[Show abstract][Hide abstract] ABSTRACT: There is only little and furthermore conflicting knowledge about the relationship between passive smoking and allergy in adults. In this work, we assess the association between exposure to environmental tobacco smoke (ETS) at home or at work, and allergic sensitization and allergic rhinitis in 4093 German adults.
Our study population comes from the German National Health Survey 1998 of which we analyzed 4093 adults (17-79 years) being non-smokers and having complete information on passive smoking and allergy. The association between ETS exposure and allergic sensitization and allergic rhinitis was assessed using logistic regression models.
The effect of ETS exposure on allergic sensitization was biggest at the workplace [adjusted OR = 1.17 (0.97, 1.41)]; the same could be observed with respect to allergic rhinitis [adjusted OR = 1.20 (0.96, 1.51)]. There was no effect of ETS exposure at home on both allergic sensitization [adjusted OR = 0.99 (0.76, 1.29)] and allergic rhinitis [adjusted OR = 1.05 (0.76, 1.43)] in our analysis.
The findings from our study show a statistically non-significant tendency that exposure to ETS at the workplace increases allergic sensitization and allergic rhinitis in adults. This tendency could not be observed with respect to ETS exposure at home.
Exposure to ETS at the workplace should be minimized in order to reduce the risk of allergic sensitization, and allergic rhinitis.
[Show abstract][Hide abstract] ABSTRACT: Motor vehicle traffic contributes to more than 50% of PM10 in Europe and might have far reaching impacts on human health. We investigated the relationship between residential street type as a surrogate for traffic intensity and the prevalence of respiratory symptoms, atopic diseases, and allergic sensitization in adults. Data from 6896 subjects of the German Health Survey 1998 with complete information on residential street type were used. Multiple logistic regression analyses were applied to model associations between street type categories, and respiratory and atopic outcomes were assessed by screening questionnaire of The European Respiratory Health Survey and specific IgE measurements. Living at extremely or considerably busy roads (23.9% of total study population) compared to roads with no or rare traffic (64.5%) was statistically significantly associated with chronic bronchitis (aOR 1.36 (95% CI) (1.01-1.83)) while nocturnal coughing attacks (past 12 months) (1.24 (0.98-1.57)), wheeze during the past 12 months (1.21 (0.93-57)), and hay fever (1.16 (0.94-1.42)) were marginally increased after adjustment for several potential confounders and for multiple testing. No increased risks were found for asthma (0.97 (0.67-1.42)) and allergic sensitization (1.05 (0.91-1.20)). We conclude that exposure to traffic-related air pollutants increases the risk of nonallergic respiratory symptoms and to a lesser degree the risk of hay fever and allergic sensitization but not the risk of asthma in adults.
No preview · Article · Jul 2005 · Environmental Research
[Show abstract][Hide abstract] ABSTRACT: Studies on health effects of air pollutants ideally define exposure through the collection of air samples in the participants' homes. Concentrations derived from these samples are then considered as an estimate for the average concentration of air pollutants in the homes. Conclusions drawn from such studies therefore depend very much on the validity of the measured air pollution concentrations. In this paper we analysed repeated BTEX and NO(2) measurements with a time period of several months lying between the two conducted home visits. We investigated the variability of their concentrations over time by determining correlation coefficients and calculating within- and between-home variances. Our population consisted of 631 homes of participants from two cohort studies within the framework of the German study on Indoor Factors and Genetics in Asthma. Air pollutants were measured using passive samplers both indoors and outdoors. The measured BTEX concentrations were poorly correlated, with Pearson's correlation coefficient r ranging from -0.19 to 0.27. Additionally, a considerable seasonal effect could be observed. A higher correlation was found for the NO(2) concentrations with r ranging between 0.24 and 0.55. For the BTEX, the between-home variance was bigger than the within-home variance, for NO(2) both variances were of about the same order. Our results indicate that in a setting of moderate climate like in Germany, the variability of BTEX and NO(2) concentrations over time is high and a single measurement is a poor surrogate for the long-term concentrations of these air pollutants.
