We report for the first time that SE-IgE is common in the general population throughout Europe and that its risk factors differ from those of IgE against aeroallergens. This is the first study to show that SE-IgE is significantly and independently associated with asthma in the general population.

103Sinusitis 104 105 Conflicts of interest 106Jan Lötvall has received consultancy and speaker fees from AstraZeneca, GlaxoSmithKline, MSD/Merck, 107Novartis, and Schering-Plough. 109Author contributions 110PT, RN, RH, and DJ analyzed the data and wrote the manuscript. WF, CB, PB and DJ conceived and supervised 111 the study. All authors collected data and critically revised the manuscript. 113Body word count: 2673 114Page 3 of 17 Allergy 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 118in epidemiological studies, the definition is based on symptoms only. We aimed to assess the reliability and 119validity of a symptom based definition of CRS using data from the GA2LEN European survey. 120Methods: On two separate occasions, 1700 subjects from 11 centers provided information on symptoms of CRS, 121allergic rhinitis and asthma. CRS was defined by the epidemiological EP3OS symptom criteria. The difference in 122prevalence of CRS between two study points, the standardized absolute repeatability and the chance corrected 123 repeatability (kappa) were determined. In two centers 342 participants underwent nasal endoscopy. The 124 association of symptom-based CRS with endoscopy and self-reported doctor-diagnosed CRS was assessed. 125Results: There was a decrease in prevalence of CRS between the two study phases, and this was consistent 126across all centers (-3.0%, 95% CI: -5.0 to -1.0%, I 2 =0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 160Study design 161In a first cross-sectional phase (the GA²LEN Survey), 11 participating centers sent a questionnaire by mail to a 162 random sample of at least 3000 subjects aged 15 to 75 years, with up to three attempts to elicit a response. 163Samples were identified by random sampling from a population based local sampling frame. 164The questionnaire was newly developed for the diagnosis of chronic rhinosinusitis ( (Table 1); additionally, subjects were asked if a doctor had ever told whether the subject had CRS 167(further referred to as 'self-reported doctor-diagnosed CRS'). Asthma was defined as reporting 'having ever had 168 asthma' and at least one of the following symptoms in the last 12 months: 1) wheeze or whistling in the chest; or 1692) waking up with chest tightness, shortness of breath or an attack of coughing. Allergic rhinitis was defined by 170 the self reported history of 'nasal allergy'. 171In a second phase (the GA²LEN Survey Follow-Up), each center invited 120 randomly selected subjects with 172 asthma, 120 with CRS, 40 with asthma and CRS and 120 with neither asthma or CRS for a clinical study visit 173with further investigations among which a questionnaire including the same questions as those describ...

CRS prevalence was affected by occupation (blue vs. white collar), but the observed effect depended on gender and smoking status. Exposure to airway irritants (occupational or smoking) increased the CRS prevalence. Studies on larger cohorts are needed to fully assess these tendencies, for example, by more extensive use of Job Exposure Matrix models.

This study gives insight into health-related quality of life and objective findings in persons with chronic rhinosinusitis recruited from the general population.

BackgroundThe consequences of lifestyle-related disease represent a major burden for the individual as well as for society at large. Individual preventive health checks to the general population have been suggested as a mean to reduce the burden of lifestyle-related diseases, though with mixed evidence on effectiveness. Several systematic reviews, on the other hand, suggest that health checks targeting people at high risk of chronic lifestyle-related diseases may be more effective. The evidence is however very limited. To effectively target people at high risk of lifestyle-related disease, there is a substantial need to advance and implement evidence-based health strategies and interventions that facilitate the identification and management of people at high risk. This paper reports on a non-randomized pilot study carried out to test the acceptability, feasibility and short-term effects of a healthcare intervention in primary care designed to systematically identify persons at risk of developing lifestyle-related disease or who engage in health-risk behavior, and provide targeted and coherent preventive services to these individuals.MethodsThe intervention took place over a three-month period from September 2016 to December 2016. Taking a two-pronged approach, the design included both a joint and a targeted intervention. The former was directed at the entire population, while the latter specifically focused on patients at high risk of a lifestyle-related disease and/or who engage in health-risk behavior. The intervention was facilitated by a digital support system. The evaluation of the pilot will comprise both quantitative and qualitative research methods. All outcome measures are based on validated instruments and aim to provide results pertaining to intervention acceptability, feasibility, and short-term effects.DiscussionThis pilot study will provide a solid empirical base from which to plan and implement a full-scale randomized study with the central aim of determining the efficacy of a preventive health intervention.Trial registrationRegistered at Clinical Trial Gov (Unique Protocol ID: TOFpilot2016). Registered 29 April 2016. The study adheres to the SPIRIT guidelines.Electronic supplementary materialThe online version of this article (10.1186/s12875-018-0820-8) contains supplementary material, which is available to authorized users.