Skip to main content
Top
Published in: Allergy, Asthma & Clinical Immunology 1/2018

Open Access 01-12-2018 | Research

Atopy and related clinical symptoms among Swiss medical students from 2007 to 2015

Authors: Lukas Steinegger, Stephan Regenass, Lucas M. Bachmann, Elsbeth Probst, Urs C. Steiner

Published in: Allergy, Asthma & Clinical Immunology | Issue 1/2018

Login to get access

Abstract

Background

Atopic allergy is a widespread disease with increasing prevalence in the second half of the twentieth century and is most often associated with clinical symptoms, like rhinoconjunctivitis, asthma or eczema. This study explored the prevalence of atopy and polysensitization in nine cohorts of Swiss medical students during the period of 2007–2015. Furthermore, the self-reported allergic symptoms, such as rhinoconjunctivitis, asthma and eczema, among students with and without atopy were assessed.

Methods

Each cohort was assessed in the third study year. Students underwent an ImmunoCAP rapid test, a qualitative point-of-care test, and completed an anonymous questionnaire on age, gender and clinical symptoms including rhinoconjunctivitis, asthma and eczema. Statistical analyses assessed the overall prevalence of atopy in each group and estimated the average annual increase using a linear mixed model. We examined the frequency of occurrence of polysensitization and differences of reported symptoms among students with and without atopy.

Results

Data of 1513 students (mean age 22.4–23.3 years across cohorts) in nine cohorts (median cohort size 215 interquartile range IQR 193–222) were available for analysis. Test results consistent with atopy were present in 39.9% of students. Average increase of atopy over the 9 years of observation was 2.25% (95% CI 0.18–4.31%; p = 0.037). Main drivers for this increase were the ubiquitously available allergens, house dust mite, timothy grass and birch pollen. Atopy and polysensitization were more pronounced in male students: Polysensitization also increased in the observation period. The clinical symptoms, rhinoconjunctivitis, asthma and eczema were reported by 463 (76.7%) atopic and by 141 (15.5%) non-atopic students.