No preview · Article · Nov 2004 · Journal of Environmental Monitoring
[Show abstract][Hide abstract] ABSTRACT: Studies investigating the effect of exposure to indoor allergens and endotoxin on human respiratory health usually take dust samples only at one single point of time and consider them to be representative for the indoor biocontaminant burden during a time period of several years. This singly measured biocontaminant concentration is related to adverse respiratory outcomes such as asthma, wheeze or others.
We analysed two repeated measurements of mite and cat allergens in mattress and living room floor dust as well as endotoxin concentrations in living room floor dust. The repeated samples were taken over a time period of about 6 years. We investigated the repeatability over time of their concentrations by determining correlation coefficients and computing within- and between-home variance components.
Our analysis was based on the population of a study on Indoor Factors and Genetics in Asthma (INGA) being carried out in 1995/96 and followed up in 2000/01. Complete data were available from 152 participants.
The measured allergen concentrations were low and a considerable percentage of the values was below the limit of detection. The crude Spearman's rank correlation coefficients between the two measurements taken in 1995/96 and 2000/01 ranged from 0.32 to 0.61 for the dust mites allergens, from 0.21 to 0.44 for cat allergen and from 0.35 to 0.51 for endotoxin. Correlations were higher if measurements were performed on the same floor or the same mattress at both sampling time-points. The within-home variance for all measured biocontaminant concentrations was of about the same order as the between-home variance.
For studies like ours with low allergen and endotoxin concentrations, the repeatability of these concentrations over a time period as long as 6 years is low and a single measurement does not accurately reflect the true long-term exposure in the homes.
No preview · Article · Jan 2004 · Clinical & Experimental Allergy
[Show abstract][Hide abstract] ABSTRACT: Recently, a study of 330 adults reported increased systolic blood pressure and higher hypertension rates in men with rhinitis. We replicated this study using data from a population-based sample of 896 subjects participating in the European Respiratory Health Survey and in a study on "Monitoring of Trends and Determinants of Cardiovascular Diseases" in Erfurt, Germany. Rhinitis was assessed by questionnaire, blood pressure was measured using a standardized method, and subjects were asked about current use of any high blood pressure medication. After adjustment for age, body mass index, and smoking, neither average systolic (p = 0.17) nor diastolic blood pressure (p = 0.60) was statistically significantly different between men with and without rhinitis. The adjusted prevalence rate of hypertension was also not different between males with and without rhinitis (p = 0.25). In addition, no statistically significant associations between rhinitis and blood pressure were seen in women. We could not confirm the conclusion of the previous study that men with rhinitis need special attention for blood pressure control.
Full-text · Article · Dec 2003 · American Journal of Respiratory and Critical Care Medicine
[Show abstract][Hide abstract] ABSTRACT: Environmental exposure to endotoxin might have a crucial role in immune maturation and development of asthma.
The aim of this study was to investigate whether the effect of endotoxin concentration in settled house dust on asthma is modified by the presence of variation in the TLR4 gene.
We performed a cross-sectional study within the German follow-up of the European Community Respiratory Health Survey. Multivariate logistic regression analysis and nonparametric effect estimates (S-Plus) were applied to examine the association between endotoxin exposure and diagnosed asthma, related clinical symptoms, and bronchial hyperreactivity (BHR) stratified for noncarriers and carriers of G299/I399 polymorphism in the TLR4 gene.
In the noncarrier group (n = 279), the prevalence of asthma was significantly increased with elevated endotoxin levels in house dust with adjusted odds ratio 6.24 (95% CI, 1.33-29.17) in the second tertile, and 4.54 (95% CI, 0.94-21.96) in the third tertile compared with the lowest endotoxin tertile. The carriers of the polymorphisms (n = 55) showed a nonsignificant trend to have a lower risk of asthma (crude odds ratio, 0.67; 95% CI, 0.06-8.06 for the second tertile and 1.33; 95% CI, 0.17-10.58 for the third tertile). We found a similar association for wheeze and endotoxin exposure that was also attenuated in subjects with G299/I399 polymorphisms.
The G299/I399 polymorphisms were associated with a modified response to endotoxin, but the functional relationship still needs clarification.
No preview · Article · Sep 2003 · Journal of Allergy and Clinical Immunology