D. Eis

Robert Koch Institut, Berlin, Land Berlin, Germany

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Publications (50)57.27 Total impact

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    ABSTRACT: Im vorliegenden Beitrag wurden Zusammenhänge zwischen einer bestehenden Asthmaerkrankung und möglichen diesbezüglichen Einflussfaktoren auf der Datenbasis der „Studie zur Gesundheit von Kindern und Jugendlichen in Deutschland“ (KiGGS) untersucht. In dieser bundesweiten Querschnittstudie wurden zwischen 2003 und 2006 17.641 null- bis 17-jährige Kinder und Jugendliche untersucht. Die Datenerfassung umfasste eine ärztliche Untersuchung des Kindes, ein Interview der Eltern und schriftliche Fragebögen. Neben Prävalenzschätzungen wurden multivariate logistische Regressionsanalysen durchgeführt. Zunehmendes Alter und männliches Geschlecht, eine atopische Vorerkrankung des Kindes, eine positive Familienanamnese für allergische Erkrankungen sowie ein niedriges Geburtsgewicht erhöhten das Risiko für Asthma bronchiale signifikant, ebenso Übergewicht und schimmlige Wände in der Wohnung. Das Stillen hatte keine schützende Wirkung. Ein niedriges Alter der Mutter bei der Geburt und Leben in ländlichen oder kleinstädtischen Regionen erwiesen sich als protektiv. Insgesamt zeigte sich, dass die genetische Prädisposition und eine atopische Vorerkrankung des Kindes die stärksten Risikofaktoren für Asthma bronchiale sind. Aber auch Umweltfaktoren (schimmlige Wände, Leben in ländlichen und kleinstädtischen Gemeinden) und einzelne Lebensstilfaktoren spielten eine modifizierende Rolle.
    No preview · Article · Mar 2012 · Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz
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    ABSTRACT: In this study, associations between current asthma and possible determinants were studied using data of the German Health Interview and Examination Survey for Children and Adolescents ("Studie zur Gesundheit von Kindern und Jugendlichen in Deutschland," KiGGS). In this nationwide cross-sectional survey, 17,461 subjects aged 0-17 years were examined between 2003 and 2006. Data collection included a medical examination of the child, an interview of the parents, and written questionnaires. Apart from prevalence estimates, multivariate logistic regression analyses were performed. Increasing age and male sex, previous atopic diseases of the child, a positive family history of allergic diseases and low birth weight were significant risk factors of asthma, as were overweight and moldy walls in the residence. Breast feeding was not associated with a reduced risk of asthma. Low age at delivery of the mother and living in rural or provincial regions were shown to be protected. Overall, this study suggests that allergies of the parents and previous atopic disease of the child are the strongest determinants of asthma. However, environmental factors (mold on walls, living in rural and provincial towns) and lifestyle factors could also modify asthma risk.
    No preview · Article · Mar 2012 · Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz
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    Dieter Helm · Detlef Laussmann · Dieter Eis
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    ABSTRACT: Since long, socio-economic status, often expressed as an index, is known to correlate with health outcomes like behavioural problems. We constructed a new index that encapsulated not only economic and social but also environmental stressors (ESES), using data of the German Health Interview and Examination Survey for Children and Adolescents, a nation-wide representative surveillance of 17,641 participants aged between 0-17 years. Different factors were selected to account for socio-economic stress (low parental education, low household income, low occupational status of the householder), domestic stress (living in large cities, exposure to tobacco smoke at home, crowded housing, mouldy walls), and prenatal stress (maternal smoking during pregnancy, drinking alcohol during pregnancy). Prior to the calculation of ESES, the different factors were multiplied by weights which were estimated by multivariate linear regression on a number of health outcomes. ESES was then used to predict emotional and social problems (SDQ scores). The resulting ORs were compared with those obtained for an established socio-economic index (SEI). ESES was superior to SEI as it could more clearly identify children and adolescents with emotional or social problems. Different types of stressors (i.e. socio-economic stress, domestic stress and prenatal stress) contributed independently to emotional and social problems.
