Incidence of allergic rhinoconjunctivitis was higher than in earlier studies, while asthma incidence remained on similar level, both being significantly higher in women. Allergic rhinoconjunctivitis doubled the risk for incident asthma.
Our aim was to study the association of smoking habits and environmental tobacco smoke (ETS) exposure with bronchial hyperresponsiveness (BHR).A random sample of 292 adults was examined using a structured interview, spirometry, skin prick tests, exhaled nitric oxide fraction (FeNO) and bronchial histamine challenge.A large majority of subjects with BHR were smokers or ex-smokers. Starting to smoke before 20 years of age was significantly associated with BHR, as was current smoking, quantity of smoking and ETS exposure. The severity of BHR increased significantly with increasing pack-years of exposure (p,0.001). Current smokers with decreased lung function were at a particularly high risk of BHR. Impaired forced expiratory volume in 1 s and mean maximal expiratory flow were independent determinants for more severe BHR, regardless of age. In multivariate analysis, smoking remained an independent determinant for BHR after adjustment for impaired lung function and other covariates: o15 pack-years yielded an odds ratio of 3.00 (95% CI 1.33-6.76) for BHR. The association between BHR and FeNO was dependent on smoking habits.The results indicate that smoking is a significant risk factor for BHR, with a dose-dependent pattern, and that the severity of BHR increases with pack-years. The findings strongly suggest assessment of smoking habits in subjects with BHR. @ERSpublications Bronchial hyperresponsiveness is dose-dependently linked to smoking; severity increases with pack-years
Objectives. To assess the prevalence of bronchial hyperresponsiveness (BHR) in a population of north Finland among subjects with no previous diagnosis of asthma or chronic bronchitis by using histamine and methacholine challenges. The agreement between the methods was also evaluated. Study design. An epidemiological study assessing the prevalence of BHR measured with direct dosimetric challenge methods. Methods. Seventy-nine randomly selected subjects ( 1-73 years) were studied; 67% had respiratory or allergic symptoms. The baseline spirometry was normal or showed mild obstruction. Bronchial challenges to methacholine and histamine were performed on each subject in a randomized order. Provocative doses inducing the decrease of FEV 1 by 15% and 0% (PD 15 FEV 1 and PD 0 FEV 1 ) and dose response ratios (DDR) were calculated for both tests. Results. BHR with the methacholine test (PD 0 FEV 1 ≤2.6 mg) was found in 20% and with the histamine test (PD 15 FEV 1 ≤1.6 mg) in 28% of subjects; the agreement was 80% (kappa 0.45; 95% CI 0. 3-0.68). In staging the severity of BHR the methods had a good agreement (weighted kappa 0.64; CI 95% 0.46-0.82). Prevalence of BHR fulfilling the criteria of the both methods was 14%. Conclusions. The findings suggest that the prevalence of BHR in the population of north Finland with no previous diagnosis of asthma or chronic bronchitis is at least 14%, probably around 0%, assessed by histamine and methacholine challenge methods. The methods have a good agreement to be used for classifying the severity of BHR. (Int J Circumpolar Health 2008; 67(4):308-317)
The prevalence of asthma is higher in Sweden and Finland than in neighbouring eastern countries including Estonia. Corresponding difference in bronchial eosinophilic inflammation could be studied by F ENO measurements. We aimed to compare F ENO in adult general populations of Sweden, Finland, and Estonia, to test the plausibility of the west-east disparity hypothesis of allergic diseases.We conducted clinical interviews (N = 2658) with participants randomly selected from the general populations in Sweden (Stockholm and Örebro), Finland (Helsinki), and Estonia (Narva and Saaremaa), and performed F ENO (n = 1498) and skin prick tests (SPT) in 1997-2003.The median (interquartile range) of F ENO (ppb) was 15.5 (9.3) in Sweden, 15.4 (13.6) in Finland and 12.5 (9.6) in Estonia. We found the lowest median F ENO values in the Estonian centres Saaremaa 13.1 (9.5) and Narva 11.8 (8.6). In the pooled population, asthma was associated with F ENO ≥25 ppb, odds ratio (OR) 3.91 (95% confidence intervals: 2.29-6.32) after adjusting for SPT result, smoking, gender and study centre. A positive SPT test increased the likelihood of asthma OR 3.19 (2.02-5.11). Compared to Saaremaa, the likelihood of having asthma was higher in Helsinki OR 2.40 (1.04-6.02),
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