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Clinical and Translational Allergy
Published in: Clinical and Translational Allergy 1/2016

Open Access 01-12-2016 | Research

Different risk factor patterns for adult asthma, rhinitis and eczema: results from West Sweden Asthma Study

Authors: Erik P. Rönmark, Linda Ekerljung, Roxana Mincheva, Sigrid Sjölander, Stig Hagstad, Göran Wennergren, Eva Rönmark, Jan Lötvall, Bo Lundbäck

Published in: Clinical and Translational Allergy | Issue 1/2016

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Abstract

Background

Atopic diseases including asthma, rhinitis and eczema have increased in the second half of the past century. This has been well studied among children and adolescents but with the exception of asthma to a much lesser extent in adults. The adult risk factor pattern of atopic diseases, in particular of eczema, and their relation to allergic sensitization are yet to be fully elucidated. Studies among adults that have compared the risk factor pattern for these conditions in the same material are very few. The objective of this study was to compare the risk factor patterns for asthma, rhinitis and eczema in a randomly selected adult population.

Methods

A questionnaire survey on atopic diseases was dispatched by mail to 30,000 randomly selected individuals in West Sweden aged 16–75 years and 62 % participated. A subgroup of 2000 individuals was selected for clinical examinations including blood sampling for specific serum Immunoglobulin E to common airborne allergens and 1172 attended.

Results

The prevalence of current asthma was 11.8 %, current rhinitis 42.8 %, current eczema 13.5 and 2.3 % had all three conditions while 13.9 % had at least two conditions. No mutual risk factor was identified for all three conditions. Allergic sensitization was a strong risk factor for current asthma (OR 4.1 CI 2.7–6.3) and current rhinitis (OR 5.1 CI 3.8–6.9) but not so for current eczema. Obesity was a risk factor for current asthma and current rhinitis, while farm childhood decreased the risk for current asthma and current rhinitis. Occupational exposure to gas dust or fumes and female sex was associated with an increased risk of current asthma and current eczema.

