SUMMARY A questionnaire study regarding airway morbidity in children and environmental factors was performed in April 1985. The parents of 5301 children, aged 6 months to 16 years, from different rural areas in mid Sweden were sent a validated questionnaire and 4990 (94%) responded. The cumulative prevalence of bronchial hyperreactivity was 9.7% and of allergic asthma 5.2%. Children living near a paper pulp plant more often had symptoms suggesting bronchial hyperreactivity (124 (13.0%), relative risk 1-3) and allergic asthma (68 (7.1%), relative risk 1.3). In children living in a damp house problem bronchial hyperreactivity was found in 76 (19-0%) (relative risk 1*9) and allergic asthma in 35 (8.7%) of the children (relative risk 1-9). Children living in a damp house with parents who smoked had the highest figures: bronchial hyperreactivity was found in 44 (23.5%) (relative risk 2.8) and allergic asthma in 22 (11-6%) (relative risk 2.5). The results indicate that various moderate environmental pollutants may act synergistically to increase bronchial hyperreactivity and allergy especially in children with a family history of allergy.
The prevalence of asthma in children shows geographical variation which is parallel to that of asthma mortality, being high in New Zealand and low in Sweden. Differential exposure to animal allergens is a possible factor in this variation.
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