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Hedman L, Andersson M, Bjerg A, Backman H, Klinteberg MA, Winberg A, Rönmark E. Is asthma in children still increasing? 20-year prevalence trends in northern Sweden. Pediatr Allergy Immunol 2024; 35:e14120. [PMID: 38556800 DOI: 10.1111/pai.14120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 03/14/2024] [Accepted: 03/18/2024] [Indexed: 04/02/2024]
Abstract
BACKGROUND In the present study, we describe prevalence trends of asthma and investigate the association with asthma symptoms, use of asthma medication, and asthma severity among 8-year-old children in Norrbotten, Sweden in 1996, 2006, and 2017. METHODS Within the Obstructive Lung Disease in Northern Sweden (OLIN) studies, three pediatric cohorts were recruited in 1996, 2006, and 2017 respectively. Identical methods were used; all children in first and second grade (median age 8 years) in three municipalities were invited to a parental questionnaire survey, completed by n = 3430 in 1996 (97% participation), n = 2585 in 2006 (96%), and n = 2785 in 2017 (91%). The questionnaire included questions about respiratory symptoms and diagnosis, treatment, and severity of asthma. RESULTS The prevalence of wheezing was stable during the study, 10.1% in 1996; 10.8% in 2006; and 10.3% in 2017, p = .621, while physician-diagnosed asthma increased: 5.7%, 7.4%, and 12.2%, p < .001. The use of asthma medication in the last 12 months increased: 7.1%, 8.7%, and 11.5%, p < .001. Among children diagnosed with asthma, the prevalence of asthma symptoms, the impact on daily life, and severe asthma decreased, while the use of inhaled corticosteroids increased from 1996 until 2017. CONCLUSION The prevalence of wheezing was stable among 8-year-old in this area from 1996 to 2017, while the prevalence of physician-diagnosed asthma doubled but without an increase in asthma morbidity. The increase of physician-diagnosed asthma without a coincident increase in asthma morbidity can partly be explained by more and earlier diagnosis among those with mild asthma.
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Affiliation(s)
- Linnea Hedman
- Department of Public Health and Clinical Medicine, The OLIN unit, Umeå University, Umeå, Sweden
| | - Martin Andersson
- Department of Public Health and Clinical Medicine, The OLIN unit, Umeå University, Umeå, Sweden
| | - Anders Bjerg
- The OLIN studies, Norrbotten County Council, Luleå, Sweden
| | - Helena Backman
- Department of Public Health and Clinical Medicine, The OLIN unit, Umeå University, Umeå, Sweden
| | - Maja Af Klinteberg
- Department of Public Health and Clinical Medicine, The OLIN unit, Umeå University, Umeå, Sweden
| | - Anna Winberg
- Department of Clinical Sciences, Section of Pediatrics, Umeå University, Umeå, Sweden
| | - Eva Rönmark
- Department of Public Health and Clinical Medicine, The OLIN unit, Umeå University, Umeå, Sweden
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Donath H, Klenner H, Hutter M, Meoli A, Trischler J, Schulze J, Blumchen K, Zielen S. Severe bronchial hyperresponsiveness along with house dust mite allergy indicates persistence of asthma in young children. Pediatr Allergy Immunol 2023; 34:e14047. [PMID: 38146109 DOI: 10.1111/pai.14047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 10/26/2023] [Accepted: 11/01/2023] [Indexed: 12/27/2023]
Abstract
BACKGROUND Significant risk factors for persistence of asthma later in life are family history of allergies, early allergic sensitization and bronchial hyperresponsiveness (BHR). The evolution of BHR in young children without allergic sensitization and with house dust mite allergy (HDM) was investigated. METHODS In this retrospective analysis, electronic charts of 4850 young children with asthma and wheezy bronchitis between 2005 and 2018 were reviewed in order to study all patients ≤6 years with BHR assessed by methacholine provocation tests (MCT) at least once (n = 1175). Patients with more than two follow-up measurements were divided in group 1 (no allergic sensitization; n = 110) and group 2 (HDM allergy; n = 88). Additionally, skin prick test, exhaled nitrite oxide (eNO), and asthma treatment were analyzed. RESULTS Forty-seven patients of group 1 aged median 4.3 years and 48 patients of group 2 aged median 4.7 years showed initially severe BHR <0.1 mg. At follow-up, patients with HDM were more likely to show persistence of severe BHR than non-sensitized patients (severe BHR group 1: n = 5 (10.6%) vs. group 2: n = 21 (43.8%), p < .001). In addition, 89.4% of group 1 had mild to moderate or no BHR, compared to only 56.2% of group 2. There was a significant difference in eN0 (median group 1: 9 ppb vs. group 2: 26 ppb, p < .001), at last follow-up. Age, sex, and asthma therapy had no effect on BHR. CONCLUSION In young children without sensitization BHR normalizes, whereas HDM allergy indicates a persistence of asthma beyond infancy.
