Prevalence and Social Determinants of Asthma among Adults in Fasa, Iran: A Population-Based Cross-Sectional Study

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Background & Objectives: Asthma is a chronic inflammatory respiratory disease characterized by variable airflow limitation and bronchial hyperresponsiveness. Its prevalence is increasing, particularly in rapidly urbanizing regions, largely due to environmental and lifestyle transitions. This study aimed to estimate the prevalence of asthma and to identify associated demographic, occupational, and health-related risk factors in Fasa, Iran. Materials & Methods: In this cross-sectional study conducted between 2013 and 2017, a total of 353 adults from both urban and rural areas were enrolled. Data were collected using a standardized checklist covering demographic characteristics, occupation, educational attainment, marital status, smoking behavior, and comorbid conditions, including diabetes. Pulmonary function was assessed via spirometry, measuring FEV₁, FVC, FEV₁/FVC ratio, and PEF, in accordance with international guidelines. Results: Of the participants, 136 (38.5%) were male and 217 (61.5%) were female. Overall, females exhibited lower spirometric indices than males. The mean FEV₁ (L) and FVC (L) were 1.54 ± 0.85 and 2.63 ± 0.52 in females, compared with 2.61 ± 0.61 and 3.67 ± 0.33 in males, respectively, findings consistent with established sex-related differences in pulmonary function. Peak expiratory flow was also substantially higher in males (384.4 ± 13.15) than in females (267.1 ± 3.10). With respect to comorbidities, diabetes, hypertension, and heart disease were not significantly associated with asthma. In contrast, respiratory symptoms, including wheezing and shortness of breath, were significantly associated with asthma, with p-values ≤ 0.05 and ≤ 0.04, respectively. Conclusion: The findings suggest that the burden of asthma in Fasa is associated with gender, occupation, educational level, marital status, and diabetes. These results underscore the need for targeted public health interventions, including early diagnosis, patient education, and improved access to care. Further longitudinal studies with larger sample sizes are warranted to confirm these associations and to elucidate potential causal pathways.

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