Conclusions

We observed a slight increase of atopy and polysensitization within 9 years of observation in Swiss medical students. The most frequent sensitization occurred with allergens with the highest chance of exposure. Rhinoconjunctivitis, asthma and eczema are a symptom complex associated with atopy but also found in non-atopic students.
Trial registration retrospectively registered by the Cantonal Ethics Committee Zurich on 22.01.2016; Nr: 08-2016
Literature
1.
go back to reference Papadopoulos NG, Agache I, Bavbek S, Bilo BM, Braido F, Cardona V, Custovic A, Demonchy J, Demoly P, Eigenmann P, et al. Research needs in allergy: an EAACI position paper, in collaboration with EFA. Clin Transl Allergy. 2012;2:21.CrossRefPubMedPubMedCentral Papadopoulos NG, Agache I, Bavbek S, Bilo BM, Braido F, Cardona V, Custovic A, Demonchy J, Demoly P, Eigenmann P, et al. Research needs in allergy: an EAACI position paper, in collaboration with EFA. Clin Transl Allergy. 2012;2:21.CrossRefPubMedPubMedCentral
2.
go back to reference Haftenberger M, Laussmann D, Ellert U, Kalcklosch M, Langen U, Schlaud M, Schmitz R, Thamm M. Prevalence of sensitisation to aeraoallergens and food allergens: results of the German Health Interview and Examination Survey for Adults (DEGS1). Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2013;56:687–97.CrossRefPubMed Haftenberger M, Laussmann D, Ellert U, Kalcklosch M, Langen U, Schlaud M, Schmitz R, Thamm M. Prevalence of sensitisation to aeraoallergens and food allergens: results of the German Health Interview and Examination Survey for Adults (DEGS1). Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2013;56:687–97.CrossRefPubMed
3.
go back to reference Salo PM, Arbes SJ Jr, Jaramillo R, Calatroni A, Weir CH, Sever ML, Hoppin JA, Rose KM, Liu AH, Gergen PJ, et al. Prevalence of allergic sensitization in the United States: results from the National Health and Nutrition Examination Survey (NHANES) 2005-2006. J Allergy Clin Immunol. 2014;134:350–9.CrossRefPubMedPubMedCentral Salo PM, Arbes SJ Jr, Jaramillo R, Calatroni A, Weir CH, Sever ML, Hoppin JA, Rose KM, Liu AH, Gergen PJ, et al. Prevalence of allergic sensitization in the United States: results from the National Health and Nutrition Examination Survey (NHANES) 2005-2006. J Allergy Clin Immunol. 2014;134:350–9.CrossRefPubMedPubMedCentral
5.
go back to reference Tanaka K, Miyake Y, Kiyohara C. Environmental factors and allergic disorders. Allergol Int. 2007;56:363–96.CrossRefPubMed Tanaka K, Miyake Y, Kiyohara C. Environmental factors and allergic disorders. Allergol Int. 2007;56:363–96.CrossRefPubMed
6.
go back to reference Braun-Fahrlander C, Gassner M, Grize L, Neu U, Sennhauser FH, Varonier HS, Vuille JC, Wuthrich B. Prevalence of hay fever and allergic sensitization in farmer’s children and their peers living in the same rural community. SCARPOL team. Swiss study on childhood allergy and respiratory symptoms with respect to air pollution. Clin Exp Allergy. 1999;29:28–34.CrossRefPubMed Braun-Fahrlander C, Gassner M, Grize L, Neu U, Sennhauser FH, Varonier HS, Vuille JC, Wuthrich B. Prevalence of hay fever and allergic sensitization in farmer’s children and their peers living in the same rural community. SCARPOL team. Swiss study on childhood allergy and respiratory symptoms with respect to air pollution. Clin Exp Allergy. 1999;29:28–34.CrossRefPubMed
7.
go back to reference von Mutius E, Vercelli D. Farm living: effects on childhood asthma and allergy. Nat Rev Immunol. 2010;10:861–8.CrossRef von Mutius E, Vercelli D. Farm living: effects on childhood asthma and allergy. Nat Rev Immunol. 2010;10:861–8.CrossRef
8.
go back to reference Gergen PJ, Turkeltaub PC, Kovar MG. The prevalence of allergic skin test reactivity to eight common aeroallergens in the US population: results from the second National Health and Nutrition Examination Survey. J Allergy Clin Immunol. 1987;80:669–79.CrossRefPubMed Gergen PJ, Turkeltaub PC, Kovar MG. The prevalence of allergic skin test reactivity to eight common aeroallergens in the US population: results from the second National Health and Nutrition Examination Survey. J Allergy Clin Immunol. 1987;80:669–79.CrossRefPubMed