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Affiliation(s)
- Helena Donath
- Department of Pediatrics, Division of Pneumology, Allergology, Infectious Diseases and Gastroenterology, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt, Germany
| | - Hans Klenner
- Department of Pediatrics, Division of Pneumology, Allergology, Infectious Diseases and Gastroenterology, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt, Germany
| | - Martin Hutter
- Department of Pediatrics, Division of Pneumology, Allergology, Infectious Diseases and Gastroenterology, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt, Germany
| | - Aniello Meoli
- Department of Pediatrics, Division of Pneumology, Allergology, Infectious Diseases and Gastroenterology, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt, Germany
- Pediatric Clinic, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Jordis Trischler
- Department of Pediatrics, Division of Pneumology, Allergology, Infectious Diseases and Gastroenterology, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt, Germany
| | - Johannes Schulze
- Department of Pediatrics, Division of Pneumology, Allergology, Infectious Diseases and Gastroenterology, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt, Germany
| | - Katharina Blumchen
- Department of Pediatrics, Division of Pneumology, Allergology, Infectious Diseases and Gastroenterology, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt, Germany
| | - Stefan Zielen
- Department of Pediatrics, Division of Pneumology, Allergology, Infectious Diseases and Gastroenterology, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt, Germany
- Institute for Respiratory Diseases, Medaimun GmbH, Frankfurt, Germany
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Pirner C, Korbely C, Heinze S, Huß J, Summer B, Oppel E, Nowak D, Herr C, Kutzora S. Atopic diseases and airway-related symptoms in Bavarian children before starting primary school: Time trend analyses. Respir Med 2021; 191:106707. [PMID: 34894592 DOI: 10.1016/j.rmed.2021.106707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 11/15/2021] [Accepted: 11/25/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND After decades of rising prevalence of atopic and airway-related diseases, studies showed stagnating prevalence in western industrialised countries. Objective of this study is to analyse the time trend of prevalence of atopic diseases and airway-related symptoms among Bavarian children before starting primary school. MATERIALS AND METHODS Five cross-sectional studies from 2004/2005, 2006/2007, 2012/2013, 2014/2015 and 2016/2017 took place in urban and rural regions in Bavaria, Germany. Using standardized parent questionnaires children's atopic diseases and airway-related symptoms were surveyed. Logistic regression analysis (Bonferroni correction: adjusted significance level 0.005) was performed to analyse prevalence of symptoms and diseases from 2004 to 2017 for time trends. RESULTS The surveys included 27384 Bavarian children aged 5-6 years (52.6% male). In all children the calculated 12-month prevalence of symptoms '≥four episodes of wheeze' (p-value = .0880) and 'rhinoconjunctivitis' (p-value = .3994) reported by parents stagnated, whereas 'wheeze' (p-value<.0001; OR = 0.97; CI = [0.96-0.98]) and 'rhinitis' (p-value = .0007; OR = 0.98; CI = [0.97-0.99]) decreased. In all children the calculated lifetime prevalence of physician-diagnosed 'asthma' (p-value = .5337), and 'hay fever' (p-value = .8206) stagnated, whereas of 'bronchitis' (p-value<.0001; OR = 0.98; CI = [0.98-0.99]) decreased over time. The calculated lifetime prevalence of physician-diagnosed 'atopic eczema' (p-value = .0002; OR = 0.98; CI = [0.97-0.99]) decreased in all children, whereas the calculated 12-month prevalence of the symptom 'itchy rash' increased (p-value = .0033; OR = 1.07; CI = [1.05-1.08]) over time. CONCLUSIONS Several calculated prevalence of children's atopic diseases and airway-related symptoms reported by parents stagnated in a subgroup of Bavarian children before starting primary school between 2004 and 2017. The time trend of prevalence in 'wheeze', 'rhinitis' and 'bronchitis' decreased. Prevalence of 'atopic eczema' decreased over time, whereas 'itchy rash' increased.
