Skip to main content
PMC home page
Archives of Disease in Childhood logoLink to Archives of Disease in Childhood
. 2002 Dec;87(6):482–488. doi: 10.1136/adc.87.6.482

Early respiratory and skin symptoms in relation to ethnic background: the importance of socioeconomic status; the PIAMA study

L Koopman 1, A Wijga 1, H Smit 1, J C de Jongste 1, M Kerkhof 1, J Gerritsen 1, A Vos 1, R T van Strien 1, B Brunekreef 1, H Neijens 1
PMCID: PMC1755839  PMID: 12456544

Abstract

Aims: To evaluate ethnic differences in the prevalence of respiratory and skin symptoms in the first two years of life.

Methods: A total of 4146 children participated in the Prevention and Incidence of Asthma and Mite Allergy (PIAMA) study. Parents completed questionnaires on respiratory and skin symptoms, ethnic background, and other potential confounders during pregnancy, and at 3 months, 1 year, and 2 years of age.

Results: In the first year, "non-Dutch" children (compared with "Dutch" children) had a higher prevalence of runny nose with itchy/watery eyes (11.0% versus 5.0%). In the second year, a higher prevalence of wheeze at least once (26.7% versus 18.5%), night cough without a cold (24.6% versus 15.5%), runny nose without a cold (34.1% versus 21.3%), and runny nose with itchy/watery eyes (13.7% versus 4.6%) was found. Adjustment for various confounders, especially adjustment for socioeconomic factors, reduced most associations between ethnicity and respiratory symptoms. Only runny nose with itchy/watery eyes in the second year of life was independently associated with non-Dutch ethnicity (adjusted odds ratio 2.89, 95% CI 1.3–6.4).

Conclusions: Non-Dutch children more often had respiratory symptoms in the first two years of life than Dutch children. This could largely be explained by differences in socioeconomic status. Follow up of the cohort will determine whether this higher prevalence of respiratory symptoms in children with non-Dutch ethnicity represents an increased risk of developing allergic disease rather than non-specific or infection related respiratory symptoms.

Full Text

The Full Text of this article is available as a PDF (192.0 KB).

Figure 1 .

Figure 1

Open in a new tab

(A) Prevalence of respiratory and skin symptoms in the first year of life, stratified for ethnic background. (B) Prevalence of respiratory symptoms in the second year of life, stratified for ethnic background. Error bars represent 95% CI. *p = 0.01; †p = 0.02; ‡p = 0.001; ¶p < 0.001, all χ2.

Figure 2 .

Figure 2

Open in a new tab

cOR and aOR (horizontal bars) and 95% CI (vertical lines) for the association between non-Dutch ethnicity and the development of respiratory symptoms in the first two years of life, using Dutch children as the reference group. *Model 1, crude odds ratios. †Model 2, adjusted for gender, allergic family history, day care, birth weight, smoke exposure in the home at age 1, type of feeding at 3 months of age, and study type (natural history, intervention active, intervention placebo). ‡Model 3, as in model 1, but also adjusted for maternal age, parental employment, and maternal education.