9.
go back to reference Schafer T, Ruhdorfer S, Weigl L, Wessner D, Heinrich J, Wichmann HE, Ring J. School education and allergic sensitization in adults. Allergy. 2001;56:1206–10.CrossRefPubMed Schafer T, Ruhdorfer S, Weigl L, Wessner D, Heinrich J, Wichmann HE, Ring J. School education and allergic sensitization in adults. Allergy. 2001;56:1206–10.CrossRefPubMed
10.
go back to reference Schlaud M, Atzpodien K, Thierfelder W. Allergic diseases. Results from the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2007;50:701–10.CrossRefPubMed Schlaud M, Atzpodien K, Thierfelder W. Allergic diseases. Results from the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2007;50:701–10.CrossRefPubMed
11.
go back to reference D’Amato G, Cecchi L, D’Amato M, Liccardi G. Urban air pollution and climate change as environmental risk factors of respiratory allergy: an update. J Investig Allergol Clin Immunol. 2010;20:95–102 (quiz following 102).PubMed D’Amato G, Cecchi L, D’Amato M, Liccardi G. Urban air pollution and climate change as environmental risk factors of respiratory allergy: an update. J Investig Allergol Clin Immunol. 2010;20:95–102 (quiz following 102).PubMed
12.
go back to reference Bergmann KC, Heinrich J, Niemann H. Current status of allergy prevalence in Germany: position paper of the Environmental Medicine Commission of the Robert Koch Institute. Allergo J Int. 2016;25:6–10.CrossRefPubMedPubMedCentral Bergmann KC, Heinrich J, Niemann H. Current status of allergy prevalence in Germany: position paper of the Environmental Medicine Commission of the Robert Koch Institute. Allergo J Int. 2016;25:6–10.CrossRefPubMedPubMedCentral
13.
go back to reference Nakagomi T, Itaya H, Tominaga T, Yamaki M, Hisamatsu S, Nakagomi O. Is atopy increasing? Lancet. 1994;343:121–2.CrossRefPubMed Nakagomi T, Itaya H, Tominaga T, Yamaki M, Hisamatsu S, Nakagomi O. Is atopy increasing? Lancet. 1994;343:121–2.CrossRefPubMed
14.
go back to reference Linneberg A, Nielsen NH, Madsen F, Frølund L, Dirksen A, Jørgensen T. Increasing prevalence of allergic rhinitis symptoms in an adult Danish population. Allergy. 1999;54:1194–8.CrossRefPubMed Linneberg A, Nielsen NH, Madsen F, Frølund L, Dirksen A, Jørgensen T. Increasing prevalence of allergic rhinitis symptoms in an adult Danish population. Allergy. 1999;54:1194–8.CrossRefPubMed
15.
16.
go back to reference Law M, Morris JK, Wald N, Luczynska C, Burney P. Changes in atopy over a quarter of a century, based on cross sectional data at three time periods. BMJ. 2005;330:1187–8.CrossRefPubMedPubMedCentral Law M, Morris JK, Wald N, Luczynska C, Burney P. Changes in atopy over a quarter of a century, based on cross sectional data at three time periods. BMJ. 2005;330:1187–8.CrossRefPubMedPubMedCentral
17.
go back to reference Linneberg A, Gislum M, Johansen N, Husemoen LL, Jorgensen T. Temporal trends of aeroallergen sensitization over twenty-five years. Clin Exp Allergy. 2007;37:1137–42.CrossRefPubMed Linneberg A, Gislum M, Johansen N, Husemoen LL, Jorgensen T. Temporal trends of aeroallergen sensitization over twenty-five years. Clin Exp Allergy. 2007;37:1137–42.CrossRefPubMed
18.
go back to reference Ronmark E, Bjerg A, Perzanowski M, Platts-Mills T, Lundback B. Major increase in allergic sensitization in schoolchildren from 1996 to 2006 in northern Sweden. J Allergy Clin Immunol. 2009;124:357–63.CrossRefPubMedPubMedCentral Ronmark E, Bjerg A, Perzanowski M, Platts-Mills T, Lundback B. Major increase in allergic sensitization in schoolchildren from 1996 to 2006 in northern Sweden. J Allergy Clin Immunol. 2009;124:357–63.CrossRefPubMedPubMedCentral
19.
