Introduction: Asthma is a chronic bronchial allergy disease common among children and adolescents. Episodes of dyspnea in asthmatic patients and other asthma symptoms are increased by environmental factors, such as exposure to dense soil and dust or dust storms due to weather fluctuations. Considering the increase in dust caused by the recent droughts in Iraq, especially in Anbar, Baghdad, and Kirkuk provinces, this study aims to investigate the dominant bacteria and the level of heavy metal in the dusty air and to measure the serum level of Interleukin 4 (IL- 4) and Interleukin 8 (IL-8) in the asthmatic patients before and after the dust storm compared to the control group. Methods: Heavy metals in the air were measured by inductively coupled plasma-mass spectrometry (ICP-MS), and serum levels of IL-4 and IL-8 were measured by ELISA. The dominant bacteria in the air (before and after the dust storm) were identified by metagenomics. Statistical analysis and examination of the relationship between the measured factors with asthma was performed using GraphPad prism software, and a significant difference was determined with a p-value <0.05. Results: The ICP-MS results showed higher concentrations of As, Ag, B, Ba, Co, Hg, Mg, Mn, Ni, Sn, S, Ti, and V in the air after the dust storm in three provinces of Iraq compared to before dust. The serum concentration of IL-4 and IL-8 in patients was significantly higher (p<0.05) after the dust compared to before the dust (p<0.05), while the difference in the concentration of these two cytokines in the control subjects was not significant before and after the dust storm(p>0.05). Regarding the investigation of the dominant bacteria in the air, the initial air metagenomics results showed that the Micrococcaceae and Pseudomonadaceae families were dominant before the dust, and the Bacillaceae and Xanthomonadaceae families were abundant after the dust. Conclusion: The result of this study showed that dust storms had a significant effect on the level of interleukins and allergic responses of asthmatic patients and also led to an increase in the concentration of heavy metals and changes in air bacteria after the dust compared to before the dust in Anbar, Kirkuk, and Baghdad provinces. This research highlights the increased risk of asthma caused by repeated dust in Iraq.