    Preview · Article · Mar 2010 · Central European journal of public health
  • Dieter Eis

    No preview · Article · Jun 2009 · International journal of hygiene and environmental health
  • Detlef Laußmann · Dieter Eis
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    ABSTRACT: In order to determine the penetration rate of outdoor particles Into indoor environments a study was performed on six unoccupied office rooms with different air tightness. Five office rooms had older wooden framed double-glazed windows. The office room with relatively high air tightness was equipped with single insulating-glazed vinyl framed windows with rubbery weather strips. The penetration factors for particles in the size range of aerodynamic equivalent diameters between > 0.3 μm and > 5 μm were derived on the base of a steady-state model, described in the present contribution.The required model parameters, air change rate and size specific particle deposition rates, were estimated from the appropriate decay curves (CO2 concentration and particle number concentrations, respectively). After declining the indoor particle concentration to equilibrium, outdoor measurements of particles were undertaken for estimation of size specific indoor/ outdoor concentration ratios. The different air tightness of the investigated rooms manifests in the measured average air change rates (0.42 h-1 vs. 0.17 h-1 in the room with vinyl framed windows) as well as in the different Indoor/outdoor particle ratios. Depending on the particle size the I/ O ratios were about a factor of 2 to 30 higher In the rooms with old wooden framed windows then in the room with vinyl framed windows. The corresponding penetration factors differed about a factor 1.3 to 10 between both room types. As expected, airtight buildings equipped with tight windows are better sealed against outdoor particles. Depending on their particle sizes this diminishes the exposure of the occupants to particulate matter of outdoor origin. Although, as a result of limited exfiltration capacity of tight closing windows, the air quality can be affected in the presence of indoor sources in such rooms.
    No preview · Article · Jan 2009 · Umweltmedizin in Forschung und Praxis
  • Detlef Laußmann · Dieter Eis
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    ABSTRACT: Within a subsample of an out-patient based study on environment related complaints we investigated, whether VOC concentrations and ventilation rates in patients‘ dwellings are statistically associated with complaints, e.g. fatigue and appraised affinity towards infections. In the dwellings of around 50 "environmental patients", volatile organic compounds, ventilation rates and humidity were measured, each under worst case conditions. An environmentalmedicine questionnaire (including items regarding fatigue, competitiveness and infections) was administered. Statistical analysis indicates an association between ventilation rate and complaints (low ventilation leads to more self-reported fatigue and infections) but no association between VOC and complaints, although a significant correlation exists between ventilation and VOC. This study focussing on home environ ments is consistent with findings of epidemiological studies in other environmental settings (e. g. office buildings). Because of the small sample size and some methodological limitations, the results of this study needs to be interpreted carefully. Further home environmental studies are needed in order to consolidate findings or to draw firm conclusions.
    No preview · Article · Jan 2009 · Umweltmedizin in Forschung und Praxis
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    ABSTRACT: In this multicentre study on multiple chemical sensitivity (MCS) 291 consecutive environmental medicine (EM) outpatients were examined in several environmental medicine outpatient centres/units throughout Germany in 2000/2003. Of the EM outpatients, 89 were male (30.6%) and 202 were female (69.4%), aged 22-80 (mean 48 years, S.D.=12 years). The sample was representative for university-based environmental outpatient departments and represented a cross-sectional study design with an integrated clinical-based case-control comparison (MCS vs. non-MCS). Three classifications of MCS were used: self-reported MCS (sMCS), clinically diagnosed MCS (cMCS), and formalised computer-assisted MCS with two variants (f1MCS, f2MCS). Data were collected by means of an environmental medicine questionnaire, psychosocial questionnaires, the German version of the Composite International Diagnostic Interview (CIDI), and a medical baseline documentation, as well as special examinations in partial projects on olfaction and genetic susceptibility markers. The hypothesis guided evaluation of the project showed that the patients' heterogenic health complaints did not indicate a characteristic set of symptoms for MCS. No systematic connection could be observed between complaints and the triggers implicated, nor was there any evidence for a genetic predisposition, or obvious disturbances of the olfactory system. The standardised psychiatric diagnostics applying CIDI demonstrated that the EM patients in general and the subgroup with MCS in particular suffered more often from mental disorders compared to an age and gender matched sample of the general population and that in most patients these disorders commenced many years before environment-related health complaints. Our results do not support the assumption of a toxicogenic-somatic basis of the MCS phenomenon. In contrast, numerous indicators for the relevance of behavioural accentuations, psychic alterations or psychosomatic impairments were found in the group of EM-outpatients with subjective "environmental illness".
