Changes in prevalence of asthma and allergies among children and adolescents in Italy: 1994-2002
Changes in prevalence of asthma and allergies among children and adolescents in Italy: 1994-2002
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DOI：
10.1542/peds.2004-2709
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发表时间：
2006-01-01
期刊：
影响因子：
8
通讯作者：
Forastiere, F
中科院分区：
文献类型：
--
作者：
Galassi, C;De Sario, M;Forastiere, F
背景20世纪90年代进行的几项研究表明，哮喘症状的患病率有所增加;最近的调查表明，这一趋势正在稳定，甚至可能正在逆转。我们比较了1994年和2002年在北方和意大利中部8个地区进行的2项横断面调查，以评估哮喘、过敏性鼻炎和湿疹的患病率变化。方法.儿童哮喘和过敏的国际研究方法和问卷调查6至7岁的儿童（1994-1995年和2002年父母填写的问卷分别为16 115份和11 287份，1994-1995年和2002年，青少年分别完成了19 723份和10 267份问卷。在每个阶段，总有效率> 90%。患病率变化计算为两次调查记录的患病率之间的绝对差异。儿童中喘息的患病率（过去12个月）略有增加（变化：0.8%; 95%置信区间[CI]：0.0%-1.6%），青少年中相当稳定。过敏性鼻炎症状（儿童：变化：5.2%; 95%CI：4.0%至6.4%;青少年：变化：4.1%; 95%CI：1.9%至6.3%）和特应性湿疹的症状（儿童：变化：4.4%; 95% CI：3.6%至5.2%;青少年：变化：2.1%; 95% CI：1.2%至3.0%）在两个年龄组中均明显增加。在青少年中，各中心存在一些异质性，特别是过敏性鼻炎，在3个大都市地区观察到较大的增加。这些变化表明，家庭发生了深刻的变化，即父母教育程度提高，母亲就业率提高，父母吸烟率降低。然而，这些因素并不能解释所有观察到的患病率变化。结果表明，在意大利的哮喘和过敏的流行病学特征正在迅速改变，虽然原因仍然不确定。
BACKGROUND. Several studies conducted during the 1990s indicated an increase in the prevalence of symptoms of asthma; more recent investigations suggest that the trend is stabilizing or may even be reversing.OBJECTIVE. We compared 2 cross-sectional surveys conducted in 1994 and 2002 in 8 areas in northern and central Italy, to evaluate prevalence changes for asthma, allergic rhinitis, and eczema. METHODS. The International Study of Asthma and Allergies in Childhood methods and questionnaires were used to investigate 6- to 7-year-old children (16 115 and 11 287 questionnaires completed by parents in 1994-1995 and 2002, respectively) and 13- to 14-year-old adolescents (19 723 and 10 267 questionnaires completed by adolescents in 1994-1995 and 2002, respectively). In each phase, the overall response rate was > 90%. Prevalence changes were calculated as the absolute difference between the prevalence recorded on the 2 occasions.RESULTS. The prevalence of wheeze (past 12 months) increased slightly among children (change: 0.8%; 95% confidence interval [CI]: 0.0% to 1.6%) and was rather stable among adolescents. Symptoms of allergic rhinitis (children: change: 5.2%; 95% CI: 4.0% to 6.4%; adolescents: change: 4.1%; 95% CI: 1.9% to 6.3%) and symptoms of atopic eczema ( children: change: 4.4%; 95% CI: 3.6% to 5.2%; adolescents: change: 2.1%; 95% CI: 1.2% to 3.0%) increased clearly in both age groups. There was some heterogeneity across the centers among adolescents, especially for allergic rhinitis, with larger increases seen in the 3 metropolitan areas. The changes observed paralleled profound family changes, ie, better parental education, higher rates of maternal employment, and lower rates of exposure to parental smoke. These factors, however, do not explain all of the observed changes in prevalence.CONCLUSIONS. The results indicate that the epidemiologic features of asthma and allergies in Italy are changing rapidly, although the causes are still uncertain.