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Objective: The objective of the study was to analyze the relationship between air pollutants and the prevalence of recent symptoms of asthma, allergic rhinitis, and atopic eczema in schoolchildren aged between 6 and 7 years., Patients and Methods: The prevalence of recent (previous 12 months) symptoms of allergic diseases was obtained by means of the questionnaire of the International Study of Asthma and Allergies in Childhood (ISAAC), Spain, with the participation of 7 centers (Asturias, Barcelona, Bilbao, Cartagena, La Coruña, Madrid, and Valencia) and 20 455 schoolchildren aged between 6 and 7 years, from 2002 to 2003. The pollutant detection systems of the aforementioned centers provided the mean annual concentrations of sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO), and total suspended particulate matter., Results: The annual average concentration of SO2 showed a significant association with a higher prevalence of recent severe asthma (adjusted odds ratio [aOR] between level-1 and level-3 pollution, 1.32; 95% confidence interval [CI], 1.01-1.73), rhinitis (aOR, 1.56; 95% CI, 1.39-1.75), and rhinoconjunctivitis (aOR, 1.70; 95% CI, 1.45-2.00). The annual average concentration of CO was associated with a higher prevalence of rhinitis (aOR, 1.65; 95% CI, 1.34-2.04), rhinoconjunctivitis (aOR, 1.76; 95% CI, 1.31-2.37), and eczema (aOR, 1.55; 95% CI, 1.17-2.04). The annual average concentration for NO2 and total suspended particulate matter showed inverse associations with the prevalence of nocturnal dry cough., Conclusions: Findings suggest that air pollutants such as SO2 and CO increase the risk of recent symptoms of asthma and allergic rhinitis in schoolchildren aged between 6 and 7 years in Spain.

Objectives: To describe the prevalence of atopic eczema (AE) and to find the characteristics of the diet of children with AE., Design: Descriptive, transversal study., Setting: Primary schools., Main Measurements: The study used the standardized and validated questionnaire of the ISAAC phase III study, which finds the prevalence of AE in children and enables inter-centre comparison to be conducted. A questionnaire about food consumption was included. The prevalence ratio (PR) of AE and food consumption (95% confidence intervals) was calculated., Results: A total of 28 448 children aged 6-7 were included in the study. The prevalence of clinically diagnosed AE was 15.35% in boys and 15.24% in girls. The foods most often consumed were: dairy and cereals, followed by rice, pasta, and eggs. The least consumed were: butter, margarine, and fast food. The PR for children who consumed pasta was (PR=1.35), seafood (PR=1.28), cereals (PR=1.26), eggs (PR=1.13), and meat (PR=1.09)., Conclusions: The prevalence of AE in Spain was 15.3%, and was associated with food consumption. The consumption of dairy products, cereals, and olive oil was appropriate. The intake of fruit, vegetables, seafood, and legumes was below the recommended amounts. Future studies on the question are needed.

Objective: To analyze geographic variations in the prevalence of symptoms related to asthma in Spanish children and adolescents., Population and Methods: In 2001 and 2002, the Spanish arm of the International Study of Asthma and Allergies in Childhood (ISAAC) Phase 3 collected information on 28 445 children in the age bracket of 6-7 years in 10 metropolitan areas (A Coruña, Asturias, Barcelona, Bilbao, Cartagena, Castellón, Madrid, Pamplona, San Sebastián, and Valencia) and on 31 257 adolescents in the bracket 13-14 years in 11 areas (the previously named areas plus Valladolid). An asthma symptom questionnaire was filled in by parents or the adolescents themselves. Differences in symptoms between geographic areas were analyzed by fitting a logistic regression model. The relationship between symptoms and age was analyzed by linear correlation., Results: The prevalence of recent wheezing (last 12 months) ranged from 7.1% to 12.9% among 6-7-year-olds and from 7.1% to 15.3% among the 13-14-year-olds. The greatest risk of recent wheezing was observed for children in A Coruña (odds ratio [OR] =1.96 in comparison with the area of lowest prevalence; 95% confidence interval [CI], 1.65-2.33) and Bilbao (OR=1.83; 95% CI, 1.54-2.18) and for adolescents in A Coruña (OR=2.38; 95% CI, 2.04-2.79) and Asturias (OR=2.37; 95% CI, 2.03-2.77). A strong correlation (r=0.72) was observed between the prevalence of recent wheezing and age in each of the geographic areas., Conclusions: Considerable geographic variation in the prevalence of asthma symptoms can be seen in Spain even among young children. Symptoms are more frequent in children and adolescents who live on the Spain s northern Atlantic coast.

