Abstract
BACKGROUND: Asthma is a prevalent chronic respiratory condition in children, particularly in the Middle East, where environmental and genetic factors contribute to its increasing burden. Indoor environmental exposures such as tobacco smoke, incense use, and carpeting are potential triggers that have not been thoroughly investigated in Saudi Arabia. OBJECTIVES: This study aims to assess the prevalence of asthma symptoms among school-aged children in the Eastern Province of Saudi Arabia and examine their association with specific environmental exposures and familial predisposition. METHODS: A cross-sectional survey was conducted among children aged 6-14 years using a structured, parent-administered questionnaire. The survey collected data on asthma symptoms, physician diagnoses, household smoking, incense use, bedroom carpeting, air conditioning type, and family history of asthma. Chi-square tests and multivariate logistic regression were used to identify associations and independent predictors of wheezing in the past 12 months. RESULTS: The prevalence of wheezing in the past 12 months was 21.5% (n = 212), and 18.6% (n = 183) of children had a physician diagnosis of asthma. Environmental exposures significantly associated with wheezing included indoor smoking (54.2% vs. 31.3%, p < 0.001; odds ratio (OR): 2.34; 95% confidence interval (CI): 1.65-3.32), daily incense use (48.6% vs. 25.2%, p < 0.001; OR: 2.10; 95% CI: 1.44-3.05), and carpeting in the bedroom (69.3% vs. 48.2%, p < 0.001; OR: 1.83; 95% CI: 1.32-2.55). A family history of asthma also showed a strong association (59.4% vs. 27.5%, p < 0.001; OR: 2.91; 95% CI: 2.05-4.13). Central air conditioning was marginally associated with wheezing (65.1% vs. 57.1%, p = 0.042; OR: 1.41; 95% CI: 1.01-1.96). CONCLUSION: This study demonstrates a notable prevalence of asthma symptoms among children in the Eastern Province of Saudi Arabia and identifies key environmental and familial risk factors. Household smoking, incense exposure, and carpeted bedrooms significantly increase the likelihood of asthma symptoms. These findings highlight the need for targeted public health interventions and environmental modifications to mitigate asthma risk in vulnerable pediatric populations.