Prevalence of asthma and allergic disorders among children in united Germany: a descriptive comparison.

Mutius, Erika von; Fritzsch, Christian; Weiland, S. K.; Roll, G. Winfield; Magnussen, H

doi:10.1136/bmj.305.6866.1395

Cited by 453 publications

(214 citation statements)

References 26 publications

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“…Several studies have reported no association; some of these studies had small numbers of asthmatic children (Ellegard, 1996;Noorhassim et al, 1995). Several studies, including early papers by von Mutius and others comparing East and West Germany (Nowak et al, 1996;Von Mutius et al, 1992) and the main ISAAC papers (Mallol et al, 2000;ISAAC, Steering Committee, 1998), have reported lower asthma prevalence in areas with higher outdoor air pollution, indicating a counterintuitive protective effect of particle exposure, that is probably due to confounding. These papers, mainly of ecologic design, have influenced the scientific communities' ways of thinking about air pollution in such a way that this exposure is often not considered an important risk factor for asthma.…”

Section: Biomass-smoke Exposurementioning

confidence: 99%

Childhood asthma and indoor woodsmoke from cooking in Guatemala

Schei

Hessen

Smith

et al. 2004

J Expo Sci Environ Epidemiol

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We estimated the prevalence and severity of asthma, and the association with cooking on open wood fires, as preparation for a large-scale randomized field trial on effects of indoor air pollution and child health. This is one of the first systematic studies of asthma and indoor wood-smoke pollution and to our knowledge the first asthma study in a purely indigeneous population in Latin America. The mothers of 1058 children aged 4-6 years were interviewed, using the standardized ISAAC (International Study of Asthma and Allergies in Childhood) procedures and questionnaire. The study population is a Mam-speaking (Maya), indigenous group living at relatively high altitude (2000 m) in Western Guatemalan Highlands. We found that asthma prevalence is low among indigenous children in Gautemala, compared to other populations in Latin America. Only 3.3% of the children reported wheezing symptoms in the last 12 months, and 72% wheezing symptoms ever. The majority of the current wheezers had at least one of the criteria for severe asthma. The prevalence of all the symptoms of asthma was higher in children from households that used open fires compared to improved stoves with chimneys. In a logistic regression model, use of open fire for cooking was a significant risk factor for a number of asthma symptoms, with odds ratios varying from 2.0 to 3.5. Among the different cooking technologies (1Fimproved stove with chimney, 2Fmixture of gas and open fire, 3Fopen fire) trends of higher prevalence with more pollution was found for some of the symptoms. Hence use of open fire for cooking, may be an important risk factor for asthma symptoms and severity.

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Section: Biomass-smoke Exposurementioning

confidence: 99%

Childhood asthma and indoor woodsmoke from cooking in Guatemala

Schei

Hessen

Smith

et al. 2004

J Expo Sci Environ Epidemiol

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“…Several surveys in children and adults have shown significantly lower prevalences of asthma and allergic diseases in eastern Europe than in western countries (113)(114)(115). In the former East Germany tremendous changes towards western lifestyle have occurred as unification and have lead to a similar rate of atopy (116).…”

Section: Role Of Infections In the Prevention Of Allergymentioning

confidence: 99%

Epigenetic inheritance of fetal genes in allergic asthma

Bousquet

Jacot

Yssel

et al. 2004

Allergy

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Asthma has been associated with an exaggerated T‐helper type 2 (Th2) over Th1 responses to allergic and nonallergic stimuli, which leads to chronic airway inflammation and airway remodeling. In the present article, we propose that many of the genes involved in IgE synthesis and airways (re)modeling in asthma are persistent or reminiscent fetal genes which may not be silenced during early infancy (or late pregnancy). Genes of the embryologic differentiation of ectodermic and endodermic tissues may explain some of the patterns of airway remodeling in asthma. In utero programming leads to gene expression, the persistence of which may be associated with epigenetic inheritance phenomena induced by nonspecific environmental factors. Clear delineation of these issues may yield new information on the mechanisms of asthma and new targets for therapeutic intervention and primary prevention.

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“…Von Mutius et al (16) compared the prevalence of asthma in schoolchildren from the cities of Munich and Leipzig in the reunified Germany. The level of pollution was far higher in Leipzig.…”

Section: Epidemiological Backgroundmentioning

confidence: 99%

“…In addition, the prevalence of atopy has risen steadily in East Germany since lifestyle and environment have become more westernized. This suggests that the increase in the prevalence of allergic disease is probably due to factors associated with a western lifestyle (16).…”

Section: Epidemiological Backgroundmentioning

confidence: 99%