go back to reference Braun-Fahrlander C, Gassner M, Grize L, Takken-Sahli K, Neu U, Stricker T, Varonier HS, Wuthrich B, Sennhauser FH, Swiss Study on Childhood A, et al. No further increase in asthma, hay fever and atopic sensitisation in adolescents living in Switzerland. Eur Respir J. 2004;23:407–13.CrossRefPubMed Braun-Fahrlander C, Gassner M, Grize L, Takken-Sahli K, Neu U, Stricker T, Varonier HS, Wuthrich B, Sennhauser FH, Swiss Study on Childhood A, et al. No further increase in asthma, hay fever and atopic sensitisation in adolescents living in Switzerland. Eur Respir J. 2004;23:407–13.CrossRefPubMed
20.
go back to reference Zollner IK, Weiland SK, Piechotowski I, Gabrio T, von Mutius E, Link B, Pfaff G, Kouros B, Wuthe J. No increase in the prevalence of asthma, allergies, and atopic sensitisation among children in Germany: 1992–2001. Thorax. 2005;60:545–8.CrossRefPubMedPubMedCentral Zollner IK, Weiland SK, Piechotowski I, Gabrio T, von Mutius E, Link B, Pfaff G, Kouros B, Wuthe J. No increase in the prevalence of asthma, allergies, and atopic sensitisation among children in Germany: 1992–2001. Thorax. 2005;60:545–8.CrossRefPubMedPubMedCentral
21.
go back to reference Grize L, Gassner M, Wuthrich B, Bringolf-Isler B, Takken-Sahli K, Sennhauser FH, Stricker T, Eigenmann PA, Braun-Fahrlander C. Trends in prevalence of asthma, allergic rhinitis and atopic dermatitis in 5–7-year old Swiss children from 1992 to 2001. Allergy. 2006;61:556–62.CrossRefPubMed Grize L, Gassner M, Wuthrich B, Bringolf-Isler B, Takken-Sahli K, Sennhauser FH, Stricker T, Eigenmann PA, Braun-Fahrlander C. Trends in prevalence of asthma, allergic rhinitis and atopic dermatitis in 5–7-year old Swiss children from 1992 to 2001. Allergy. 2006;61:556–62.CrossRefPubMed
22.
go back to reference Asher MI, Montefort S, Bjorksten B, Lai CK, Strachan DP, Weiland SK, Williams H. Worldwide time trends in the prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and eczema in childhood: ISAAC phases one and three repeat multicountry cross-sectional surveys. Lancet. 2006;368:733–43.CrossRefPubMed Asher MI, Montefort S, Bjorksten B, Lai CK, Strachan DP, Weiland SK, Williams H. Worldwide time trends in the prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and eczema in childhood: ISAAC phases one and three repeat multicountry cross-sectional surveys. Lancet. 2006;368:733–43.CrossRefPubMed
23.
go back to reference Warm K, Lindberg A, Lundback B, Ronmark E. Increase in sensitization to common airborne allergens among adults—two population-based studies 15 years apart. Allergy Asthma Clin Immunol. 2013;9:20.CrossRefPubMedPubMedCentral Warm K, Lindberg A, Lundback B, Ronmark E. Increase in sensitization to common airborne allergens among adults—two population-based studies 15 years apart. Allergy Asthma Clin Immunol. 2013;9:20.CrossRefPubMedPubMedCentral
24.
go back to reference General Assembly of the World Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. J Am Coll Dent. 2014;81:14–8. General Assembly of the World Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. J Am Coll Dent. 2014;81:14–8.
25.
go back to reference Cevallos M, Poole C, von Elm E, Altman D, Egger M. Response to Rezaeian: strengthening the reporting of observational studies in epidemiology (STROBE) extension for ecological studies. J Clin Epidemiol. 2014;67:837–8.CrossRefPubMed Cevallos M, Poole C, von Elm E, Altman D, Egger M. Response to Rezaeian: strengthening the reporting of observational studies in epidemiology (STROBE) extension for ecological studies. J Clin Epidemiol. 2014;67:837–8.CrossRefPubMed
26.
go back to reference Imhof K, Probst E, Seifert B, Regenass S, Schmid-Grendelmeier P. Ash pollen allergy: reliable detection of sensitization on the basis of IgE to Ole e 1. Allergo J Int. 2014;23:78–83.CrossRefPubMedPubMedCentral Imhof K, Probst E, Seifert B, Regenass S, Schmid-Grendelmeier P. Ash pollen allergy: reliable detection of sensitization on the basis of IgE to Ole e 1. Allergo J Int. 2014;23:78–83.CrossRefPubMedPubMedCentral