    Full-text · Article · Jun 2008 · International Journal of Hygiene and Environmental Health
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    ABSTRACT: Abstract Abstract A single-blinded study was performed to analyze whether indoor environments with and without mold infestation differ significantly in microbial volatile organic compounds (MVOC) concentrations. Air sampling for MVOC was performed in 40 dwellings with evident mold damage and in 44 dwellings, where mold damage was excluded after a thorough investigation. The characteristics of the dwellings, climatic parameters, airborne particles and air exchange rates (AER) were recorded. The parameters mold status, characteristics of the interiors and measured climatic parameters were included in the multiple regression model. The results show no significant association between most of the analyzed MVOC and the mold status. Only the compounds 2-methyl-1-butanol and 1-octen-3-ol indicated a statistically significant, but weak association with the mold status. However, the concentrations of the so-called MVOC were mainly influenced by other indoor factors. 2-Methylfuran and 3-methylfuran, often used as main indicators for mold damage, had a highly significant correlation with the smoking status. These compounds were also significantly correlated with the humidity and the AER. The compounds 3-methyl-1-butanol, 2-hexanone, 3-heptanone and dimethyl disulfide were weakly correlated with the recorded parameters, the humidity being the strongest influencing factor. Only 2-methyl-1-butanol and 1-octen-3-ol showed a statistically significant association with the mold status; however, only a small portion (10% in this case) of the total variability could be explained by the predictor mold status; they do not qualify as indicator compounds, because such minor correlations lead to a too excessive part of incorrect classifications, meaning that the diagnostic sensitivity and specificity of these compounds are too low.
    No preview · Article · May 2008 · Indoor Air
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    ABSTRACT: The aim of this article was to re-evaluate and possibly modify the standardized Environmental Worry Scale (EWS) by Hodapp et al. [1996. Evaluation eines Fragebogens zur Erfassung von Umweltbesorgnis. Z. Gesundheitspsychologie IV(1), 22-36] with regard to its content and structure. In order to do this, 161 participants were chosen as a reference group to take part in a survey. The data were analyzed and a factor analysis yielded two instead of one component of worry, namely "personal" and "general" environmental worry, leading to a new evaluation method. This revised evaluation method was then applied to patients (n=227) with or without self-reported multiple chemical sensitivity (MCS) and thus used in the context of reported health complaints. The outlined results indicate that the assessment of worry as proposed by Hodapp et al. [1996. Evaluation eines Fragebogens zur Erfassung von Umweltbesorgnis. Z. Gesundheitspsychologie IV(1), 22-36] should be elaborated by the newly developed evaluation method with which a ratio determined by "personal" and "general" worry can be calculated. In addition to analyzing the absolute quantity of worry, the calculated ratio allows to draw conclusions on the structure of worry. It will be discussed to what extent the results present new insights into the role of worry among patients suffering from environmental diseases.
    Full-text · Article · Apr 2008 · International Journal of Hygiene and Environmental Health
  • Dieter Helm · Dieter Eis
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    ABSTRACT: Between 1999 and 2003 all consecutive outpatients of the environmental medicine unit of the Charité hospital in Berlin were invited to participate in a study on environmentally related disorders. One hundred and sixty-nine of the patients completed a psychosocial questionnaire which comprised SCL-90-R and 14 other tests. When compared with clinical controls, SCL-90-R mean scores of the environmental patients (EP) were found to lie in between those of inpatients of a psychosomatic clinic and melanoma aftercare patients; but they were, with exception of the somatisation dimension, much closer to the latter. Application of the TwoStep Cluster component of SPSS resulted in three subgroups with high, moderate and low scores which were significantly different (p<0.001) although separation was incomplete (87% correct identification; cross-validated discriminant analysis). With all subgroups, scores for somatisation, depression and obsessive compulsion were highest and those for phobic anxiety and psychoticism were lowest. SCL-90-R scores correlated well with results of the Freiburg Personality Inventory, Whiteley Index of hypochondriasis, the short form health questionnaire (SF-36), and the Composite International Diagnostic Interview (CIDI). Hierarchical grouping (average linkage between groups), performed with involvement of SCL-90-R data from literature, resulted in a dendrogram with three distinct groups and three outliers. EP with low SCL-90-R scores were assigned to a group which comprised also general populations (USA, Germany), allergy patients, and melanoma controls. Those with moderate SCL-90-R scores were placed in a group together with chronic pain patients, and 26 'environmentally ill' subjects. The third subgroup of EP formed a cluster with our psychosomatic controls, psychosomatic patients from another study, depressed people, and patients undergoing psychotherapy. The three outliers of the dendrogram, however, were SCL-90-R profiles obtained from persons with toxic waste exposure, neurotoxic workplace exposure or with solvent-induced chronic toxic encephalopathy.
