Clinical Abstracts: Veil-Wearing and Asthma

Source: Ahmad EFEM, et al. The effect of wearing the veil by Saudi ladies on the occurrence of respiratory diseases. J Asthma 2001;38:423-426.

Design/Subjects/Setting: A total of 710 adult women in Dammam, Saudi Arabia, were interviewed by structured questionnaire. Questions were asked about the subjects’ age, residence, smoking, veil-wearing, occurrence of upper respiratory tract infections, and occurrence of other respiratory diseases.

Results: Fifty-eight percent of subjects used the veil. Self-reported attacks of asthma and common colds were significantly more frequent among veil users than among non-users (P < 0.0003, P < 0.00001).

Comments: The veil popular in Saudi Arabia is made of two or three layers of black cloth with small slits for the eyes. The researchers suggest that because the veil is worn so close to the face, a very humid micro-environment may facilitate the growth of microorganisms. This study also noted that members of the same household may share veils, possibly spreading infection more readily. It is unclear whether the researchers actually know whether veil-sharing takes place; certainly it would have been a simple matter to ask study participants.

Many more questions should have been asked. There may be other differences (e.g., living situation and mood) between women who wear veils and women who don’t that were not picked up by this questionnaire. In addition, the prevalence of smoking is given only for the aggregate sample (12.1%) without stating whether prevalence of smoking differed between groups.

Both discrimination and depression are risk factors for chronic diseases and may play a factor here. Veil-wearing may exemplify more traditional roles that could influence results (perhaps veil-wearing women stay at home more, are around children more, etc.)

The true relationship between veil-wearing and respiratory disease will have to await a better study.