Stephen Montefort (left) and Peter Fsadni say Malta has a disproportionately high burden of asthma when compared to other Mediterranean countries.

Asthma among children aged between five and eight continued rising throughout the past 20 years, prompting experts to conduct new research to identify the possible triggers of the allergy on the islands.

Speaking to Times of Malta, respiratory specialists Stephen Montefort and Peter Fsadni point out that Malta has a disproportionately high burden of asthma when compared to other Mediterranean countries.

“The fact that Mediterranean countries have a much lower prevalence than Malta shows that something is wrong,” Prof. Monte-fort says. “Malta’s placing is worrying because there is something that is causing this increase in the allergy,” Dr Fsadni adds. “Apart from treating the symptoms, we need to focus on the causes. To prevent asthma, we need to know what we’re dealing with.”

You can’t change your genes, so you have to try and change the environment around you

As new statistics for the 12-15 agegroup are awaited and statistics for the adult population are not based on formal studies, Prof. Montefort estimates that about 10 per cent of the Maltese population is asthmatic.

Dr Fsadni has just finished conducting research on the indoor air quality in Maltese primary schools, which will form part of the pan-European Sinphonie study. The findings will be officially published later this year.

“Everyone is concerned about outdoor air quality,” Prof. Montefort says. “That’s very important, but indoor air quality is even more so because we spend most of our time indoors. And schools are of particular relevance because children spend the greater part of their time there.”

The study focused on Year 5 and Year 6 children attending the government primary schools of Birżebbuġa, Fgura, Pembroke, Qormi and Dingli and examined the prevalence of asthma, allergic rhin-itis (hayfever) and eczema.

Although the results haven’t yet been published, there are already some indicators as to what the issues could be.

One of the major determining factors is the location of the school: whether it is in an industrialised area with heavy traffic, the way it was built and if classrooms overlook the road. Studies have consistently shown that children who attend schools in the south of Malta are the most prone to suffer from asthma. The south, Prof. Montefort explains, is more industrial, with narrower roads and more traffic.

However, children in places like Dingli were found to suffer more from allergic rhinitis due to rural and agricultural activities.

“We must remember that Malta is a small and windy country,” Prof. Montefort says.

“What happens in Mellieħa will affect Birżebbuġa within a few hours’ time. We’re also exposed to a number of elements such as dust from the Sahara desert and salt from the sea, which are also triggers. There is dust from quarries, and the construction industry in Malta is quite rampant. Fireworks could also be potential air pollutants.”

The study also found that Maltese classrooms had higher levels of ozone compared with other countries. Ozone, Prof. Montefort explains, is formed by a reaction of sunlight with oxygen and acts as an irritant to the airways.

“Although the classes should have sunlight coming in, you shouldn’t have direct sunlight. In fact, old schools are better equipped. New schools tend to have large windows with no shading.”

Dr Fsadni explains that poor ventilation systems, the type of detergents and cleaning agents used by janitors and even certain types of furniture were all found to be potential triggers for asthma.

“Asthma results from a conglomeration of your genetic predispos-ition and environmental factors,” Prof. Montefort says.

“You can’t change your genes, so you have to try and change the environment around you. You must look out for things that are obvious triggers: people smoking around you, certain pets and certain things in the house that harbour dust mites.”