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Allergol Immunopathol (Madr). 2019 Feb 20. pii: S0301-0546(19)30007-2. doi: 10.1016/j.aller.2018.12.008. [Epub ahead of print]

Residential crowding and asthma in preschool children, a cross-sectional study.

Author information

1
Department of Occupational and Environmental Health/Epidemiology, Bavarian Health and Food Safety Authority (LGL), Pfarrstr. 3, 80538 Munich, Germany. Electronic address: Susanne.Kutzora@lgl.bayern.de.
2
Department of Occupational and Environmental Health/Epidemiology, Bavarian Health and Food Safety Authority (LGL), Pfarrstr. 3, 80538 Munich, Germany.
3
Bavarian Health and Food Safety Authority (LGL), Veterinärstraße 2, 85764 Oberschleißheim, Germany.
4
Department of Occupational and Environmental Health/Epidemiology, Bavarian Health and Food Safety Authority (LGL), Pfarrstr. 3, 80538 Munich, Germany; Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Clinic of the University of Munich, Ziemssenstr. 1, 80336 Munich, Germany.

Abstract

BACKGROUND:

Asthma is the most common chronic disease in children, and associations with crowding have been reported. The aim of this study was to explore possible associations of crowding with asthma in children.

METHODS:

Seven cross-sectional surveys with preschool children were conducted within the framework of the health monitoring units in Bavaria, Germany, from 2004 to 2014. Residential crowding was defined as habitation of more than one person per room or less than 20m2 living space per person. Logistic regression models examined temporal changes in crowding, applying the first survey as reference. The relationship between crowding and physician-diagnosed asthma, asthma defined by the International Study of Asthma and Allergies in Childhood (ISAAC) and asthma symptoms were analyzed.

RESULTS:

Analyzing temporal changes of crowding rates did not reveal any differences over the years. However, the stratified descriptive analysis indicated a crowding increase in time in urban households where parents had a low education level (47.9% in 2004/05, 55.8% in 2014/15). No association was found between crowding and the variables "physician-diagnosed asthma" in 2014/15, "asthma defined by ISAAC" in 2014/15, or "wheezing" in 2014/15. A positive association with cough was identified in 2014/15 after adjusting for confounders (aOR=1.42 [95% CI: 1.20-1.69]).

CONCLUSIONS:

In general, residential crowding did not change from 2004 to 2014; however, there seems to be a small upsurge for children with low-educated parents, living in urban areas over the years. A statistically significant association between crowding and cough was only found in the survey from 2014/15.

KEYWORDS:

Asthma; Asthma symptoms; Cross-sectional study; Crowding, preschool children; Germany; Health monitoring units; ISAAC; Migration status; Physician diagnosed asthma; Residential crowding

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