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Affiliation(s)
- Christina Pirner
- Institute for Medical Informatics, Biometry and Epidemiology (IBE) at the Ludwig-Maximilians-University Munich, Marchioninistraße 15, 81377, Munich, Germany; Pettenkofer School of Public Health, Marchioninistraße 15, 81377, Munich, Germany; Bavarian Health and Food Safety Authority, Pfarrstraße 3, 80538, Munich, Germany.
| | - Christine Korbely
- Bavarian Health and Food Safety Authority, Pfarrstraße 3, 80538, Munich, Germany
| | - Stefanie Heinze
- Bavarian Health and Food Safety Authority, Pfarrstraße 3, 80538, Munich, Germany; Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Hospital of the University of Munich, Ziemssenstraße 1, 80336, Munich, Germany
| | - Jonas Huß
- Bavarian Health and Food Safety Authority, Pfarrstraße 3, 80538, Munich, Germany
| | - Burkhard Summer
- Department of Dermatology and Allergology, Ludwig-Maximilians-University Munich, Frauenlobstrasse 9-11, 80337, Munich, Germany
| | - Eva Oppel
- Department of Dermatology and Allergology, Ludwig-Maximilians-University Munich, Frauenlobstrasse 9-11, 80337, Munich, Germany
| | - Dennis Nowak
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital of the Ludwig-Maximilians-University Munich, Ziemssenstr. 1, 80336, Munich, Germany; Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research (DZL), Munich, Germany
| | - Caroline Herr
- Bavarian Health and Food Safety Authority, Pfarrstraße 3, 80538, Munich, Germany; Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Hospital of the University of Munich, Ziemssenstraße 1, 80336, Munich, Germany
| | - Susanne Kutzora
- Bavarian Health and Food Safety Authority, Pfarrstraße 3, 80538, Munich, Germany
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Kutzora S, Herrera Reyes D, Weinberger A, Huß J, Nennstiel U, von Mutius E, Herr C, Heinze S. Medical care and treatment of children with asthmatic or wheezing health outcomes and urban-rural differences in Bavaria - a cross-sectional study. J Asthma 2021; 59:1343-1352. [PMID: 33998939 DOI: 10.1080/02770903.2021.1926487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Introduction: Asthma is among the most common chronic conditions in children. The aim of this publication is to describe prevalence rates and factors associated with asthmatic or wheezing preschoolers and to evaluate medical care and treatment with regard to urban-rural differences.Methods: Data for this cross-sectional study were collected through a questionnaire, which was distributed to parents within the Health Monitoring Units in Bavaria (HMU), Germany. Data from 4767 children were available (2016/17). Those children were classified into four diagnostic groups: Unremitting Wheeze, International Study of Asthma and Allergies in Children (ISAAC) Asthma, Physician-diagnosed Asthma, and healthy control group. Urban-rural differences were tested by Pearson's chi-squared test or by Fisher's exact test. Independent variables were factors associated with health outcomes, for example, residency or migrant status. To examine associations between independent and outcome variables multivariate logistic regression analysis was performed.Results: Prevalence rates were 6.3% for 'Unremitting Wheeze', 5.2% for 'ISAAC Asthma', and 1.2% for 'Physician-diagnosed Asthma'. Factors associated with health outcomes were the occurrence of asthma in first-degree relatives, male sex, and migrant status. Generally, higher rates of doctor's visits, positive allergy tests, and corticosteroids intake in the diagnostic groups in rural compared to urban areas were observed. Rates of performed allergy tests were 55.6% for 'ISAAC Asthma' and 74.6% for 'Physician-diagnosed Asthma'.Conclusions: Prevalence rates of the diagnostic groups decreased compared to the HMU 2014/15. According to previous studies, factors associated with asthmatic or wheezing health outcomes could be confirmed. Children in rural areas generally received more medical care.Key pointsChildren's prevalence rates of asthma or wheezing disorders decreased in the past 2 years within Bavaria.This study is consistent with risk factors for asthma from the literature: asthma in the family, male gender, and migrant status.Children in rural areas receive more medical care than children in urban areas.There should me more allergy tests among children with medical diagnosis in Bavaria as low rates indicate gaps in care.
