Is it the Sickened? I doubt it since it is usually extra specific if a condition that has a default duration/goes away by itself is overridden by a different duration (Interstellar Void for example).
Is it the area of effect? If so, I'm guessing it forces the save when cast, but the usual conditions laid out on when future saves are missing such as: when a creature enters, starts its turn, or ends its turn in the area.
Both effects, maybe?
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It's the Area effect and its fortitude check.
Every time that you Sustain the creatures in the area, make a new fortitude save.
It is a bit lacking in that it is missing the usual designations of when a creature that moves into the area after it is cast makes saves against the effects.
But yes, it is the area effects of the spell that are being sustained. The Sickened condition has ways of removing itself, so that is not necessarily even magical and the Sickened condition can persist after the end of the spell. Or be removed before and separately from the spell, but doing so while still inside the spell's area may not be the best idea - the area effect will just reapply the Sickened condition if you don't crit succeed at the save.
It is a bit lacking in that it is missing the usual designations of when a creature that moves into the area after it is cast makes saves against the effects.
I didn't notice Ashen Wind had a legacy version, but I just checked and that might be why. The legacy version wasn't a sustained spell at all. It was just a one time burst so I can see why it didn't account for creatures going in and out of it. It does reinforce that the sickened has nothing to do with sustaining though, at least to me.