Skip to main content
PMC home page
Archives of Disease in Childhood logoLink to Archives of Disease in Childhood
. 1995 Jun;72(6):487–493. doi: 10.1136/adc.72.6.487

Risk factors for respiratory symptoms and atopic sensitisation in the Baltic area.

L Bråbäck 1, A Breborowicz 1, K Julge 1, A Knutsson 1, M A Riikjärv 1, M Vasar 1, B Björkstén 1
PMCID: PMC1511140  PMID: 7618931

Abstract

Recent studies have indicated that atopic sensitisation is uncommon while respiratory symptoms are common among schoolchildren in Eastern Europe. Risk factors for respiratory symptoms and atopic sensitisation were evaluated in a cross sectional study involving 2594 schoolchildren (10-12 years) from Sweden (n = 665), Poland (n = 410), and Estonia (n = 1519). The measurements included parental questionnaires and skin prick tests with eight standardised allergens. Multiple logistic analyses demonstrated that atopic heredity was a significant independent risk factor for respiratory symptoms and atopic sensitisation in all the countries. Current dampness and maternal smoking were related to respiratory symptoms whereas domestic crowding, male gender, and passive smoking during infancy were related to atopic sensitisation. Current maternal smoking had a strong dose response association with current coughing attacks (nocturnal cough > 4 weeks or exercise induced coughing attacks) but only in Eastern Europe. A strong inverse relationship was recorded between domestic crowding and sensitisation as the risk for sensitisation increased with decreasing number of persons per room in the household (odds ratio (OR) 0.58, 95% confidence interval (CI) 0.43 to 0.77). Exposure to tobacco smoke at home during infancy was a risk factor for atopic sensitisation but only to animal dander and only in Eastern Europe (OR 1.41, 95% CI 1.03 to 1.93). In conclusion, there were small differences in the pattern of risk factors between Eastern and Western Europe. The only exception was environmental tobacco smoke being a risk factor only in Eastern Europe. The study also suggests that factors related to domestic crowding protect against atopic sensitisation in Estonia and Poland. A higher standard of living with less crowding may give rise to an increasing prevalence of atopic sensitisation also in Eastern Europe.

