In the study, researchers from Taipei Hospital, Taiwan, describe a particular genetic susceptibility to the toxic effects of indoor incense smoke among school children. When exposed to irritants, children carrying a glutathione S-transferase (GST) genetic polymorphism are at higher risk of developing asthma, Dr I-Jen Wang and colleagues report.
"Exposure to incense smoke may be comparable to exposure to tobacco smoke because incense burning is a traditional and popular practice. In addition to burning huge amounts of incense during major Chinese or religious festivals, many believers also burn incense when they worship at home or in the temple."
Typical Chinese incense is composed of aromatic plant materials, often combined with essential oils. The emitted smoke contains particulate matter, diethylphthalate, gas products, and many other organic compounds. Due to its slow and incomplete combustion, incense burning produces continuous smoke that generates toxic gases and chemical particles, such as polycyclic aromatic hydrocarbons (PAHs), carbon monoxide, isoprene and benzene, that can easily accumulate inside houses with inadequate ventilation.
It is reported that PAHs and airborne particulate matter from incense burning constitute potential health hazards, which are related to respiratory symptoms, asthma, elevated cord blood immunoglobulin E levels, contact dermatitis and cancer.
In 2007, the researchers evaluated almost 4,000 seventh grade schoolchildren using a standard questionnaire on respiratory symptoms and environmental exposures. Of the 3,738 participants included in the final analysis, 63.0% had been exposed to residential incense smoke.
Glutathione S-transferase theta 1 (GSTT1) is a member of a family of enzymes that protect from oxidative damage. Children carrying the GSTT1 null genotype were found to be the most susceptible to the adverse effects of incense smoke. The overall allele frequencies were 48.1% for null GSTT1 polymorphism. The authors note that incense burning is a common trigger for worsening of wheezing among asthmatic children. It is suspected that incense burning may play a more important role in exacerbating asthmatic symptoms among GSTT1 null children.
Multiple logistic regression analyses were performed, in order to assess the association between GST polymorphisms and incense burning frequency on asthma and wheeze, after adjusting for potential confounders. The frequency of incense burning at home was associated with increased risk of current asthma (p=0.05), medication use (p=0.03), and exercise wheeze (p=0.001). GSTT1 null genotypes were associated with current asthma (OR 1.43, 95% CI 1.00–2.04) and medication use (OR 1.46, 95% CI 1.01–2.22).
The frequency of incense burning was associated with increased risk of current asthma, medication use, lifetime wheeze, nocturnal wheeze and exercise wheeze in an exposure-response manner among children with GSTT1 null genotype (p<0.05). Incense burning is a risk factor for asthma and wheezing, especially in GSTT1 genetically susceptible children.
"Household incense exposure has adverse effects on children carrying the GSTT1 null genotype. Since incense smoke is a complex mixture of chemicals and other metabolic genes may be involved, additional long-term research is warranted to explore the relative role of other genes in determining genetic susceptibility to adverse respiratory outcomes", the authors conclude.
Reference:
Wang IJ et al. Eur Respir J. 2010 Nov 25.
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