Prevalence of respiratory and atopic disorders among children in the East and West of Germany five years after unification

Abstract

Living conditions in eastern Germany have changed rapidly since unification in 1990 and little is known about how these changes affect the prevalence of atopic diseases. This study describes methods and prevalences of a large epidemiological project investigating determinants of childhood asthma and allergies in eastern (Dresden and Leipzig) and western (Munich) Germany in 1995/1996.Community based random samples of 9±11 yr old children in Dresden (n=3,017) and Munich (n=2,612), and of 5±7 yr old children in Dresden (n=3,300), Leipzig (n=3,167) and Munich (n=2,165) were studied by parental questionnaires, bronchial challenges with hypertonic saline, skin examination, skin-prick tests, and measurements of specific and total serum immunoglobulin (Ig)E using Phase II modules of the International Study of Asthma and Allergies in Childhood (ISAAC).In 9±11 yr old children, the prevalence of physician diagnosed asthma (7.9% versus 10.3%; p<0.01) and bronchial hyperresponsiveness (15.7% versus 19.9%; p<0.05) was lower in Dresden than in Munich. No difference between Munich and Dresden was observed in the prevalence of diagnosed hay fever, skin test reactivity to $1 allergen, and increased levels (>0.35 kU . L -1 ) of specific IgE against inhalant and food allergens. Symptoms and visible signs of atopic eczema tended to be more prevalent in Dresden. Similar East-West differences between the three study areas were seen in the younger age group.These findings are in line with recently observed increases in the prevalence of hay fever and atopic sensitization, but not of asthma and bronchial hyperresponsiveness, among 9±11 yr old children in Leipzig.

A complete screening of the IL4 gene

“…We have shown previously that within the relatively short time between the unification of Germany in 1990 and the second survey in 1995 and 1996, the prevalence of atopic diseases has increased to western European levels, and thus no significant difference in atopic diseases existed at the time of the survey. 21 Furthermore, no significant ethnic or genetic differences exist between children from both parts of Germany, as shown previously. 11,22 In this study all associations have been tested separately in both populations to ensure that the effects of the respective polymorphisms would be reproducible.…”

“…12 Parental questionnaires for self-completion were sent through the schools to the families. Children underwent skin prick testing, pulmonary function testing, and bronchial challenge with hyperosmolar (4.5%) saline (Munich) or cold-air hyperventilation for 4 minutes (Leipzig).…”

“…The study methods have been described in detail elsewhere. 12 Therefore only methods pertaining to this analysis are given below. Supplementary information on technical procedures, primers, and PCR conditions is publicly available in the Journal's Online Repository at www.mosby.com/jaci.…”

“…12 Children whose parents reported a physician's diagnosis of either asthma, recurrent spastic bronchitis, or recurrent asthmatic bronchitis were classified as having asthma. Current wheeze was defined as wheezing in the last 12 months.…”

Air pollution and risk of lung cancer in a prospective study in Europe

“…Several studies have documented substantial differences in concentration of traffic-related pollutants between traffic and background locations. 9,10 For all homes, we used detailed Internet maps (www.streetmap.co.uk and www.mappy.com) to evaluate whether the home was located in a major street. The map-based classification of streets was validated using traffic count data obtained from Municipalities and local environmental agencies, or were downloaded from Internet sites.…”