Conclusions

There are different risk factor patterns for asthma, rhinitis and eczema in adults but some risk factors are overlapping between some of the conditions. The effect of mutable risk factors should be assessed further in longitudinal studies.
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Literature
1.
Bantz SK, Zhu Z, Zheng T. The atopic march: progression from atopic dermatitis to allergic rhinitis and asthma. J Clin Cell Immunol. 2014;5(2).
2.
Spergel JM, Paller AS. Atopic dermatitis and the atopic march. J Allergy Clin Immunol. 2003;112(6 Suppl):S118–27.PubMedCrossRef
3.
4.
Illi S, von Mutius E, Lau S, Nickel R, Gruber C, Niggemann B, et al. The natural course of atopic dermatitis from birth to age 7 years and the association with asthma. J Allergy Clin Immunol. 2004;113(5):925–31.PubMedCrossRef
5.
Gustafsson D, Sjoberg O, Foucard T. Development of allergies and asthma in infants and young children with atopic dermatitis—a prospective follow-up to 7 years of age. Allergy. 2000;55(3):240–5.PubMedCrossRef
6.
7.
Holgate ST. The epithelium takes centre stage in asthma and atopic dermatitis. Trends Immunol. 2007;28(6):248–51.PubMedCrossRef
8.
Bulek K, Swaidani S, Aronica M, Li X. Epithelium: the interplay between innate and Th2 immunity. Immunol Cell Biol. 2010;88(3):257–68.PubMedCrossRef
9.
Scott IR, Harding CR. Filaggrin breakdown to water binding compounds during development of the rat stratum corneum is controlled by the water activity of the environment. Dev Biol. 1986;115(1):84–92.PubMedCrossRef
10.
Palmer CN, Irvine AD, Terron-Kwiatkowski A, Zhao Y, Liao H, Lee SP, et al. Common loss-of-function variants of the epidermal barrier protein filaggrin are a major predisposing factor for atopic dermatitis. Nat Genet. 2006;38(4):441–6.PubMedCrossRef
11.
Rodriguez E, Baurecht H, Herberich E, Wagenpfeil S, Brown SJ, Cordell HJ, et al. Meta-analysis of filaggrin polymorphisms in eczema and asthma: robust risk factors in atopic disease. J Allergy Clin Immunol. 2009;123(6):1361–70 (e7).PubMedCrossRef
12.
Weidinger S, O’Sullivan M, Illig T, Baurecht H, Depner M, Rodriguez E, et al. Filaggrin mutations, atopic eczema, hay fever, and asthma in children. J Allergy Clin Immunol. 2008;121(5):1203–9 (e1).PubMedCrossRef
13.
Neuman A, Hohmann C, Orsini N, Pershagen G, Eller E, Kjaer HF, et al. Maternal smoking in pregnancy and asthma in preschool children: a pooled analysis of eight birth cohorts. Am J Respir Crit Care Med. 2012;186(10):1037–43. doi:10.​1164/​rccm.​201203-0501OC.PubMedCrossRef
14.
Bergmann RL, Edenharter G, Bergmann KE, Lau S, Wahn U. Socioeconomic status is a risk factor for allergy in parents but not in their children. Clin Exp Allergy. 2000;30(12):1740–5.PubMedCrossRef
15.
Silverberg JI, Greenland P. Eczema and cardiovascular risk factors in 2 US adult population studies. J Allergy Clin Immunol. 2015;135(3):721–8 (e6).PubMedCrossRef
16.
Silverberg JI, Hanifin JM. Adult eczema prevalence and associations with asthma and other health and demographic factors: a US population-based study. J Allergy Clin Immunol. 2013;132(5):1132–8.PubMedCrossRef
17.
Hanifin JM, Reed ML. A population-based survey of eczema prevalence in the United States. Dermatitis. 2007;18(2):82–91.PubMedCrossRef
18.
Lotvall J, Ekerljung L, Ronmark EP, Wennergren G, Linden A, Ronmark E, et al. West Sweden Asthma Study: prevalence trends over the last 18 years argues no recent increase in asthma. Respir Res. 2009;10:94.PubMedPubMedCentralCrossRef
19.
Ronmark EP, Ekerljung L, Lotvall J, Toren K, Ronmark E, Lundback B. Large scale questionnaire survey on respiratory health in Sweden: effects of late- and non-response. Respir Med. 2009;103(12):1807–15.PubMedCrossRef
20.
Lundback B, Nystrom L, Rosenhall L, Stjernberg N. Obstructive lung disease in northern Sweden: respiratory symptoms assessed in a postal survey. Eur Respir J. 1991;4(3):257–66.PubMed
21.
Pallasaho P, Lundback B, Laspa SL, Jonsson E, Kotaniemi J, Sovijarvi AR, et al. Increasing prevalence of asthma but not of chronic bronchitis in Finland? Report from the FinEsS-Helsinki Study. Respir Med. 1999;93(11):798–809.PubMedCrossRef
22.
Bousquet J, Burney PG, Zuberbier T, Cauwenberge PV, Akdis CA, Bindslev-Jensen C, et al. GA2LEN (Global Allergy and Asthma European Network) addresses the allergy and asthma ‘epidemic’. Allergy. 2009;64(7):969–77.PubMedCrossRef
23.
Lindberg M, Isacson D, Bingefors K. Self-reported skin diseases, quality of life and medication use: a nationwide pharmaco-epidemiological survey in Sweden. Acta Derm Venereol. 2014;94(2):188–91.PubMedCrossRef
24.
Pesce G, Marcon A, Carosso A, Antonicelli L, Cazzoletti L, Ferrari M, et al. Adult eczema in Italy: prevalence and associations with environmental factors. J Eur Acad Dermatol Venereol. 2015;29(6):1180–7.PubMedCrossRef