Full text

PDF
490

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Andrae S., Axelson O., Björkstén B., Fredriksson M., Kjellman N. I. Symptoms of bronchial hyperreactivity and asthma in relation to environmental factors. Arch Dis Child. 1988 May;63(5):473–478. doi: 10.1136/adc.63.5.473. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Björkstén B. Risk factors in early childhood for the development of atopic diseases. Allergy. 1994 Jul;49(6):400–407. doi: 10.1111/j.1398-9995.1994.tb00831.x. [DOI] [PubMed] [Google Scholar]
  3. Brunekreef B., Dockery D. W., Speizer F. E., Ware J. H., Spengler J. D., Ferris B. G. Home dampness and respiratory morbidity in children. Am Rev Respir Dis. 1989 Nov;140(5):1363–1367. doi: 10.1164/ajrccm/140.5.1363. [DOI] [PubMed] [Google Scholar]
  4. Bråbäck L., Breborowicz A., Dreborg S., Knutsson A., Pieklik H., Björkstén B. Atopic sensitization and respiratory symptoms among Polish and Swedish school children. Clin Exp Allergy. 1994 Sep;24(9):826–835. doi: 10.1111/j.1365-2222.1994.tb01805.x. [DOI] [PubMed] [Google Scholar]
  5. Burchfiel C. M., Higgins M. W., Keller J. B., Howatt W. F., Butler W. J., Higgins I. T. Passive smoking in childhood. Respiratory conditions and pulmonary function in Tecumseh, Michigan. Am Rev Respir Dis. 1986 Jun;133(6):966–973. doi: 10.1164/arrd.1986.133.6.966. [DOI] [PubMed] [Google Scholar]
  6. Burr M. L., Butland B. K., King S., Vaughan-Williams E. Changes in asthma prevalence: two surveys 15 years apart. Arch Dis Child. 1989 Oct;64(10):1452–1456. doi: 10.1136/adc.64.10.1452. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Charlton A. Children's coughs related to parental smoking. Br Med J (Clin Res Ed) 1984 Jun 2;288(6431):1647–1649. doi: 10.1136/bmj.288.6431.1647. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Clough J. B. The effect of gender on the prevalence of atopy and asthma. Clin Exp Allergy. 1993 Nov;23(11):883–885. doi: 10.1111/j.1365-2222.1993.tb00272.x. [DOI] [PubMed] [Google Scholar]
  9. Cook D. G., Whincup P. H., Jarvis M. J., Strachan D. P., Papacosta O., Bryant A. Passive exposure to tobacco smoke in children aged 5-7 years: individual, family, and community factors. BMJ. 1994 Feb 5;308(6925):384–389. doi: 10.1136/bmj.308.6925.384. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Dales R. E., Zwanenburg H., Burnett R., Franklin C. A. Respiratory health effects of home dampness and molds among Canadian children. Am J Epidemiol. 1991 Jul 15;134(2):196–203. doi: 10.1093/oxfordjournals.aje.a116072. [DOI] [PubMed] [Google Scholar]
  11. Gergen P. J., Turkeltaub P. C., Kovar M. G. The prevalence of allergic skin test reactivity to eight common aeroallergens in the U.S. population: results from the second National Health and Nutrition Examination Survey. J Allergy Clin Immunol. 1987 Nov;80(5):669–679. doi: 10.1016/0091-6749(87)90286-7. [DOI] [PubMed] [Google Scholar]
  12. Gold D. R., Rotnitzky A., Damokosh A. I., Ware J. H., Speizer F. E., Ferris B. G., Jr, Dockery D. W. Race and gender differences in respiratory illness prevalence and their relationship to environmental exposures in children 7 to 14 years of age. Am Rev Respir Dis. 1993 Jul;148(1):10–18. doi: 10.1164/ajrccm/148.1.10. [DOI] [PubMed] [Google Scholar]
  13. Kuehr J., Frischer T., Karmaus W., Meinert R., Barth R., Herrmann-Kunz E., Forster J., Urbanek R. Early childhood risk factors for sensitization at school age. J Allergy Clin Immunol. 1992 Sep;90(3 Pt 1):358–363. doi: 10.1016/s0091-6749(05)80015-6. [DOI] [PubMed] [Google Scholar]
  14. Magnussen H., Jörres R., Nowak D. Effect of air pollution on the prevalence of asthma and allergy: lessons from the German reunification. Thorax. 1993 Sep;48(9):879–881. doi: 10.1136/thx.48.9.879. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Ninan T. K., Russell G. Respiratory symptoms and atopy in Aberdeen schoolchildren: evidence from two surveys 25 years apart. BMJ. 1992 Apr 4;304(6831):873–875. doi: 10.1136/bmj.304.6831.873. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Peat J. K., van den Berg R. H., Green W. F., Mellis C. M., Leeder S. R., Woolcock A. J. Changing prevalence of asthma in Australian children. BMJ. 1994 Jun 18;308(6944):1591–1596. doi: 10.1136/bmj.308.6944.1591. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Rusznak C., Devalia J. L., Davies R. J. The impact of pollution on allergic disease. Allergy. 1994;49(18 Suppl):21–27. doi: 10.1111/j.1398-9995.1994.tb04234.x. [DOI] [PubMed] [Google Scholar]
  18. Strachan D. P. Damp housing and childhood asthma: validation of reporting of symptoms. BMJ. 1988 Nov 12;297(6658):1223–1226. doi: 10.1136/bmj.297.6658.1223. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Strachan D. P. Hay fever, hygiene, and household size. BMJ. 1989 Nov 18;299(6710):1259–1260. doi: 10.1136/bmj.299.6710.1259. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Waegemaekers M., Van Wageningen N., Brunekreef B., Boleij J. S. Respiratory symptoms in damp homes. A pilot study. Allergy. 1989 Apr;44(3):192–198. doi: 10.1111/j.1398-9995.1989.tb02261.x. [DOI] [PubMed] [Google Scholar]
  21. Williams H. C., Strachan D. P., Hay R. J. Childhood eczema: disease of the advantaged? BMJ. 1994 Apr 30;308(6937):1132–1135. doi: 10.1136/bmj.308.6937.1132. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. von Mutius E., Fritzsch C., Weiland S. K., Röll G., Magnussen H. Prevalence of asthma and allergic disorders among children in united Germany: a descriptive comparison. BMJ. 1992 Dec 5;305(6866):1395–1399. doi: 10.1136/bmj.305.6866.1395. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. von Mutius E., Martinez F. D., Fritzsch C., Nicolai T., Reitmeir P., Thiemann H. H. Skin test reactivity and number of siblings. BMJ. 1994 Mar 12;308(6930):692–695. doi: 10.1136/bmj.308.6930.692. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. von Mutius E., Martinez F. D., Fritzsch C., Nicolai T., Roell G., Thiemann H. H. Prevalence of asthma and atopy in two areas of West and East Germany. Am J Respir Crit Care Med. 1994 Feb;149(2 Pt 1):358–364. doi: 10.1164/ajrccm.149.2.8306030. [DOI] [PubMed] [Google Scholar]

Articles from Archives of Disease in Childhood are provided here courtesy of BMJ Publishing Group

RESOURCES