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Respir Res. 2010 Jan 21;11:8. doi: 10.1186/1465-9921-11-8.

Which population level environmental factors are associated with asthma, rhinoconjunctivitis and eczema? Review of the ecological analyses of ISAAC Phase One.

Collaborators (144)

Asher MI, Clayton TO, Ellwood P, Mitchell EA, Stewart AW, Bezzaoucha A, Melaku K, Seyoum B, Esamai FO, Odhiambo JA, Onadeko BO, Nelson H, Chen YZ, Chen KH, Zhong NS, Bao-Shan M, Xiao ML, Lai C, Lau YL, Baratawidjaja K, Nishima S, Teh KH, Yeong LW, de Bruyne J, Quah BS, Chum KW, Cua-Lim F, Lee SI, Lee BW, Hsieh KH, Vichyanond P, Trakultivakorn M, Masjedi MR, al-Momen JA, Ramadan FM, Al Riyami BM, Montefort S, Bouayad Z, Bennis A, Bhutta ZA, Salmun N, Rosário N, Stein R, Bezerra PG, de Freitas Souza L, Solé D, Sanchez I, Amarales L, Cortez E, Calvo MA, Romieu I, Cukier G, Guggiari-Chase JA, Chiarella P, Holgado D, Sears MR, Taylor B, Persky V, Redding GJ, Priftanji A, Riikjärv MA, Kajosaari M, Pekkanen J, Soininen L, Koivikko TA, Khetsuriani N, Gamkrelidze A, Leja M, Lis G, Brêborowicz A, Dumitrascu D, Khaitov RM, Kjellman NI, Foucard T, Aripova T, Kennedy D, Robertson CF, Landau L, Peat J, Bauman A, Asher MI, Moyes C, Pattemore P, Barry D, Mackay R, Crane J, Maheshwari RM, Joshi MK, Pai UA, Raghavan K, Khatav VA, Kumar L, Jain KC, Sukumaran TU, Rajajee S, Somu N, Chopra K, Jayaraj G, Kar PK, Hanumante NM, Riedler J, Haidinger G, Vermeire P, Jeffs D, Grainger CR, Charpin D, Godard P, Taytard A, Kopferschmitt C, Annesi-Maesano I, Kramer A, Keil U, Gratziou C, Powell PV, Bonini S, Bonci E, Rusconi F, Biocca M, Chetoni L, Chellini E, Ronchetti R, Bisanti L, Forastiere F, Renzoni E, Ciccone G, Piffer S, Boner A, Corbo G, Borges FD, Rosado Pinto JE, Nunes C, Lopes dos Santos JM, Clancy L, Busquets RM, Rubio AD, Asensio AR, García-Marcos L, Arnedo-Pena A, Guillén-Grima F, Morales-Suárez-Varela MM, Blanco Quirós A, Anderson HR, Shamssain MH, Strachan D.

Author information

1
Department of Paediatrics, Child and Youth Health, The University of Auckland, Auckland, New Zealand. mi.asher@auckland.ac.nz

Abstract

The International Study of Asthma and Allergies in Childhood (ISAAC) Phase One showed large worldwide variations in the prevalence of symptoms of asthma, rhinoconjunctivitis and eczema, up to 10 to 20 fold between countries. Ecological analyses were undertaken with ISAAC Phase One data to explore factors that may have contributed to these variations, and are summarised and reviewed here.In ISAAC Phase One the prevalence of symptoms in the past 12 months of asthma, rhinoconjunctivitis and eczema were estimated from studies in 463,801 children aged 13 - 14 years in 155 centres in 56 countries, and in 257,800 children aged 6-7 years in 91 centres in 38 countries. Ecological analyses were undertaken between symptom prevalence and the following: Gross National Product per capita (GNP), food intake, immunisation rates, tuberculosis notifications, climatic factors, tobacco consumption, pollen, antibiotic sales, paracetamol sales, and outdoor air pollution.Symptom prevalence of all three conditions was positively associated with GNP, trans fatty acids, paracetamol, and women smoking, and inversely associated with food of plant origin, pollen, immunisations, tuberculosis notifications, air pollution, and men smoking. The magnitude of these associations was small, but consistent in direction between conditions. There were mixed associations of climate and antibiotic sales with symptom prevalence.The potential causality of these associations warrant further investigation. Factors which prevent the development of these conditions, or where there is an absence of a positive correlation at a population level may be as important from the policy viewpoint as a focus on the positive risk factors. Interventions based on small associations may have the potential for a large public health benefit.

PMID:
20092649
PMCID:
PMC2831000
DOI:
10.1186/1465-9921-11-8
[Indexed for MEDLINE]
Free PMC Article

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