    No preview · Article · Jan 2008 · International Journal of Hygiene and Environmental Health
  • D. Helm · D. Eis
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    ABSTRACT: Background: As part of the Berlin study on environmentally related disorders (1999-2003) a human biomonitoring (HBM) was performed with the environmental outpatients (EP) of the environmental outpatient station of the Charité RKI-Network for Clinical Environmental Medicine and three clinical control groups. We tested the hypothesis of whether the EP showed higher concentrations of pollutants than other groups of patients or the general population. Methods: The following measurements were performed: cadmium, arsenic and mercury in urine samples; mercury, lead and cadmium in blood; organochlorines in heparinised blood and PCP in serum. Statistical analysis was done with the Mann Whitney-test. Proportions of patients with values exceeding reference values were evaluated with the Chi square-test. Additionally, measurement data from the German Environmental Survey in 1998 and from a study on environmental outstation patients in Augsburg (Hardt et al. Umweltmed Forsch Prax 2004; 9(6): 336-346) were used for comparison. Results: For the metals measured in blood and urine, no increased values could be proven for the EP. α-HCH and PCB congeners showed consistently higher values for the EP. These differences, although statistically significant (p < 0.001), were however within the range of the analytical uncertainty. Moreover, the proportion of reference exceedances was approx. equal to the expectance value. Also a comparison with the Augsburg study and the data of the Berlin volunteers of the Environmental Survey in 1998 brought no evidence of increased exposure. Patients of the Berlin study had equally high or even lower proportions of exceedances compared to Augsburg. Similarly, the comparison with the Environmental Survey of 1998 yielded no evidence for more exceedances amongst the EP. Furthermore, the mean pollutant concentrations agreed very well, and as rule they were even lower for the EP than for the Berlin volunteers of the Environmental Survey. Conclusions: Altogether, a higher burden of the EP could not be proven.
    No preview · Article · Jan 2008 · Umweltmedizin in Forschung und Praxis
  • Dieter Eis · Dieter Helm

    No preview · Article · May 2007 · Psychosomatic Medicine
  • D. Helm · D. Eis
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    ABSTRACT: Background: Among other features, the Berlin Study on environmentally related disorders assessed the environmental worry (EW) of environmental patients and clinical controls (outpatients of family doctors, melanoma aftercare patients, inpatients of a psychosomatic clinic).The study presented here investigates whether environmental patients differ from controls in respect to environmental worry (or components thereof). Methods: The sum score of the environmental worry scale (= Skala für Umweltbesorgnis, SUB) is a measure for the overall EW. A principle component analysis (PCA) was used to extract principle components (PC) which represented different aspects of EW. Results: According to the sum score of SUB no differences between environmental patients and controls could be found in regard to the overall EW. There were, however, remarkable differences between the groups when the PCs were considered. The 'general EW (PC1 ), not referring to the own person, is highly significantly lower for environmental patients than for clinical controls, whilst the 'self-centered hea Ith-related EW (PC2), referring to the own person, is significantly or even highly significantly stronger. For the third PC ('general health-related EW) no differences could be found. During the past 10 years the SUB sum score declined remarkable, but the decline observed for environmental patients was stronger than that for 'healthy' persons or other than environmental patients which lead to the present equality. Discussion and conclusions: We discuss possible reasons for the decline of environmental worry. When assessing environmental worry by means of the environmental worry scale (SUB) it should be differentiated between 'general EW' and 'self-centered healthrelated EW'.
    No preview · Article · Jan 2007

  • No preview · Article · Apr 2006 · PPmP - Psychotherapie · Psychosomatik · Medizinische Psychologie

  • No preview · Article · Jan 2006 · Umweltmedizin in Forschung und Praxis
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    ABSTRACT: 3 mycological methods (sampling of airborne mould spores, of settling mould spores, and of mould spores in household/carpet dust), and the analysis of MVOC were checked regarding their ability to predict the mould status in indoor environments. ROC curves were used to evaluate these methods in regard to sensitivity (= prediction of correct-positive results) and specificity (= prediction of correctnegative results). Whereas for the traditional mycological methods an area under the ROC curve of nearly 1 was calculated (1.0 = 'perfect test'), the area under the MVOC curve was 0.620 (0.5 = 'useless test').