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Affiliation(s)
- Susanne Kutzora
- Department of Occupational and Environmental Medicine, Bavarian Health and Food Safety Authority, Munich, Germany
| | - Daniela Herrera Reyes
- Department of Occupational and Environmental Medicine, Bavarian Health and Food Safety Authority, Munich, Germany.,Institute for Medical Information Processing, Biometry and Epidemiology (IBE), Ludwig-Maximilians-University, Munich, Germany
| | - Alisa Weinberger
- Department of Occupational and Environmental Medicine, Bavarian Health and Food Safety Authority, Munich, Germany
| | - Jonas Huß
- Department of Occupational and Environmental Medicine, Bavarian Health and Food Safety Authority, Munich, Germany
| | - Uta Nennstiel
- Bavarian Health and Food Safety Authority, Oberschleißheim, Germany
| | - Erika von Mutius
- Dr. von Haunersches Children's Hospital and Polyclinic, Ludwig-Maximilians-University, Munich, Germany.,Helmholtz Zentrum München/German Research Center for Environmental Health, Institute for Asthma and Allergy Prevention, Neuherberg, Germany
| | - Caroline Herr
- Department of Occupational and Environmental Medicine, Bavarian Health and Food Safety Authority, Munich, Germany.,Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Clinic of the University of Munich, Munich, Germany
| | - Stefanie Heinze
- Department of Occupational and Environmental Medicine, Bavarian Health and Food Safety Authority, Munich, Germany.,Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Clinic of the University of Munich, Munich, Germany
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Kass B, Kutzora S, Weinberger A, Nennstiel U, Heißenhuber A, Herr C, Heinze S. Poststratification as a suitable approach to generalize findings of two cross-sectional studies along the Bavarian compulsory school entrance examination: An exemplary poststratified analysis for asthma, hay fever and wheezing. Int J Hyg Environ Health 2021; 234:113718. [PMID: 33740566 DOI: 10.1016/j.ijheh.2021.113718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 02/12/2021] [Accepted: 02/15/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND A compulsory school entrance examination of pre-school children (SEU) is administered in the German state of Bavaria. Every second year since 2004, the examinations are expanded in six study regions using a cross-sectional survey design (GME). However, the extent to which the results of the GME surveys are generalizable to the SEU population is unknown. Therefore, this study carried out a poststratification of two different GME surveys. The aim was to observe the impact of poststratification on an exemplary analysis of influencing factors for three allergy and asthma related outcomes (hay fever, asthma, wheezing) and thus to better understand this important question. METHODS First, poststratification was applied to correct for deviances of the GME sample in comparison to the SEU population. Logistic regression was used to determine the auxiliary variables for the poststratification. Following this, a composite variable as a linear combination was created to calculate weighting factors. Next, logistic regression analyses were applied to analyze possible influencing factors for three allergy and asthma related outcomes (hay fever, asthma and wheezing) in two GME surveys (2005/2006 and 2012/2013). Subsequently, the