Literature DB >> 10505455

Different pattern of risk factors for atopic and nonatopic asthma among children--report from the Obstructive Lung Disease in Northern Sweden Study.

E Rönmark1, E Jönsson, T Platts-Mills, B Lundbäck.   

Abstract

BACKGROUND: A cross-sectional study was performed among 78-year-old schoolchildren during the winter of 1996 in three municipalities in the most northern province of Sweden, Norrbotten. The study was the starting point of a longitudinal study of asthma, rhinitis, eczema, and type-1 allergy, and provided data on prevalence and risk factors for these conditions. The aim of the present study was to validate the classification of asthma based on a parental questionnaire, and to examine risk factors for atopic and nonatopic asthma.
METHODS: The ISAAC questionnaire with additional questions was distributed by the schools to the parents. The response rate was 97%, and 3431 completed questionnaires were returned. The children in Kiruna and Luleå were also invited to be skin tested, and 2149 (88%) were tested with 10 common airborne allergens. A structured interview was administered by pediatricians in stratified samples of the children to test the validity of the diagnosis of asthma based on the questionnaire.
RESULTS: After the validation study, the prevalence of "ever asthma" was estimated to be 8.0%. The specificity of the question, "Has your child been diagnosed as having asthma by a physician?", was high, >99%, while the sensitivity was around 70%. The strongest risk factor for "ever asthma" was a positive skin test (OR 3.9). Risk factors for asthma in the asthmatics who were not sensitized were family history of asthma, OR 3.6; breast-feeding less than 3 months, OR 1.8; past or present dampness at home, OR 1.8; smoking mother, OR 1.7; and male sex, OR 1.6. Among the sensitized asthmatics, only a family history of asthma was a significant risk factor (OR 3.0), while breast-feeding less than 3 months was not associated with an increased risk (OR 1.0). A synergistic effect between genetic and environmental factors was found especially in the nonatopic asthmatics; the children with a family history of asthma who had a smoking mother and past or present dampness at home had an OR for "ever asthma" of 13.
CONCLUSIONS: Different risk-factor patterns were found for asthma and type-1 allergy. In addition, the risk factors for atopic or allergic asthma diverged from those for nonatopic asthma.

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Year:  1999        PMID: 10505455     DOI: 10.1034/j.1398-9995.1999.00044.x

Source DB:  PubMed          Journal:  Allergy        ISSN: 0105-4538            Impact factor:   13.146


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