Asthma is an important chronic condition often beginning in childhood.  Genetic factors and environmental allergens have been identified. This study examined reported research to determine the possibility or degree to which reported family history of asthma or atopic disease could serve as a predictive indicator of the risk and could contribute to screening tools to identify children at risk.  The utility of a screening tool would be to promote preventive measures, i.e., make environmental changes to reduce the likelihood of asthma or its severity for identified children at risk.

Over thirty worldwide studies were reviewed.  Limitations included a wide range of prevalence (2% to 26%) of asthma in study populations and inconsistent definitions of “positive family history.” Family history of asthma in one or more first-degree relatives (parent or sibling) was consistently found to be a risk factor. However, there was no consistency among the ten studies which calculated the predictive value of a positive family history of asthma or atopy.

With this review, family history of asthma would not be sufficient to press for environmental changes (providing mattress covers, laundry facilities, housing features) to reduce the risk of developing asthma among undiagnosed members.  Such efforts should be directed to families with children who have been diagnosed to benefit a greater number at risk for poor health outcomes.

(Burke W et al. Am J Prev Med 2003;24(2):160-169)

Comment: This article was part of a series outlining research in the use of family history as a predictor of chronic conditions such as colon cancer, cardiovascular disease and type 2 diabetes.  Family history is part of medical intake but we do not know the relative merit or how the information should be used for patient counseling.--J.O.