
11. Talay F, Kurt B, Tug T, Kurt OK, Goksugur N, Yasar Z. (2014) The prevalence of asthma and allergic diseases among adults 30 – 49 years of age in Bolu, Western Black Sea Region Turkey. Clin Ter  165: 59-63.
12. Cerveri I, Cazzoletti L, Corsico A. et al. (2012) The impact of cigarette smoking on asthma: a population-based cohort study. Int Arch Allergy Immunol 158: 175-183.
13. Skoner D (2001) Controlling asthma: why we must do better. Contemp Pediatr 18: 49 -62.
14. Almqvist C, Worm M, Leynaert B (2008) Impact of gender on asthma in childhood and adolescence. Allergy 63: 47-57.
15. Melgert BN Ray A, Hylkema MN, Timens W, Postma DS (2007) Are there reasons why adult asthma is more common in females? Curr Allergy Asthma Rep 7: 143-150.
16. Bjerg A, Sandstrom T, Lundback B, Ronmark Ev (2010) Time trends in asthma and wheeze in Swedish children 1996 – 2006: prevalence and risk factors by sex. Allergy 56: 48- 55.
17. DesaluOO, Fadare JO, Adeoti AO, Adekoya AO (2013) Risk factors for Asthma Hospitalization and Emergency department visit in Nigeria: The role of symptoms frequency and drug utilization. Indian J allergy Asthma Immunol 27: 129 -133.