Selected References

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

  1. Asher M. I., Keil U., Anderson H. R., Beasley R., Crane J., Martinez F., Mitchell E. A., Pearce N., Sibbald B., Stewart A. W. International Study of Asthma and Allergies in Childhood (ISAAC): rationale and methods. Eur Respir J. 1995 Mar;8(3):483–491. doi: 10.1183/09031936.95.08030483. [DOI] [PubMed] [Google Scholar]
  2. Cunningham J., Dockery D. W., Gold D. R., Speizer F. E. Racial differences in the association between maternal smoking during pregnancy and lung function in children. Am J Respir Crit Care Med. 1995 Aug;152(2):565–569. doi: 10.1164/ajrccm.152.2.7633708. [DOI] [PubMed] [Google Scholar]
  3. Duran-Tauleria E., Rona R. J. Geographical and socioeconomic variation in the prevalence of asthma symptoms in English and Scottish children. Thorax. 1999 Jun;54(6):476–481. doi: 10.1136/thx.54.6.476. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Glezen W. P., Paredes A., Allison J. E., Taber L. H., Frank A. L. Risk of respiratory syncytial virus infection for infants from low-income families in relationship to age, sex, ethnic group, and maternal antibody level. J Pediatr. 1981 May;98(5):708–715. doi: 10.1016/s0022-3476(81)80829-3. [DOI] [PubMed] [Google Scholar]
  5. Gold D. R., Burge H. A., Carey V., Milton D. K., Platts-Mills T., Weiss S. T. Predictors of repeated wheeze in the first year of life: the relative roles of cockroach, birth weight, acute lower respiratory illness, and maternal smoking. Am J Respir Crit Care Med. 1999 Jul;160(1):227–236. doi: 10.1164/ajrccm.160.1.9807104. [DOI] [PubMed] [Google Scholar]
  6. Halfon N., Newacheck P. W. Childhood asthma and poverty: differential impacts and utilization of health services. Pediatrics. 1993 Jan;91(1):56–61. [PubMed] [Google Scholar]
  7. Hjern A., Haglund B., Bremberg S. Lower respiratory tract infections in an ethnic and social context. Paediatr Perinat Epidemiol. 2000 Jan;14(1):53–60. doi: 10.1046/j.1365-3016.2000.00231.x. [DOI] [PubMed] [Google Scholar]
  8. Hjern A., Haglund B., Hedlin G. Ethnicity, childhood environment and atopic disorder. Clin Exp Allergy. 2000 Apr;30(4):521–528. doi: 10.1046/j.1365-2222.2000.00793.x. [DOI] [PubMed] [Google Scholar]
  9. Kabesch M., Schaal W., Nicolai T., von Mutius E. Lower prevalence of asthma and atopy in Turkish children living in Germany. Eur Respir J. 1999 Mar;13(3):577–582. doi: 10.1183/09031936.99.13357799. [DOI] [PubMed] [Google Scholar]
  10. Koopman L. P., Brunekreef B., de Jongste J. C., Neijens H. J. Definition of respiratory symptoms and disease in early childhood in large prospective birth cohort studies that predict the development of asthma. Pediatr Allergy Immunol. 2001 Jun;12(3):118–124. doi: 10.1034/j.1399-3038.2001.012003118.x. [DOI] [PubMed] [Google Scholar]
  11. Lakwijk N., Van Strien R. T., Doekes G., Brunekreef B., Gerritsen J. Validation of a screening questionnaire for atopy with serum IgE tests in a population of pregnant Dutch women. Clin Exp Allergy. 1998 Apr;28(4):454–458. doi: 10.1046/j.1365-2222.1998.00254.x. [DOI] [PubMed] [Google Scholar]
  12. Malveaux F. J., Fletcher-Vincent S. A. Environmental risk factors of childhood asthma in urban centers. Environ Health Perspect. 1995 Sep;103 (Suppl 6):59–62. doi: 10.1289/ehp.95103s659. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Margolis P. A., Greenberg R. A., Keyes L. L., LaVange L. M., Chapman R. S., Denny F. W., Bauman K. E., Boat B. W. Lower respiratory illness in infants and low socioeconomic status. Am J Public Health. 1992 Aug;82(8):1119–1126. doi: 10.2105/ajph.82.8.1119. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Stein R. T., Holberg C. J., Sherrill D., Wright A. L., Morgan W. J., Taussig L., Martinez F. D. Influence of parental smoking on respiratory symptoms during the first decade of life: the Tucson Children's Respiratory Study. Am J Epidemiol. 1999 Jun 1;149(11):1030–1037. doi: 10.1093/oxfordjournals.aje.a009748. [DOI] [PubMed] [Google Scholar]
  15. Wijga A., Smit H. A., Brunekreef B., Gerritsen J., Kerkhof M., Koopman L. P., Neijens H. J. Are children at high familial risk of developing allergy born into a low risk environment? The PIAMA Birth Cohort Study. Prevention and Incidence of Asthma and Mite Allergy. Clin Exp Allergy. 2001 Apr;31(4):576–581. doi: 10.1046/j.1365-2222.2001.01072.x. [DOI] [PubMed] [Google Scholar]
  16. Wissow L. S., Gittelsohn A. M., Szklo M., Starfield B., Mussman M. Poverty, race, and hospitalization for childhood asthma. Am J Public Health. 1988 Jul;78(7):777–782. doi: 10.2105/ajph.78.7.777. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Wright A. L., Taussig L. M., Ray C. G., Harrison H. R., Holberg C. J. The Tucson Children's Respiratory Study. II. Lower respiratory tract illness in the first year of life. Am J Epidemiol. 1989 Jun;129(6):1232–1246. doi: 10.1093/oxfordjournals.aje.a115243. [DOI] [PubMed] [Google Scholar]

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

RESOURCES