27.
go back to reference Asher MI, Keil U, Anderson HR, Beasley R, Crane J, Martinez F, Mitchell EA, Pearce N, Sibbald B, Stewart AW, et al. International Study of Asthma and Allergies in Childhood (ISAAC): rationale and methods. Eur Respir J. 1995;8:483–91.CrossRefPubMed Asher MI, Keil U, Anderson HR, Beasley R, Crane J, Martinez F, Mitchell EA, Pearce N, Sibbald B, Stewart AW, et al. International Study of Asthma and Allergies in Childhood (ISAAC): rationale and methods. Eur Respir J. 1995;8:483–91.CrossRefPubMed
28.
go back to reference Wuthrich B, Schindler C, Leuenberger P, Ackermann-Liebrich U. Prevalence of atopy and pollinosis in the adult population of Switzerland (SAPALDIA study). Swiss study on air pollution and lung diseases in adults. Int Arch Allergy Immunol. 1995;106:149–56.CrossRefPubMed Wuthrich B, Schindler C, Leuenberger P, Ackermann-Liebrich U. Prevalence of atopy and pollinosis in the adult population of Switzerland (SAPALDIA study). Swiss study on air pollution and lung diseases in adults. Int Arch Allergy Immunol. 1995;106:149–56.CrossRefPubMed
29.
go back to reference Pallasaho P, Ronmark E, Haahtela T, Sovijarvi AR, Lundback B. Degree and clinical relevance of sensitization to common allergens among adults: a population study in Helsinki, Finland. Clin Exp Allergy. 2006;36:503–9.CrossRefPubMed Pallasaho P, Ronmark E, Haahtela T, Sovijarvi AR, Lundback B. Degree and clinical relevance of sensitization to common allergens among adults: a population study in Helsinki, Finland. Clin Exp Allergy. 2006;36:503–9.CrossRefPubMed
30.
go back to reference Henriksen L, Simonsen J, Haerskjold A, Linder M, Kieler H, Thomsen SF, Stensballe LG. Incidence rates of atopic dermatitis, asthma, and allergic rhinoconjunctivitis in Danish and Swedish children. J Allergy Clin Immunol. 2015;136(360–366):e362. Henriksen L, Simonsen J, Haerskjold A, Linder M, Kieler H, Thomsen SF, Stensballe LG. Incidence rates of atopic dermatitis, asthma, and allergic rhinoconjunctivitis in Danish and Swedish children. J Allergy Clin Immunol. 2015;136(360–366):e362.
31.
go back to reference Langen U, Schmitz R, Steppuhn H. Prevalence of allergic diseases in Germany: results of the German Health Interview and Examination Survey for Adults (DEGS1). Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2013;56:698–706.CrossRefPubMed Langen U, Schmitz R, Steppuhn H. Prevalence of allergic diseases in Germany: results of the German Health Interview and Examination Survey for Adults (DEGS1). Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2013;56:698–706.CrossRefPubMed
32.
go back to reference Lee KS, Rha YH, Oh IH, Choi YS, Choi SH. Socioeconomic and sociodemographic factors related to allergic diseases in Korean adolescents based on the Seventh Korea Youth Risk Behavior Web-based Survey: a cross-sectional study. BMC Pediatr. 2016;16:19.CrossRefPubMedPubMedCentral Lee KS, Rha YH, Oh IH, Choi YS, Choi SH. Socioeconomic and sociodemographic factors related to allergic diseases in Korean adolescents based on the Seventh Korea Youth Risk Behavior Web-based Survey: a cross-sectional study. BMC Pediatr. 2016;16:19.CrossRefPubMedPubMedCentral
33.
go back to reference Von Linstow ML, Porsbjerg C, Ulrik CS, Nepper-Christensen S, Backer V. Prevalence and predictors of atopy among young Danish adults. Clin Exp Allergy. 2002;32:520–5.CrossRef Von Linstow ML, Porsbjerg C, Ulrik CS, Nepper-Christensen S, Backer V. Prevalence and predictors of atopy among young Danish adults. Clin Exp Allergy. 2002;32:520–5.CrossRef
34.
go back to reference PausJenssen ES, Cockcroft DW. Sex differences in asthma, atopy, and airway hyperresponsiveness in a university population. Ann Allergy Asthma Immunol. 2003;91:34–7.CrossRefPubMed PausJenssen ES, Cockcroft DW. Sex differences in asthma, atopy, and airway hyperresponsiveness in a university population. Ann Allergy Asthma Immunol. 2003;91:34–7.CrossRefPubMed
