Decreased importance of environmental risk factors for childhood asthma from 1996 to 2006
Decreased importance of environmental risk factors for childhood asthma from 1996 to 2006
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DOI：
10.1111/cea.12439
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发表时间：
2015-01-01
影响因子：
6.1
通讯作者：
Ronmark, E.
中科院分区：
文献类型：
--
作者：
Bjerg, A.;Hedman, L.;Ronmark, E.
背景哮喘患病率的大幅增加在几个地区持续，但不是所有地区。尽管已经确定了个体风险因素，观察到的患病率趋势的原因在很大程度上是未知的。这项研究试图描述伴随哮喘患病率趋势的危险因素的趋势。来自同一瑞典研究地区的10岁儿童，通过扩展的儿童哮喘和过敏症国际研究调查问卷进行了10年的比较apart.在1996年和2006年，分别完成了3430份（97%参与）和2585份（96%参与）调查问卷。一个子集是皮肤点刺试验：在1996年和2006年，2148（88%的参与）和1700（90%的参与）的儿童，分别。调整后的人口归因分数（aPAF）计算使用的患病率和多变量比值比的每个危险factor.ResultsThe目前的哮喘和喘息的患病率是相似的，在1996年和2006年。然而，过敏性敏化从21%增加到30%。父母哮喘的患病率从17%上升到24%，而呼吸道感染和母亲吸烟的患病率下降（分别为60%到29%和32%到16%）。1996-2006年，哮喘非环境危险因素的aPAF增加：过敏性致敏从35%增加到41%，父母哮喘从27%增加到45%，男性从20%增加到25%。相反，环境风险因素的aPAF降低：呼吸道感染从36%下降到32%，潮湿的家庭和母亲吸烟分别从14%和19%下降到2006年接近于零。结论和临床意义从1996年到2006年，非环境危险因素父母哮喘，在7- 8岁的儿童中，过敏性致敏和男性对当前哮喘的重要性增加或不变。潮湿的家庭环境、呼吸道感染和母亲吸烟的重要性降低。这种危险因素的平衡可以解释目前哮喘的流行程度。
BackgroundThe large increase in asthma prevalence continues in several, but not all areas. Despite the individual risk factors that have been identified, the reasons for the observed trends in prevalence are largely unknown.ObjectiveThis study sought to characterize what trends in risk factors accompanied trends in asthma prevalence.MethodsTwo population-based cohorts of 7- to 8-year-old children from the same Swedish study areas examined by expanded International Study of Asthma and Allergy in Childhood questionnaires were compared 10years apart. In 1996 and 2006, 3430 (97% participation) and 2585 (96% participation) questionnaires were completed, respectively. A subset was skin-prick-tested: in 1996 and 2006, 2148 (88% participation) and 1700 (90% participation) children, respectively. The adjusted population-attributable fraction (aPAF) was calculated using the prevalence and multivariate odds ratio of each risk factor.ResultsThe prevalence of current asthma and wheeze was similar in 1996 and 2006. Allergic sensitization, however, increased from 21% to 30%. The prevalence of parental asthma increased from 17% to 24%, while respiratory infections and maternal smoking decreased (60% to 29% and 32% to 16%, respectively). The aPAFs of non-environmental risk factors for current asthma increased in 1996-2006: allergic sensitization from 35% to 41%, parental asthma from 27% to 45% and male sex from 20% to 25%. Conversely, the aPAFs of environmental risk factors decreased: respiratory infections from 36% to 32% and damp home and maternal smoking from 14% and 19%, respectively, to near zero in 2006.Conclusions and Clinical RelevanceFrom 1996 to 2006, the non-environmental risk factors parental asthma, allergic sensitization and male sex had an increasing or constant importance for current asthma in 7- to 8-year-old children. The importance of the environmental exposures damp home, respiratory infections and maternal smoking decreased. This counterbalancing in risk factors may explain the level of prevalence of current asthma.