Email updates

Keep up to date with the latest news and content from BMC Pulmonary Medicine and BioMed Central.

Open Access Research article

Home exposure to Arabian incense (bakhour) and asthma symptoms in children: a community survey in two regions in Oman

Omar A Al-Rawas1*, Abdullah A Al-Maniri2 and Bazdawi M Al-Riyami1

Author Affiliations

1 Department of Medicine, College of Medicine and Health Science, Sultan Qaboos University, PO Box 35, Postal Code 123, Muscat, Sultanate of Oman

2 Department of Family Medicine and Public Health, College of Medicine and Health Science, Sultan Qaboos University, PO Box: 35, Postal Code 123, Muscat, Sultanate of Oman

For all author emails, please log on.

BMC Pulmonary Medicine 2009, 9:23  doi:10.1186/1471-2466-9-23

Published: 19 May 2009



Incense burning has been reported to adversely affect respiratory health. The aim of this study was to explore whether exposure to bakhour contributes to the prevalence of asthma and/or triggers its symptoms in Omani children by comparing two Omani regions with different prevalence of asthma.


A randomly selected sample of 10 years old schoolchildren were surveyed using an Arabic version of ISAAC Phase II questionnaires with the addition of questions concerning the use and effect of Arabian incense on asthma symptoms. Current asthma was defined as positive response to wheeze in the past 12 months or positive response to "ever had asthma" together with a positive response to exercise wheeze or night cough in the past 12 months. Simple and multivariable logistic regression analyses were performed to estimate the effect of bakhour exposure and other variables on current asthma diagnosis and parents' response to the question: "Does exposure to bakhour affect your child breathing?"


Of the 2441 surveyed children, 15.4% had current asthma. Bakhour use more than twice a week was three times more likely to affect child breathing compared to no bakhour use (adjusted OR 3.01; 95% CI 2.23–4.08) and this effect was 2.55 times higher in asthmatics (adjusted OR 2.55; 95% CI 1.97–3.31) compared to non-asthmatics. In addition, bakhour caused worsening of wheeze in 38% of the asthmatics, making it the fourth most common trigger factor after dust (49.2%), weather (47.6%) and respiratory tract infections (42.2%). However, there was no significant association between bakhour use and the prevalence of current asthma (adjusted OR 0.87; 95% CI 0.63–1.20).


Arabian incense burning is a common trigger of wheezing among asthmatic children in Oman. However, it is not associated with the prevalence asthma.