differences arising from poststratification were examined in more detail. RESULTS This study supports the hypothesis that the GME sample deviates from the SEU population. Mother tongue other than German of at least one parent, complete vaccination status and conspicuous visuomotor test results were positively associated with participation in both GME surveys. The prevalence for hay fever, asthma and frequent wheeze did not change statistically significant from 2005/2006 to 2012/2013. In the twelve analyses before and after poststratification, male sex was statistically significant associated with the three allergy and asthma related outcomes (e.g. asthma 2005/2006 after poststratification, aOR: 2.06, 95%-CI: 1.56-2.71). A high body mass index was positively associated with asthma (e.g. 2005/2006 after poststratification, aOR: 1.12, 95%-CI: 1.05-1.20). Poststratification caused a significant change in the sample composition. CONCLUSIONS It might be suggested that a poststratification should be performed for each GME survey. Poststratification tended to make results more comparable with previous research. In accordance with previous research, this study confirmed that male sex and high BMI are associated with asthma.
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Affiliation(s)
- Bernhard Kass
- Institute for Medical Information Processing, Biometry and Epidemiology - IBE, LMU Munich, Munich, Germany; Pettenkofer School of Public Health, Munich, Germany; Department of Occupational and Environmental Health/Epidemiology, Bavarian Health and Food Safety Authority (LGL), Pfarrstr. 3, 80538, Munich, Germany.
| | - Susanne Kutzora
- Department of Occupational and Environmental Health/Epidemiology, Bavarian Health and Food Safety Authority (LGL), Pfarrstr. 3, 80538, Munich, Germany
| | - Alisa Weinberger
- Department of Occupational and Environmental Health/Epidemiology, Bavarian Health and Food Safety Authority (LGL), Pfarrstr. 3, 80538, Munich, Germany
| | - Uta Nennstiel
- Bavarian Health and Food Safety Authority (LGL), Veterinärstraße 2, 85764, Oberschleißheim, Germany
| | - Annette Heißenhuber
- Bavarian Health and Food Safety Authority (LGL), Veterinärstraße 2, 85764, Oberschleißheim, Germany
| | - Caroline Herr
- Department of Occupational and Environmental Health/Epidemiology, Bavarian Health and Food Safety Authority (LGL), Pfarrstr. 3, 80538, Munich, Germany; Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Clinic of the University of Munich, Ziemssenstr. 1, 80336, Munich, Germany
| | - Stefanie Heinze
- Department of Occupational and Environmental Health/Epidemiology, Bavarian Health and Food Safety Authority (LGL), Pfarrstr. 3, 80538, Munich, Germany; Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Clinic of the University of Munich, Ziemssenstr. 1, 80336, Munich, Germany
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Vlaski E, Stavrikj K, Kimovska M, Cholakovska VC, Lawson JA. Divergent trends in the prevalence of asthma-like symptoms and asthma in a developing country: three repeated surveys between 2002 and 2016. Allergol Immunopathol (Madr) 2020; 48:475-483. [PMID: 32284265 DOI: 10.1016/j.aller.2019.11.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 10/22/2019] [Accepted: 11/12/2019] [Indexed: 12/14/2022]
Abstract
INTRODUCTION AND OBJECTIVES There have been differences in temporal trends of asthma prevalence by geographic region and economic prosperity. The aim of this study was to assess temporal trends in asthma prevalence among young adolescents in Skopje, Republic of North Macedonia as a developing country with a low asthma prevalence. SUBJECTS AND METHODS Data were obtained from three cross-sectional surveys (2002, 2006, and 2016) of adolescents (12-15 years) from randomly selected schools in Skopje. Trends in the prevalence of asthma and asthma-like symptoms were investigated descriptively and using multiple logistic regression