35.
go back to reference Bousquet J, Anto JM, Bachert C, Bousquet PJ, Colombo P, Crameri R, Daeron M, Fokkens W, Leynaert B, Lahoz C, et al. Factors responsible for differences between asymptomatic subjects and patients presenting an IgE sensitization to allergens. A GA2LEN project. Allergy. 2006;61:671–80.CrossRefPubMed Bousquet J, Anto JM, Bachert C, Bousquet PJ, Colombo P, Crameri R, Daeron M, Fokkens W, Leynaert B, Lahoz C, et al. Factors responsible for differences between asymptomatic subjects and patients presenting an IgE sensitization to allergens. A GA2LEN project. Allergy. 2006;61:671–80.CrossRefPubMed
36.
go back to reference Arbes SJ Jr, Gergen PJ, Elliott L, Zeldin DC. Prevalences of positive skin test responses to 10 common allergens in the US population: results from the third National Health and Nutrition Examination Survey. J Allergy Clin Immunol. 2005;116:377–83.CrossRefPubMed Arbes SJ Jr, Gergen PJ, Elliott L, Zeldin DC. Prevalences of positive skin test responses to 10 common allergens in the US population: results from the third National Health and Nutrition Examination Survey. J Allergy Clin Immunol. 2005;116:377–83.CrossRefPubMed
37.
go back to reference Bousquet PJ, Castelli C, Daures JP, Heinrich J, Hooper R, Sunyer J, Wjst M, Jarvis D, Burney P. Assessment of allergen sensitization in a general population-based survey (European Community Respiratory Health Survey I). Ann Epidemiol. 2010;20:797–803.CrossRefPubMed Bousquet PJ, Castelli C, Daures JP, Heinrich J, Hooper R, Sunyer J, Wjst M, Jarvis D, Burney P. Assessment of allergen sensitization in a general population-based survey (European Community Respiratory Health Survey I). Ann Epidemiol. 2010;20:797–803.CrossRefPubMed
38.
go back to reference Toppila-Salmi S, Huhtala H, Karjalainen J, Renkonen R, Makela MJ, Wang DY, Pekkanen J. Sensitization pattern affects the asthma risk in Finnish adult population. Allergy. 2015;70:1112–20.CrossRefPubMed Toppila-Salmi S, Huhtala H, Karjalainen J, Renkonen R, Makela MJ, Wang DY, Pekkanen J. Sensitization pattern affects the asthma risk in Finnish adult population. Allergy. 2015;70:1112–20.CrossRefPubMed
39.
go back to reference Valero A, Pereira C, Loureiro C, Martinez-Cocera C, Murio C, Rico P, Palomino R, Davila I. Interrelationship between skin sensitization, rhinitis, and asthma in patients with allergic rhinitis: a study of Spain and Portugal. J Investig Allergol Clin Immunol. 2009;19:167–72.PubMed Valero A, Pereira C, Loureiro C, Martinez-Cocera C, Murio C, Rico P, Palomino R, Davila I. Interrelationship between skin sensitization, rhinitis, and asthma in patients with allergic rhinitis: a study of Spain and Portugal. J Investig Allergol Clin Immunol. 2009;19:167–72.PubMed
40.
go back to reference Pinart M, Benet M, Annesi-Maesano I, von Berg A, Berdel D, Carlsen KC, Carlsen KH, Bindslev-Jensen C, Eller E, Fantini MP, et al. Comorbidity of eczema, rhinitis, and asthma in IgE-sensitised and non-IgE-sensitised children in MeDALL: a population-based cohort study. Lancet Respir Med. 2014;2:131–40.CrossRefPubMed Pinart M, Benet M, Annesi-Maesano I, von Berg A, Berdel D, Carlsen KC, Carlsen KH, Bindslev-Jensen C, Eller E, Fantini MP, et al. Comorbidity of eczema, rhinitis, and asthma in IgE-sensitised and non-IgE-sensitised children in MeDALL: a population-based cohort study. Lancet Respir Med. 2014;2:131–40.CrossRefPubMed
Metadata
Title
Atopy and related clinical symptoms among Swiss medical students from 2007 to 2015
Authors
Lukas Steinegger
Stephan Regenass
Lucas M. Bachmann
Elsbeth Probst
Urs C. Steiner
Publication date
01-12-2018
Publisher
BioMed Central
Published in
Allergy, Asthma & Clinical Immunology / Issue 1/2018
Electronic ISSN: 1710-1492
DOI
https://doi.org/10.1186/s13223-018-0230-4

Other articles of this Issue 1/2018

Allergy, Asthma & Clinical Immunology 1/2018 Go to the issue