ABSTRACT.Objective. Sensitization to perennial aeroallergens is associated with asthma in industrialized countries with a Western lifestyle. Because silk products are commonly used in Chinese society, we were interested in examining the relation between sensitization to silk and asthma.Design. Cross-sectional study of 871 children in 503 families living in Anqing, a predominantly rural province of China.Results. After adjustment for age, gender, familial correlations, and sensitization to other aeroallergens, skin test reactivity to silk was an independent predictor of asthma (odds ratio ؍ 2.6; 95% confidence interval ؍ 1.2-5.7). This association became stronger after inclusion of the eosinophil count and history of parasitic diseases of the participants in the multivariate model (odds ratio ؍ 3.6; 95% confidence interval ؍ 1.4 -8.9).Conclusion. Because sericulture is an important activity in China and other countries throughout the world, sensitization to silk may influence the pathogenesis and severity of asthma in people living in these nations. T he silk production industry began in China ϳ2640 BC, when the Empress Hsi-ling Shih is credited with learning how to raise silkworms and unwind the silk filaments from their cocoons. Although sericulture then spread to Japan and later westward over India and Central Asia, China is the main producer of raw silk in the world today.Skin test reactivity to perennial aeroallergens, such as the house dust mite, animal dander, and mold, is strongly associated with asthma in countries with a Western lifestyle. [1][2][3][4][5][6] Because silk is an aeroallergen that is ubiquitous in Chinese society, 7 we were interested in examining the relation between sensitization to silk and asthma among 871 children living in Anqing, a predominantly rural province of China.
METHODSAnqing stretches for ϳ80 km along the northern bank of the Yangtze river. The annual temperature is 15°C. Anqing has 3 urban areas and 8 rural counties, with a total area of 15 000 km. 2 The population in 1990 was 5.8 million (urban, 9%; rural, 91%). Families were selected from the general population. All families were selected by a 2-stage random sampling technique using 1992 census records. The sample unit at the first stage was the administrative unit (eg, the village). At the second stage, the unit was the household. The following criteria were used for inclusion of families in the study: 1) 2 or more siblings in the family; 2) age of the youngest sibling Ն6 years; and 3) both parents available.
ProceduresInformed consent was obtained from the parents of all participating children Ͻ12 years old and from all participating children Ͼ12 years old. Local officials and health centers arranged for appointments to take place at a central office at a time convenient for the participants. Data were collected by faculty members from Anhui Medical University and by trained interviewers between July 1, 1994, and January 26, 1998.The following procedures were conducted: 1) completion of a modified American Thor...