International Study of Asthma and Allergies in Childhood (ISAAC): rationale and methods

Asher, M. Innes; Keil, Ulrich; Anderson, H R; Beasley, Richard; Crane, Julian; Martínez, Fernando D.; Mitchell, Ed; Pearce, Neil; Sibbald, Bonnie; Stewart, Alistair; Strachan, D P; Weiland, S. K.; Williams, Hywel C

doi:10.1183/09031936.95.08030483

Cited by 3,049 publications

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“…Further, data were collected retrospectively by parent-administered questionnaires and information on atopic diseases was collected by simple questions without further validation through detailed questions on atopic symptoms e.g. according to the ISAAC questionnaires [20]. Therefore, selection bias, recall bias and misclassification could have affected the observed associations.…”

Section: Discussionmentioning

confidence: 99%

“…Information on children's history of atopic diseases was collected by the following simple questions also included in the ISAAC core questionnaires [20]: Has your child ever had asthma (yes/no), hay fever (yes/no), eczema (yes/no) (before diabetes onset)? Questionnaire data further included information on potential confounding factors: family history (parents, siblings or grandparents) of Type 1 diabetes (yes/no), family's socio-economic status (low, middle, high) based on parents' highest level of school education and occupational status, duration of overall breastfeeding (not at all or <2 weeks, 2-6 weeks, 7 weeks-4 months, ≥5 months), number of children in the family (1, 2, ≥3), maternal age at delivery (≤20, 21-25, 26-40, ≥41 years).…”

Section: Methodsmentioning

confidence: 99%

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Atopic eczema in early childhood could be protective against Type 1 diabetes

2003

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Aims/hypothesis. According to the Th1/Th2 paradigm Type 1 diabetes and atopic diseases are assumed to be mutually exclusive on the individual level. We analysed the association between Type 1 diabetes and atopic diseases in a case-control design in order to test the hypothesis that atopic diseases in early childhood could protect against Type 1 diabetes. Methods. We carried out a nationwide populationbased case-control study enrolling 760 cases newlydiagnosed with Type 1 diabetes under five years of age between July 1992 and December 1995 and 1871 controls randomly selected from the general population and individually matched on sex, age and place of residence. Information on atopic diseases was obtained by a mailed parent-administered questionnaire. Data were analysed by multivariate logistic regression adjusting for potential confounders (family history of diabetes, social status, duration of overall breast feeding, number of children in family, maternal age at delivery). Results. Atopic eczema was less frequent in diabetic (13.3%) than in non-diabetic children (18.0%) and was significantly associated with a reduced risk of Type 1 diabetes. The adjusted odds ratio was 0.71 (95% CI 0.53-0.96). Hay fever and asthma were not significantly associated with diabetes risk (OR 0.98 (95% CI 0.47-2.01) and 1.46 (95% CI 0.70-3.06), respectively). Conclusion/interpretation.In this large populationbased case-control study in pre-school children an inverse association was observed between atopic eczema and Type 1 diabetes. Thus, in accordance with the Th1/Th2 paradigm development of atopic eczema in early childhood could be protective against childhood Type 1 diabetes. [Diabetologia (2003) 46:784-788]

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Atopic eczema in early childhood could be protective against Type 1 diabetes

2003

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“…The questionnaire included the International Study of Asthma and Allergies in Childhood (ISAAC) core questionnaire (Asher et al., 1995). The questionnaire was expanded with additional questions about symptoms, use of medications and physician diagnoses as well as possible risk factors including school environment and physical activity (Rönmark et al., 2009).…”

Section: Methodsmentioning

confidence: 99%

Asthma in adolescence affects daily life and school attendance - Two cross-sectional population-based studies 10 years apart

et al. 2017

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AimThe aim of this study was to study the impact of asthma on daily life, school absenteeism and physical education. In addition, to describe asthma triggers at school.DesignTwo cross‐sectional population‐based studies ten years apart.MethodWithin the OLIN‐studies, in 2003 (n = 3,327) and in 2013 (n = 2,345) adolescents (14–15 years) answered an expanded ISAAC questionnaire. Of these, 8% and 11%, respectively with current asthma participated in this study.ResultsBetween the years 2003–2013, the proportion of adolescents reporting that asthma interfered with daily life had increased, in 2013, girls were significantly more affected than boys. The proportion reporting a worsening of asthma at school had decreased, but it was still over a quarter. The proportion of absenteeism from school and from physical education was at the same level both years. Asthma triggers were described to be poor air quality, poorly cleaned environment, allergens, strong fragrance, rebuilding projects, physical education and stress.