to adjust for potential confounding factors. RESULTS The prevalence of asthma increased, although the changes were not statistically significant (2002: 1.7%; 2006: 2.0%; 2016: 2.8%; p=0.075). Statistically significant (p<0.05) reductions in wheeze prevalence over time (2002, 2006, 2016) were observed for current wheeze (8.8%, 7.2%, 5.5%), exercise-induced wheeze (14.2%, 7.9%, 1.9%), and night dry cough (16.5%, 13.5%, 9.6%). After adjustment for potential confounding factors, there was an increase in asthma likelihood by year compared to 2002 (2006: OR=1.22, 95%CI=0.67-2.22; 2016: OR=2.45, 95%CI=1.24-4.84). In the adjusted analyses, associations between year and the asthma-like symptoms confirmed the descriptive results, except for current wheeze, where statistical significance disappeared. CONCLUSIONS Divergent trends in prevalence with a decrease in asthma-like symptoms and an increase in physician-diagnosed asthma in Skopje during a period of 14 years were established. Improved asthma labelling and effective preventative treatment of symptoms may explain some of these changes, although changes in environment and lifestyle could not be ruled out.
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Affiliation(s)
- E Vlaski
- Department of Pulmonology and Allergology, University Children's Clinic, Skopje, Republic of North Macedonia.
| | - K Stavrikj
- Department of Immunology, University Children's Clinic, Skopje, Republic of North Macedonia
| | - M Kimovska
- Intensive Care Unit, University Children's Clinic, Skopje, Republic of North Macedonia
| | - V C Cholakovska
- Department of Pulmonology and Allergology, University Children's Clinic, Skopje, Republic of North Macedonia
| | - J A Lawson
- Department of Medicine and Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Canada
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Kutzora S, Puerto Valencia L, Weber A, Huß J, Hendrowarsito L, Nennstiel-Ratzel U, Herr C, Heinze S. Residential crowding and asthma in preschool children, a cross-sectional study. Allergol Immunopathol (Madr) 2019; 47:386-400. [PMID: 30797627 DOI: 10.1016/j.aller.2018.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 11/22/2018] [Accepted: 12/04/2018] [Indexed: 10/27/2022]
Abstract
BACKGROUND Asthma is the most common chronic disease in children, and associations with crowding have been reported. The aim of this study was to explore possible associations of crowding with asthma in children. METHODS Seven cross-sectional surveys with preschool children were conducted within the framework of the health monitoring units in Bavaria, Germany, from 2004 to 2014. Residential crowding was defined as habitation of more than one person per room or less than 20m2 living space per person. Logistic regression models examined temporal changes in crowding, applying the first survey as reference. The relationship between crowding and physician-diagnosed asthma, asthma defined by the International Study of Asthma and Allergies in Childhood (ISAAC) and asthma symptoms were analyzed. RESULTS Analyzing temporal changes of crowding rates did not reveal any differences over the years. However, the stratified descriptive analysis indicated a crowding increase in time in urban households where parents had a low education level (47.9% in 2004/05, 55.8% in 2014/15). No association was found between crowding and the variables "physician-diagnosed asthma" in 2014/15, "asthma defined by ISAAC" in 2014/15, or "wheezing" in 2014/15. A positive association with cough was identified in 2014/15 after adjusting for confounders (aOR=1.42 [95% CI: 1.20-1.69]). CONCLUSIONS In general, residential crowding did not change from 2004 to 2014; however, there seems to be a small upsurge for children with low-educated parents, living in urban areas over the years. A statistically significant association between crowding and cough was only found in the survey from 2014/15.
