Atopic diseases and airway-related symptoms in Bavarian children before starting primary school: Time trend analyses

Christina Pirner; Christine Korbely; Stefanie Heinze; Jonas Huß; Burkhard Summer; Eva Oppel; Dennis Nowak; Caroline Herr; Susanne Kutzora; HMU Study Group

doi:10.1016/j.rmed.2021.106707

Atopic diseases and airway-related symptoms in Bavarian children before starting primary school: Time trend analyses

Respir Med. 2022 Jan:191:106707. doi: 10.1016/j.rmed.2021.106707. Epub 2021 Dec 2.

Authors

Christina Pirner¹, Christine Korbely², Stefanie Heinze³, Jonas Huß², Burkhard Summer⁴, Eva Oppel⁴, Dennis Nowak⁵, Caroline Herr³, Susanne Kutzora²; HMU Study Group

Collaborators

HMU Study Group:
Wiltrud Doerk⁶, Angelika Pfister⁶, Rosemarie Sittig⁶, Winfried Strauch⁶, Heidi Thamm⁶, Anita Wunder⁶, Tatjana Frieß-Hesse⁷, Franziska Lang⁷, Dagmar Rudolph⁷, Roland Schmid⁷, Gudrun Winter⁷, Isabella Bockmann⁸, Christine Gampenrieder⁸, Margot Motzet⁸, Elisabeth Schneider⁸, Traudl Tontsch⁸, Gerlinde Woelk⁸, Sylvia Kranebitter⁹, Heidi Mayrhofer⁹, Gertraud Rohrhirsch⁹, Brigitte Weise⁹, Luisa Wolf⁹, Kornelia Baranek¹⁰, Gitte Koch-Singer¹⁰, Maximilian Kühnel¹⁰, Ladan Baghi¹¹, Otmar Bayer¹¹, Rüdiger von Kries¹¹, Gabriele Bolte¹², Hermann Fromme¹², Annette Heißenhuber¹², Lana Hendrowarsito¹², Caroline Herr¹², Martina Kohlhuber¹², Joseph Kuhn¹², Bernhard Liebl¹², Anja Lüders¹², Nicole Meyer¹², Christine Mitschek¹², Gabriele Morlock¹², Michael Mosetter¹², Uta Nennstiel-Ratzel¹², Dorothee Twardella¹², Manfred Wildner¹², Angelika Zirngibl¹²

Affiliations

¹ Institute for Medical Informatics, Biometry and Epidemiology (IBE) at the Ludwig-Maximilians-University Munich, Marchioninistraße 15, 81377, Munich, Germany; Pettenkofer School of Public Health, Marchioninistraße 15, 81377, Munich, Germany; Bavarian Health and Food Safety Authority, Pfarrstraße 3, 80538, Munich, Germany. Electronic address: christina.pirner@lgl.bayern.de.
² Bavarian Health and Food Safety Authority, Pfarrstraße 3, 80538, Munich, Germany.
³ Bavarian Health and Food Safety Authority, Pfarrstraße 3, 80538, Munich, Germany; Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Hospital of the University of Munich, Ziemssenstraße 1, 80336, Munich, Germany.
⁴ Department of Dermatology and Allergology, Ludwig-Maximilians-University Munich, Frauenlobstrasse 9-11, 80337, Munich, Germany.
⁵ Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital of the Ludwig-Maximilians-University Munich, Ziemssenstr. 1, 80336, Munich, Germany; Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research (DZL), Munich, Germany.
⁶ Health Authority of the District Office of Bamberg, Germany.
⁷ Health Authority of the District Office of Günzburg, Germany.
⁸ Health Authority of the City Ingolstadt, Germany.
⁹ Department of Health and Environment, City of Munich, Germany.
¹⁰ Health Authority of the District Office of Schwandorf, Germany.
¹¹ Institute of Social Pediatrics and Adolescent Medicine, Ludwig-Maximilian-University Munich, Germany.
¹² Bavarian Health and Food Safety Authority, Munich and Oberschleissheim, Germany.

PMID: 34894592
DOI: 10.1016/j.rmed.2021.106707

Abstract

Background: After decades of rising prevalence of atopic and airway-related diseases, studies showed stagnating prevalence in western industrialised countries. Objective of this study is to analyse the time trend of prevalence of atopic diseases and airway-related symptoms among Bavarian children before starting primary school.

Materials and methods: Five cross-sectional studies from 2004/2005, 2006/2007, 2012/2013, 2014/2015 and 2016/2017 took place in urban and rural regions in Bavaria, Germany. Using standardized parent questionnaires children's atopic diseases and airway-related symptoms were surveyed. Logistic regression analysis (Bonferroni correction: adjusted significance level 0.005) was performed to analyse prevalence of symptoms and diseases from 2004 to 2017 for time trends.

Results: The surveys included 27384 Bavarian children aged 5-6 years (52.6% male). In all children the calculated 12-month prevalence of symptoms '≥four episodes of wheeze' (p-value = .0880) and 'rhinoconjunctivitis' (p-value = .3994) reported by parents stagnated, whereas 'wheeze' (p-value<.0001; OR = 0.97; CI = [0.96-0.98]) and 'rhinitis' (p-value = .0007; OR = 0.98; CI = [0.97-0.99]) decreased. In all children the calculated lifetime prevalence of physician-diagnosed 'asthma' (p-value = .5337), and 'hay fever' (p-value = .8206) stagnated, whereas of 'bronchitis' (p-value<.0001; OR = 0.98; CI = [0.98-0.99]) decreased over time. The calculated lifetime prevalence of physician-diagnosed 'atopic eczema' (p-value = .0002; OR = 0.98; CI = [0.97-0.99]) decreased in all children, whereas the calculated 12-month prevalence of the symptom 'itchy rash' increased (p-value = .0033; OR = 1.07; CI = [1.05-1.08]) over time.

Conclusions: Several calculated prevalence of children's atopic diseases and airway-related symptoms reported by parents stagnated in a subgroup of Bavarian children before starting primary school between 2004 and 2017. The time trend of prevalence in 'wheeze', 'rhinitis' and 'bronchitis' decreased. Prevalence of 'atopic eczema' decreased over time, whereas 'itchy rash' increased.

Keywords: Allergy; Asthma; Atopic eczema; Child; Time trend analysis.

MeSH terms

Child
Child, Preschool
Cross-Sectional Studies
Dermatitis, Atopic* / epidemiology
Female
Humans
Male
Prevalence
Respiratory Sounds / etiology
Rhinitis, Allergic, Seasonal* / epidemiology
Schools
Surveys and Questionnaires