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“…A completed questionnaire was returned by parents of 3,312 (83%) children of ages 5±7 yrs and of 3,045 (85.7%) children of ages 9±11 yrs. The questions on respiratory and allergic disorders included those developed for the ISAAC-project [19]. The focus of this analysis is on responses to the ISAAC questions on "wheeze in the last 12 months", "number of wheezing attacks in the last 12 months", and on "sleep-disturbing" and "speech-limiting" wheezing in the last 12 months.…”

Section: Study Population and Health Outcome Measurementsmentioning

confidence: 99%

Inner city air pollution and respiratory health and atopy in children

Hirsch¹,

Weiland²,

Mutius³

et al. 1999

Eur Respir J

188

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The impact of inner city air pollution on the development of respiratory and atopic diseases in childhood is still unclear.In a cross sectional study in Dresden, Germany, 5,421 children in two age groups (5±7 yrs and 9±11 yrs) were studied according to the International Study of Asthma and Allergies in Childhood (ISAAC) phase II protocol. The prevalences of wheezing and cough as well as doctor diagnosed asthma and bronchitis were assessed by parental questionnaires. Children also underwent skin-prick testing, venipuncture for the measurement of serum immunoglobulin (Ig)E, lung function testing and a bronchial challenge test (4.5% saline) to assess airway hyperresponsiveness. Exposure was assessed on an individual basis by relating mean annual air pollution levels (SO 2 , NO 2 , CO, benzene, and O 3 ) which had been measured on a 1 km 2 grid, to the home and school address of each study subject.After adjusting for potential confounding factors an increase in the exposure to benzene of 1 mg . m 3 air was associated with an increased prevalence of morning cough (adjusted odds ratio (aOR)): 1.15; 1.04±1.27) and bronchitis (aOR: 1.11; 1.03±1.19). Similar associations were observed for NO 2 and CO. In turn, the prevalences of atopic sensitization, symptoms of atopic diseases and bronchial hyperresponsiveness were not positively associated with exposure to any of these pollutants.It is concluded that in this study a moderate increase in exposure to traffic-related air pollution was associated with an increased prevalence of cough and bronchitis, but not with atopic conditions in children. Eur Respir J 1999; 14: 669±677. [3,4,6] and the occurrence of respiratory tract illnesses. Not all reports attempted to discriminate between the different phenotypes of these conditions. Reports that provide detailed information suggest an effect on the prevalence of cough and bronchitis, but not on asthma and atopy [2,7,8].Other epidemiological studies found an association between automobile [9,10] or truck traffic frequency [11± 13] and wheeze. Higher exposure to truck traffic and black smoke was also associated with impaired forced expiratory volume in one second (FEV1) [14]. Some studies also reported an association between truck traffic frequency [12,13] or black smoke exposure [11] and symptoms of allergic rhinitis. A large Italian study on 39,275 children [15] found a significant association between truck traffic exposure and wheeze, but the associations with other respiratory symptoms (cough and phlegm) were more pronounced. No positive associations were seen between traffic exposure and doctor-diagnosed asthma [9, 11], atopy [11] or bronchial hyperrespon-siveness (BHR) [9]. In contrast to these findings data from in vitro studies and laboratory experiments suggest that particles from diesel exhaust, one of the major contributors to particulate matter pollution in urban areas, specifically promote allergic reactions and BHR [16].Limitations of study design and exposure assessment have hampered the interpretation ...

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International Study of Asthma and Allergies in Childhood (ISAAC): rationale and methods

Cited by 3,049 publications

References 50 publications

Atopic eczema in early childhood could be protective against Type 1 diabetes

Atopic eczema in early childhood could be protective against Type 1 diabetes

Asthma in adolescence affects daily life and school attendance - Two cross-sectional population-based studies 10 years apart

Inner city air pollution and respiratory health and atopy in children

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