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Weyers S, Wahl S, Dragano N, Müller-Thur K. Ist der Datenschatz schon gehoben? PRÄVENTION UND GESUNDHEITSFÖRDERUNG 2018. [DOI: 10.1007/s11553-018-0641-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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9
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Weber A, Fuchs N, Kutzora S, Hendrowarsito L, Nennstiel-Ratzel U, von Mutius E, Herr C, Heinze S. Exploring the associations between parent-reported biological indoor environment and airway-related symptoms and allergic diseases in children. Int J Hyg Environ Health 2017; 220:1333-1339. [PMID: 28941773 DOI: 10.1016/j.ijheh.2017.09.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2016] [Revised: 09/01/2017] [Accepted: 09/01/2017] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Asthma and allergic rhinitis are diseases which require special attention in childhood. Risk factors for these diseases are manifold and include environmental factors. Previous studies have shown associations between indoor mould and respiratory diseases in children. Besides indoor mould, organic waste storage, potted plants, pets and crowding could influence the microbial indoor environment at home and the respiratory health of children. Our aim was therefore to explore the associations of these factors with airway-related symptoms and respiratory diseases in preschoolers. METHODS In this cross-sectional study we evaluated data based on parent-questionnaires regarding the health of their children from the 2014/2015 Health Monitoring Units (GME) in Bavaria. Bivariate and multivariate odds ratios (OR) with 95% confidence intervals (95%-CI) were calculated with logistic regression to explore associations between exposures (visible mould, organic waste storage, potted plants, pets and crowding) and outcome variables (doctor diagnosed allergic rhinitis with symptoms in the last 12 months, doctor diagnosed asthma with symptoms in the last 12 months, 12 month prevalence of symptoms such as dry cough at night without a cold, wheeze, wheeze attacks and allergic rhinitis symptoms). RESULTS We analysed data from 4732 children (response rate 56.7%) with a mean age of 5.3 years. Visible mould was present in 4.7% of all households and associated with doctor diagnosed asthma with symptoms in the last 12 months [aOR 2.16 (95%-CI 1.01-4.63)], wheeze in the last 12 months [aOR 1.60 (95%-CI 1.0-2.50)] and allergic rhinitis symptoms in the last 12 months [aOR 1.75 (95%-CI 1.07-2.87)]. Crowding was associated with dry cough at night without a cold in the last 12 months [aOR 1.71 (95%-CI 1.42-2.05). The other indoor factors showed no association with respiratory health of the children. CONCLUSION Our results, in line with previous studies, showed positive associations between visible mould at home and airway-related symptoms and allergic diseases in children irrespective of the effect of the other considered indoor exposures. Despite the low prevalence of mould exposure in our study population, our results suggest intervention should be taken for those who do have visible mould exposure at home.
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Affiliation(s)
- Alisa Weber
- Department of Occupational and Environmental Health/Epidemiology, Bavarian Health and Food Safety Authority, Pfarrstr. 3, 80538 Munich, Germany.
