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Atopic diseases and airway-related symptoms in Bavarian children before starting primary school: Time trend analyses - 25/01/22

Doi : 10.1016/j.rmed.2021.106707 
Christina Pirner a, b, c, ⁎ , Christine Korbely c, Stefanie Heinze c, d, Jonas Huß c, Burkhard Summer e, Eva Oppel e, Dennis Nowak f, g, Caroline Herr c, d, Susanne Kutzora c

for the HMU Study Group

Wiltrud Doerk h, Angelika Pfister h, Rosemarie Sittig h, Winfried Strauch h, Heidi Thamm h, Anita Wunder h, Tatjana Frieß-Hesse i, Franziska Lang i, Dagmar Rudolph i, Roland Schmid i, Gudrun Winter i, Isabella Bockmann j, Christine Gampenrieder j, Margot Motzet j, Elisabeth Schneider j, Traudl Tontsch j, Gerlinde Woelk j, Sylvia Kranebitter k, Heidi Mayrhofer k, Gertraud Rohrhirsch k, Brigitte Weise k, Luisa Wolf k, Kornelia Baranek l, Gitte Koch-Singer l, Maximilian Kühnel l, Ladan Baghi m, Otmar Bayer m, Rüdiger von Kries m, Gabriele Bolte n, Hermann Fromme n, Annette Heißenhuber n, Lana Hendrowarsito n, Caroline Herr n, Martina Kohlhuber n, Joseph Kuhn n, Bernhard Liebl n, Anja Lüders n, Nicole Meyer n, Christine Mitschek n, Gabriele Morlock n, Michael Mosetter n, Uta Nennstiel-Ratzel n, Dorothee Twardella n, Manfred Wildner n, Angelika Zirngibl n
h Health Authority of the District Office of Bamberg, Germany 
i Health Authority of the District Office of Günzburg, Germany 
j Health Authority of the City Ingolstadt, Germany 
k Department of Health and Environment, City of Munich, Germany 
l Health Authority of the District Office of Schwandorf, Germany 
m Institute of Social Pediatrics and Adolescent Medicine, Ludwig-Maximilian-University Munich, Germany 
n Bavarian Health and Food Safety Authority, Munich and Oberschleissheim, Germany 

a Institute for Medical Informatics, Biometry and Epidemiology (IBE) at the Ludwig-Maximilians-University Munich, Marchioninistraße 15, 81377, Munich, Germany 
b Pettenkofer School of Public Health, Marchioninistraße 15, 81377, Munich, Germany 
c Bavarian Health and Food Safety Authority, Pfarrstraße 3, 80538, Munich, Germany 
d Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Hospital of the University of Munich, Ziemssenstraße 1, 80336, Munich, Germany 
e Department of Dermatology and Allergology, Ludwig-Maximilians-University Munich, Frauenlobstrasse 9-11, 80337, Munich, Germany 
f Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital of the Ludwig-Maximilians-University Munich, Ziemssenstr. 1, 80336, Munich, Germany 
g Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research (DZL), Munich, Germany 

∗Corresponding author. Department of Occupational and Environmental Epidemiology Bavarian Health and Food Safety Authority, Pfarrstraße 3, 80538, Munich, Germany.Department of Occupational and Environmental Epidemiology Bavarian Health and Food Safety AuthorityPfarrstraße 3Munich80538Germany

Abstract

Background

After decades of rising prevalence of atopic and airway-related diseases, studies showed stagnating prevalence in western industrialised countries. Objective of this study is to analyse the time trend of prevalence of atopic diseases and airway-related symptoms among Bavarian children before starting primary school.

Materials and methods

Five cross-sectional studies from 2004/2005, 2006/2007, 2012/2013, 2014/2015 and 2016/2017 took place in urban and rural regions in Bavaria, Germany. Using standardized parent questionnaires children's atopic diseases and airway-related symptoms were surveyed. Logistic regression analysis (Bonferroni correction: adjusted significance level 0.005) was performed to analyse prevalence of symptoms and diseases from 2004 to 2017 for time trends.

Results

The surveys included 27384 Bavarian children aged 5–6 years (52.6% male). In all children the calculated 12-month prevalence of symptoms ‘≥four episodes of wheeze’ (p-value = .0880) and ‘rhinoconjunctivitis’ (p-value = .3994) reported by parents stagnated, whereas ‘wheeze’ (p-value<.0001; OR = 0.97; CI = [0.96–0.98]) and ‘rhinitis’ (p-value = .0007; OR = 0.98; CI = [0.97–0.99]) decreased. In all children the calculated lifetime prevalence of physician-diagnosed ‘asthma’ (p-value = .5337), and ‘hay fever’ (p-value = .8206) stagnated, whereas of ‘bronchitis’ (p-value<.0001; OR = 0.98; CI = [0.98–0.99]) decreased over time. The calculated lifetime prevalence of physician-diagnosed ‘atopic eczema’ (p-value = .0002; OR = 0.98; CI = [0.97–0.99]) decreased in all children, whereas the calculated 12-month prevalence of the symptom ‘itchy rash’ increased (p-value = .0033; OR = 1.07; CI = [1.05–1.08]) over time.

Conclusions

Several calculated prevalence of children's atopic diseases and airway-related symptoms reported by parents stagnated in a subgroup of Bavarian children before starting primary school between 2004 and 2017. The time trend of prevalence in ‘wheeze’, ‘rhinitis’ and ‘bronchitis’ decreased. Prevalence of ‘atopic eczema’ decreased over time, whereas ‘itchy rash’ increased.

Le texte complet de cet article est disponible en PDF.

Highlights

•
Some atopic and respiratory conditions stagnated over time in Bavarian children before starting primary school.
•
Less of these children had 12-month wheeze and rhinitis in 2004 compared to 2017 according to parent reported assessments.
•
Lifetime bronchitis and atopic eczema decreased in Bavarian children before starting primary school.
•
Monitoring should be ensured because of serious effects for affected children and health system.

Le texte complet de cet article est disponible en PDF.

Keywords : Asthma, Allergy, Atopic eczema, Child, Time trend analysis


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Vol 191

Article 106707- janvier 2022 Retour au numéro
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