The classic environmental triggers for asthma are clearly known, but Harvard researchers have added new twist: family violence.

Women in a study who had experience domestic violence in the past year suffered a 37-percent higher risk of asthma than women who didn’t live in such households, according to Harvard’s School of Public Health.

The findings linking domestic violence and the sometimes debilitating respiratory condition raises the question about the role of stress in bringing on asthmatic attacks, researchers said.

“Classic environmental triggers for asthma have been carefully studied, but there is less information on the role of stress in asthma episodes," said Dr. S.V. Subramanian, the lead researcher. “The risk posed by domestic violence – and perhaps other psychosocial factors – could be as high as some well-known risk factors, such as smoking."

Many triggers

In the United States, asthma affects 20 million people, whose sensitivity to allergens and other irritating substances makes the airways leading to the lungs swell and narrow, which restricts the flow of air to the lungs. The sufferers then wheeze, cough, feel tightness in the chest and have trouble breathing.

A severe asthma attack closes the airways so tightly that oxygen cannot get to vital organs, creating a medical emergency that sometimes ends in death, according to the federal government's National Heart, Lung and Blood Institute.

Some of the major environmental triggers for asthma attacks include exercise, animal dander, dust mites, cockroaches, pollen, indoor and outdoor mold, cigarette smoke, air pollution, cold air, weather changes, strong odors from paint or cooking, scented products, and emotional expressions, such as crying and laughing.

However, researchers also have linked domestic violence and other forms of stress to asthmatic attacks in the United States. One study showed that young children of mothers who live in high-crime areas are at greater risk of getting asthma.

Women, children and men
 
In the Harvard project, Subramanian and his team turned to 92,000 households in India, where domestic violence is highly prevalent. People in the study were asked if anyone in their families suffered from asthma and whether they had experiencing or witnessing domestic violence.

Researchers also accounted for many other factors that have been associated with asthma, including exposure to tobacco smoke and level of education and income.

In addition to the 37-percent increased risk of asthma in abused women, the study found that women who were not abused but lived in a household where a woman had been beaten were 21 percent more likely to get asthma than other woman in non-violent surroundings.

Living in a household where a woman experienced domestic violence also increased the risk of asthma in children and adult men.

“If you live in a household with a woman being abused, everyone is at risk for asthma,” Subramanian said.

Affecting immunity, inflammation

While the researchers noted that the study cannot prove unarguably that domestic violence actually causes asthma, exposure to violence and other major psychosocial stresses can affect the body’s immune system and bring on inflammation, which can trigger asthma.

People exposed to violence also may adopt certain “coping” behaviors, such as smoking cigarettes, that make them susceptible to asthma, the researchers said.

"Our study suggests a new method for identifying stress-induced episodes and also reveals another terrible health risk of domestic violence,” Subramanian said.

Source: Harvard School of Public Health
Reference: International Journal of Epidemiology

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