The exposome: What you and your asthma patients need to know

American Journal of Respiratory and Critical Care MedicineScott Cunningham MD PhD, et al. | November 30, 2022



Despite effective medications for controlling asthma, very little progress has been made in preventing asthma. Although the prevalence of asthma is declining, approximately 300 million children and adults worldwide have asthma.

The current study identified specific, non-genetic, environmental factors by applying the exposome paradigm in 4 domains to identify risk factors for asthma and uncontrolled asthma.

A total of 20,833 adults (mean age = 56.2 years) from the French NutriNet-Sante cohort were studied. The asthma symptom and 87-factor, 4-domain (socioeconomic, external environment, early-life environment, and lifestyle-anthropomorphic) exposome scores were determined.

Of the 20,833 adults studied, 5546 (27%) has asthma symptom scores > 1, of which 1206 (6%) and 194 (1%) had controlled and uncontrolled asthma, respectively.

Three early-life environmental exposures were shown to be associated with asthma and uncontrolled asthma: passive smoking and owning dogs; poor birth parameters, daycare attendance, and center city birth; and > 2 breastfed siblings.

One lifestyle-anthropomorphic exposure was shown to be associated with asthma and uncontrolled asthma: unhealthy diet, heavy smoking, and overweight.