| | - Nina Fuchs
- Department of Occupational and Environmental Health/Epidemiology, Bavarian Health and Food Safety Authority, Pfarrstr. 3, 80538 Munich, Germany
| | - Susanne Kutzora
- Department of Occupational and Environmental Health/Epidemiology, Bavarian Health and Food Safety Authority, Pfarrstr. 3, 80538 Munich, Germany
| | - Lana Hendrowarsito
- Department of Occupational and Environmental Health/Epidemiology, Bavarian Health and Food Safety Authority, Pfarrstr. 3, 80538 Munich, Germany
| | - Uta Nennstiel-Ratzel
- Bavarian Health and Food Safety Authority, Veterinärstr. 2, 85764 Oberschleißheim, Germany
| | - Erika von Mutius
- Children Hospital and Children Polyclinic in the Dr. von Haunersches Children Hospital, Ludwig-Maximilians-University, Lindwurmstr. 4, 80337 Munich, Germany
| | - Caroline Herr
- Department of Occupational and Environmental Health/Epidemiology, Bavarian Health and Food Safety Authority, Pfarrstr. 3, 80538 Munich, Germany; Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Ludwig-Maximilians-University Munich, Ziemssenstr. 1, 80336 Munich, Germany
| | - Stefanie Heinze
- Department of Occupational and Environmental Health/Epidemiology, Bavarian Health and Food Safety Authority, Pfarrstr. 3, 80538 Munich, Germany; Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Ludwig-Maximilians-University Munich, Ziemssenstr. 1, 80336 Munich, Germany
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Gabet S, Just J, Couderc R, Bousquet J, Seta N, Momas I. Early polysensitization is associated with allergic multimorbidity in PARIS birth cohort infants. Pediatr Allergy Immunol 2016; 27:831-837. [PMID: 27501330 DOI: 10.1111/pai.12622] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/03/2016] [Indexed: 12/20/2022]
Abstract
BACKGROUND Profiles of allergic sensitization are poorly documented in infancy. Relations between early sensitization and allergic morbidity need to be clarified. METHODS This study dealt with children involved in the Pollution and Asthma Risk: an Infant Study (PARIS), a population-based prospective birth cohort. Allergic sensitization to twelve food and four inhalant allergens was assessed at 18 months and defined by a specific immunoglobulin E (IgE) level ≥0.35 kUA /l. Health data were collected by standardized questionnaires at 2 and 6 years. Early allergic profiles were identified by an unsupervised cluster analysis based on health data at 2 years and IgE measurements. Profiles were compared with regard to allergic morbidity and multimorbidity at 6 years. RESULTS Sensitization to any allergen concerned 13.6% of infants. By cluster analysis, 1525 infants were grouped into three profiles: 89.2% not or rarely sensitized (only 3.7% of sensitized), 9.2% mainly sensitized to one or few allergens (45.2% of monosensitized and 45.9% of paucisensitized) and 1.6% all polysensitized. The prevalence of doctor-diagnosed asthma, rhinitis, eczema, food allergy and multimorbidity at 2 years increased from profile one to profile three (p-trend <0.001). At 6 years, symptoms of current asthma, rhinitis, eczema and multimorbidity were significantly more frequent in the last two profiles. CONCLUSIONS This study highlights, as early as 18 months of age, three profiles of increasing severity with regard to allergic sensitization and diseases. These profiles also differ in terms of allergic morbidity at 6 years. Early sensitization can predict allergic multimorbidity in childhood, and in the case of early polysensitization, multimorbidity is more frequent as soon as infancy.
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Affiliation(s)
- Stephan Gabet
- EA 4064 Épidémiologie environnementale, Université Paris Descartes, Sorbonne Paris Cité, Paris, France.,Cellule Cohorte, Direction de l'Action Sociale, de l'Enfance et de la Santé, Mairie de Paris, Paris, France
| | - Jocelyne Just
- Centre de l'Asthme et des Allergies, Groupe Hospitalier d'Enfants Trousseau-La Roche Guyon, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Rémy Couderc
- Service de Biochimie et Biologie Moléculaire, Hôpital d'Enfants Armand Trousseau, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Jean Bousquet
- VIMA: Vieillissement et maladies chroniques. Approches épidémiologiques et de santé publique, U1168, INSERM, Paris, France.,UMR-S 1168, Université de Versailles Saint-Quentin, Versailles, France
| | - Nathalie Seta
- EA 4064 Épidémiologie environnementale, Université Paris Descartes, Sorbonne Paris Cité, Paris, France.,Département de Biochimie, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Isabelle Momas
- EA 4064 Épidémiologie environnementale, Université Paris Descartes, Sorbonne Paris Cité, Paris, France.,Cellule Cohorte, Direction de l'Action Sociale, de l'Enfance et de la Santé, Mairie de Paris, Paris, France
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