NIHR Global Health Research Unit on Respiratory Health (RESPIRE)

Ecological analysis of asthma health outcomes in Malaysia

This project is based at the University of Malaya in Malaysia


  • Project title:  An ecological analysis of asthma health outcomes in Malaysia: a feasibility study
  • Acute or chronic:  Chronic
  • Based at:  University of Malaya
  • Start date:  August 2019
  • End date:  December 2020
  • Principal investigator:  Ee Ming Khoo
  • Project team:  Norita Hussein, Nasrin Aghamohammadi, Su May Liew, Nik Sherina Hanafi, Yong Kek Pang, Ahmad Ihsan Bin Abu Bakar, Ahmad Tajuddin B. Mohamad Nor, Chun Lin, Hilary Pinnock, Harry Campbell, Jürgen Schwarze, Stefan Reis


Asthma is the most prevalent chronic respiratory disease globally. Outdoor air pollution has been reported to contribute to the increasing burden of asthma.

In Malaysia, haze episodes are common and are mainly related to biomass burning, industrial activities and traffic emissions. Haze was reported to be associated with increased outpatient attendance and hospital admissions for respiratory illnesses including asthma, increased mortality and annual economic loss.

Aim and impact

To perform an ecological analysis of asthma health outcomes in Klang Valley, using eDPSEEA as a conceptual framework, to pilot the approach to determine the influence of potential environmental factors on asthma events over a four-year period. The research will also identify potential strategies for interventions to reduce asthma exacerbations related to haze.

Based on the findings, the study will determine the correlation between air pollution levels and asthma events. The long-term goal of the project is to inform policy interventions to reduce air pollution, and associated respiratory diseases in Malaysia.

Although the primary focus in Malaysia is on air pollution, a second RESPIRE project in Pakistan is also interested in the interactions between the environment, pollen and respiratory conditions. These projects have therefore adopted a common framework – eDPSEEA.

Using the eDPSEEA model framework across the pilot studies will ensure that all potential drivers of respiratory health effects are systematically accounted for and associations between drivers and effects, as well as potential intervention points, are identified in a consistent manner.

Key developments

  • Data collection has started.
  • An oral presentation was presented in the IPCRG conference in Bucharest in May 2019.
  • A meeting has taken place with the study team and stakeholders, including hospital and health clinic officials, researchers and officials from the Malaysian Meteorological Department.
  • A data set has been generated for air quality and meteorological data, 2014-2017.

Project data

Download the project Data Management Plan

View project metadata on the Health Data Research Innovation Gateway