    No preview · Article · Jan 2006

  • No preview · Article · Dec 2005 · DMW - Deutsche Medizinische Wochenschrift
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    ABSTRACT: As part of the multicentric MCS study carried out by the Robert Koch Institute in collaboration with the University of Goettingen (Department of Clinical Pharmacology) with the participation of the German MCS research network, blood samples from 205 outpatients attending environmental medicine clinics (136 women (66.3%), 69 men (33.7%), mean age 49 years) were investigated for 26 variants in 17 genes. Literature research had suggested the hypothesis that these gene variants could be associated with increased sensitivity to chemicals in the environment. Some of the selected gene variants are considered by individual environmental clinicians and laboratories offering such tests to be markers for increased sensitivity to chemicals (markers of the so called MCS). The object, therefore, was to establish whether the selected allele variants were more frequent in outpatients of environmental medicine clinics than in various control groups and whether any differences in frequencies were sufficiently marked to provide the basis for a diagnostic strategy. For the molecular genetic analyses, 205 consecutive blood samples from 5 outpatient clinics for environmental medicine were available. The allele frequencies in the group of environmental medicine outpatients were, after appropriate adjustment for alpha errors, not significantly different from the frequencies for the Caucasian/European population known from other studies. Nor were there any statistically significant differences in the genotypes of the environmental medicine outpatients with self-reported MCS (sMCS) and those of the non-sMCS patients. The study yielded no evidence of a diagnostically useable excess of certain gene variants in outpatients attending environmental medicine clinics or in persons who consider themselves to have MCS. Such molecular genetic test results are therefore not considered to be of diagnostic relevance at the present time for outpatients attending environmental medicine clinics and exposed to low doses of chemicals.
    No preview · Article · Apr 2005
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    ABSTRACT: Abstract Abstract Laboratory trials were performed in order to search for the variety of the production of microbial volatile organic compounds (MVOC), which could be used as indicators for hidden mold damage. Concerning MVOC production the experiments showed a dependency on the mold genus/species, the different strains used and the building materials used as substrate. It could be proved that the production of certain MVOC is not consistent at all times. On the whole low emission rates in terms of μg/h/m2 of the MVOC were found. Extrapolating the emissions rates from the laboratory trails to an indoor air situation results in concentrations below the analytical detection limit in most cases. According to these results only heavy or very large fungal contaminations might be detected by this method in indoor air. The studies were performed at the Institute of Hygiene and Environmental Medicine, Charitè, Germany.
    No preview · Article · Feb 2005 · Indoor Air
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    ABSTRACT: In order to validate microbial methods for the detection of mold infestations in indoor areas in a first step the sampling of airborne fungal spores with an impaction method was checked. When the group ?moldy apartments? was compared with the group ?non-moldy apartments?, only the genera Aspergillus and Penicillium were in significantly higher concentrations in the infested rooms (nutrient: malt extract agar). As these two genera appeared complementarily in moldy homes as a rule, a sum score was calculated by the logistic regression model. With this sum score cutoff50 values were calculated: 110 cfu/m³ for airborne fungal spores (S A + P) without correction for the outdoor situation and 80 cfu/m³ (S A + P) with correction for the outdoor air concentration. With these cutoff50 values a very good classification (high sensitivity and high specificity) concerning moldy and non-moldy apartments was achieved. Dans le but de valider les méthodes microbiennes employées pour la détection des infestations de moisissures dans les environnements intérieurs, on a vérifié dans un premier temps l'échantillonnage de spores fongiques dans l'atmosphère selon une méthode par impaction. Lorsque le groupe des « appartements infestés » a été comparé au groupe des « appartements non infestés », seuls les genres Aspergillus et Penicillium sont apparus en concentrations plus élevés dans un ordre appréciable dans les pièces infestées (substance nutritive : gélose extrait de malt). Comme ces deux genres étaient présents de façon complémentaire dans les maisons infestées, en principe, on a calculé une cote somme au moyen du modèle de régression logistique. Avec cette cote somme, des valeurs seuils 50 ont été calculées : 110 cfu/m³ (cellules souches indéterminés pluripotentielles par mètre cube), dans le cas des spores fongiques dans l'atmosphère (S A + P), sans correction en fonction de la situation à l'extérieur, et 80 cfu/m³ (S A + P), avec correction en fonction de la concentration atmosphérique à l'extérieur. À partir de ces valeurs seuils 50, il a été possible de parvenir à une classification très satisfaisante (sensibilité et spécificité élevées) des appartements infestés de moisissures et des appartements non infestés. RES
    Full-text · Article · Jan 2005