25.
Vinding GR, Zarchi K, Ibler KS, Miller IM, Ellervik C, Jemec GB. Is adult atopic eczema more common than we think?—a population-based study in Danish adults. Acta Derm Venereol. 2014;94(4):480–2.PubMedCrossRef
26.
Dennis RJ, Caraballo L, Garcia E, Rojas MX, Rondon MA, Perez A, et al. Prevalence of asthma and other allergic conditions in Colombia 2009–2010: a cross-sectional study. BMC Pulm Med. 2012;12:17.PubMedPubMedCentralCrossRef
27.
Wang J, Engvall K, Smedje G, Norback D. Rhinitis, asthma and respiratory infections among adults in relation to the home environment in multi-family buildings in Sweden. PLoS ONE. 2014;9(8):e105125.PubMedPubMedCentralCrossRef
28.
Upton MN, McConnachie A, McSharry C, Hart CL, Smith GD, Gillis CR, et al. Intergenerational 20 year trends in the prevalence of asthma and hay fever in adults: the Midspan family study surveys of parents and offspring. BMJ. 2000;321(7253):88–92.PubMedPubMedCentralCrossRef
29.
Bjerg A, Ekerljung L, Middelveld R, Dahlen SE, Forsberg B, Franklin K, et al. Increased prevalence of symptoms of rhinitis but not of asthma between 1990 and 2008 in Swedish adults: comparisons of the ECRHS and GA(2)LEN surveys. PLoS ONE. 2011;6(2):e16082.PubMedPubMedCentralCrossRef
30.
Linneberg A, Jorgensen T, Nielsen NH, Madsen F, Frolund L, Dirksen A. The prevalence of skin-test-positive allergic rhinitis in Danish adults: two cross-sectional surveys 8 years apart. The Copenhagen Allergy Study. Allergy. 2000;55(8):767–72.PubMedCrossRef
31.
de Marco R, Cappa V, Accordini S, Rava M, Antonicelli L, Bortolami O, et al. Trends in the prevalence of asthma and allergic rhinitis in Italy between 1991 and 2010. Eur Respir J. 2012;39(4):883–92.PubMedCrossRef
32.
Pallasaho P, Juusela M, Lindqvist A, Sovijarvi A, Lundback B, Ronmark E. Allergic rhinoconjunctivitis doubles the risk for incident asthma–results from a population study in Helsinki, Finland. Respir Med. 2011;105(10):1449–56.PubMedCrossRef
33.
James AL, Knuiman MW, Divitini ML, Hui J, Hunter M, Palmer LJ, et al. Changes in the prevalence of asthma in adults since 1966: the Busselton health study. Eur Respir J. 2010;35(2):273–8.PubMedCrossRef
34.
Kainu A, Pallasaho P, Piirila P, Lindqvist A, Sovijarvi A, Pietinalho A. Increase in prevalence of physician-diagnosed asthma in Helsinki during the Finnish Asthma Programme: improved recognition of asthma in primary care? A cross-sectional cohort study. Prim Care Respir J. 2013;22(1):64–71.PubMedCrossRef
35.
Browatzki A, Ulrik CS, Lange P. Prevalence and severity of self-reported asthma in young adults, 1976–2004. Eur Respir J. 2009;34(5):1046–51.PubMedCrossRef
36.
Thuesen BH, Heede NG, Tang L, Skaaby T, Thyssen JP, Friedrich N, et al. No association between vitamin D and atopy, asthma, lung function or atopic dermatitis: a prospective study in adults. Allergy. 2015;70(11):1501–4.PubMedCrossRef
37.
38.
Wuthrich B. Clinical aspects, epidemiology, and prognosis of atopic dermatitis. Ann Allergy Asthma Immunol. 1999;83(5):464–70.PubMedCrossRef
39.
Harrop J, Chinn S, Verlato G, Olivieri M, Norback D, Wjst M, et al. Eczema, atopy and allergen exposure in adults: a population-based study. Clin Exp Allergy. 2007;37(4):526–35.PubMedCrossRef
40.
Thyssen JP, Tang L, Husemoen LL, Stender S, Szecsi PB, Menne T, et al. Filaggrin gene mutations are not associated with food and aeroallergen sensitization without concomitant atopic dermatitis in adults. J Allergy Clin Immunol. 2015;135(5):1375–8 (e1).PubMedCrossRef
41.
Williams HC, Burney PG, Hay RJ, Archer CB, Shipley MJ, Hunter JJ, et al. The U.K. Working Party’s Diagnostic Criteria for Atopic Dermatitis. I. Derivation of a minimum set of discriminators for atopic dermatitis. Br J Dermatol. 1994;131(3):383–96.PubMedCrossRef
42.
Backman H, Hedman L, Jansson SA, Lindberg A, Lundback B, Ronmark E. Prevalence trends in respiratory symptoms and asthma in relation to smoking—two cross-sectional studies ten years apart among adults in northern Sweden. World Allergy Organ J. 2014;7(1):1.PubMedPubMedCentralCrossRef
43.
Eriksson J, Ekerljung L, Lotvall J, Pullerits T, Wennergren G, Ronmark E, et al. Growing up on a farm leads to lifelong protection against allergic rhinitis. Allergy. 2010;65(11):1397–403.PubMedCrossRef
44.
Sybilski AJ, Raciborski F, Lipiec A, Tomaszewska A, Lusawa A, Samel-Kowalik P, et al. Epidemiology of atopic dermatitis in Poland according to the Epidemiology of Allergic Disorders in Poland (ECAP) study. J Dermatol. 2015;42(2):140–7.PubMedCrossRef
45.
Hedlund U, Eriksson K, Ronmark E. Socio-economic status is related to incidence of asthma and respiratory symptoms in adults. Eur Respir J. 2006;28(2):303–10.PubMedCrossRef
46.
Schatz M, Camargo CA Jr. The relationship of sex to asthma prevalence, health care utilization, and medications in a large managed care organization. Ann Allergy Asthma Immunol. 2003;91(6):553–8.PubMedCrossRef
47.
Melgert BN, Ray A, Hylkema MN, Timens W, Postma DS. Are there reasons why adult asthma is more common in females? Curr Allergy Asthma Rep. 2007;7(2):143–50.PubMedCrossRef
48.
Xu X, Christiani DC. Occupational exposures and physician-diagnosed asthma. Chest. 1993;104(5):1364–70.PubMedCrossRef
49.
Halldin CN, Doney BC, Hnizdo E. Changes in prevalence of chronic obstructive pulmonary disease and asthma in the US population and associated risk factors. Chron Respir Dis. 2015;12(1):47–60.PubMedCrossRef
50.
Eagan TM, Gulsvik A, Eide GE, Bakke PS. Occupational airborne exposure and the incidence of respiratory symptoms and asthma. Am J Respir Crit Care Med. 2002;166(7):933–8.PubMedCrossRef
51.
Talay F, Kurt B, Tug T, Kurt OK, Goksugur N, Yasar Z. The prevalence of asthma and allergic diseases among adults 30–49 years of age in Bolu, Western Black Sea Region of Turkey. Clin Ter. 2014;165(1):e59–63.PubMed
52.
Traupe H, Menge G, Kandt I, Karmaus W. Higher frequency of atopic dermatitis and decrease in viral warts among children exposed to chemicals liberated in a chemical accident in Frankfurt, Germany. Dermatology. 1997;195(2):112–8.PubMedCrossRef
53.
Maestrelli P, Boschetto P, Fabbri LM, Mapp CE. Mechanisms of occupational asthma. J Allergy Clin Immunol. 2009;123(3):531–42 (quiz 43-4).PubMedCrossRef
54.
55.
Riedler J, Eder W, Oberfeld G, Schreuer M. Austrian children living on a farm have less hay fever, asthma and allergic sensitization. Clin Exp Allergy. 2000;30(2):194–200.PubMedCrossRef
56.
Kilpelainen M, Terho EO, Helenius H, Koskenvuo M. Farm environment in childhood prevents the development of allergies. Clin Exp Allergy. 2000;30(2):201–8.PubMedCrossRef
57.
Radon K, Schulze A, Nowak D. Inverse association between farm animal contact and respiratory allergies in adulthood: protection, underreporting or selection? Allergy. 2006;61(4):443–6.PubMedCrossRef
58.
Flohr C, Pascoe D, Williams HC. Atopic dermatitis and the ‘hygiene hypothesis’: Too clean to be true? Br J Dermatol. 2005;152(2):202–16.PubMedCrossRef
59.
Braback L, Hjern A, Rasmussen F. Trends in asthma, allergic rhinitis and eczema among Swedish conscripts from farming and non-farming environments. A nationwide study over three decades. Clin Exp Allergy. 2004;34(1):38–43.PubMedCrossRef
60.
Luder E, Ehrlich RI, Lou WY, Melnik TA, Kattan M. Body mass index and the risk of asthma in adults. Respir Med. 2004;98(1):29–37.PubMedCrossRef
61.
62.
Ronmark E, Andersson C, Nystrom L, Forsberg B, Jarvholm B, Lundback B. Obesity increases the risk of incident asthma among adults. Eur Respir J. 2005;25(2):282–8.PubMedCrossRef
63.
Guerra S, Sherrill DL, Bobadilla A, Martinez FD, Barbee RA. The relation of body mass index to asthma, chronic bronchitis, and emphysema. Chest. 2002;122(4):1256–63.PubMedCrossRef
64.
Huovinen E, Kaprio J, Koskenvuo M. Factors associated to lifestyle and risk of adult onset asthma. Respir Med. 2003;97(3):273–80.PubMedCrossRef
65.
Konno S, Hizawa N, Fukutomi Y, Taniguchi M, Kawagishi Y, Okada C, et al. The prevalence of rhinitis and its association with smoking and obesity in a nationwide survey of Japanese adults. Allergy. 2012;67(5):653–60.PubMedCrossRef
66.
Sybilski AJ, Raciborski F, Lipiec A, Tomaszewska A, Lusawa A, Furmanczyk K, et al. Obesity—a risk factor for asthma, but not for atopic dermatitis, allergic rhinitis and sensitization. Public Health Nutr. 2015;18(3):530–6.PubMedCrossRef
67.
Silverberg JI, Silverberg NB, Lee-Wong M. Association between atopic dermatitis and obesity in adulthood. Br J Dermatol. 2012;166(3):498–504.PubMedCrossRef
68.
Flohr C, Weinmayr G, Weiland SK, Addo-Yobo E, Annesi-Maesano I, Bjorksten B, et al. How well do questionnaires perform compared with physical examination in detecting flexural eczema? Findings from the International Study of Asthma and Allergies in Childhood (ISAAC) Phase Two. Br J Dermatol. 2009;161(4):846–53.PubMedCrossRef
Metadata
Title
Different risk factor patterns for adult asthma, rhinitis and eczema: results from West Sweden Asthma Study
Authors
Erik P. Rönmark
Linda Ekerljung
Roxana Mincheva
Sigrid Sjölander
Stig Hagstad
Göran Wennergren
Eva Rönmark
Jan Lötvall
Bo Lundbäck
Publication date
01-12-2016
Publisher
BioMed Central
Published in
Clinical and Translational Allergy / Issue 1/2016
Electronic ISSN: 2045-7022
DOI
https://doi.org/10.1186/s13601-016-0112-0

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