Background: Phase III of the International Study of Asthma and other Allergies in Childhood (ISAAC) was carried out in schoolchildren aged 6-7 years from eight areas of Spain to estimate time trends and geographic variations in the prevalence of symptoms of allergic rhinitis (AR)., Material and Method: A standard and validated questionnaire was used following ISAAC methodology and was completed by the schoolchildren's parents. The prevalence of symptoms of AR in Phase I (1993-1994) and Phase III (2001-2002) was compared. Eight centers participated: Asturias, Barcelona, Bilbao, Cartagena, Castellón, Madrid, Pamplona and Valencia. Poisson regression was used in the analysis., Results: A total of 25,113 schoolchildren were studied with a median participation of 81.7 %. In all centers, AR symptoms tended to increase, with a prevalence ratio of rhinoconjunctivitis in the previous year of 1.61 (95 % confidence interval: 1.48-1.76) when both phases, adjusted by gender, center, and seasonal variation, were compared. The prevalence of AR symptoms was higher in boys than in girls. Wide variations in the prevalence of AR were observed across centers with a higher prevalence in Asturias, Madrid, Cartagena and Bilbao. Lower prevalences were reported in Barcelona, Castellón and Pamplona., Conclusions: There seems to have been a general increase in AR symptoms. Substantial variations between centers suggested that there may be local differences in risk factors. Intense research will be required for satisfactory preventive actions.

Background and Objective: Our goal was to estimate the time trends in the prevalence of symptoms of allergic rhinitis (AR) and its geographic variations., Population and Method: During 2001-2002, the phase 3 of ISAAC study was carried out, and a comparison with the phase 1 (1993-1994) was done. This cross sectional study included 30,046 schoolchildren 13-14 years-old from 9 centers (Asturias, Barcelona, Bilbao, Cartagena, Castellon, Madrid, Pamplona, Valencia, and Valladolid). A questionnaire about rhinitis symptoms self-administered to schoolchildren was used at schools and institutes with a participation rate of 100% to 75.8%., Results: A divergent time trend of AR prevalence symptoms was observed with a decrease in Barcelona and Bilbao, a stabilization in Cartagena, Pamplona, and Valencia, and an increase in Castellon; Madrid and Valladolid; however, there was an overall increase in nasal allergy. The prevalence of rhinoconjunctivitis in the past year (Prevalence Ratio [PR] = 1,13; 95% Confidence Interval [CI], 1.07-1.19) and nasal allergy ever (PR = 1.22; 95% CI, 1.15-1.30) increased after adjusting for gender, center and season change. The prevalence of rhinoconjunctivitis and nasal allergy varied according to centres, Madrid, Asturias, Cartagena and Bilbao exhibiting the higher prevalence. Taken as a whole, these data indicate a middle prevalence of AR when compared with other countries following an ISAAC methodology., Conclusions: Two patterns of time trend of prevalence of symptoms of AR were observed. The investigation of risk factors at local level could be important in order to undertake preventive measures.

Background: The ISAAC phase I results have supplied valuable information on the prevalence of asthma and allergy in childhood throughout the world., Objectives: To describe the implementation and participation rate of normal children in each test performed in phase II of the ISAAC in the four Spanish cities participating the study, and to establish the influence of type of school and geographical situation (in a polluted or unpolluted area) in Cartagena., Methods: The ISAAC phase II included a questionnaire on symptoms, risk factors and treatment, skin examination, skin-prick test, bronchial challenge test, total and specific IgE measurement, as well as mite and bacterial endotoxin determination in house dust. The questionnaire was distributed with a letter requesting authorization from the parents in primary schools (fourth and fifth grades) in sufficient number to achieve approximately 1,000 skin prick-test authorizations in each city., Results: The participation rate for the questionnaire, skin examination, skin-prick test, blood extraction, bronchial challenge test, and dust collection was, respectively, for each city: Cartagena: 58.9, 49.2, 43.2, 33.1, 39.9 and 29.8 %; Almería: 42.5, 40.6, 39.1, 39.1 and 37.6 %; Valencia: 43.7, 30.4, 23.5, 21.5, 20.1 and 17.1 %; Madrid: 53.2, 40.8, 38.6, 27.6, 30.6 and 21.1 %. In Cartagena, participation was significantly higher in private schools receiving a state subsidy and in those in unpolluted areas., Conclusions: The participation rate was highly variable and lower than that among the European centres that have already completed the study. The rate was significantly influenced by geographical area and type of school.

Aim: To describe the rate of hospitalization for bronchiolitis among newborn infants in our environment, to evaluate the influence of prematurity and other perinatal conditions on hospitalization for bronchiolitis, and to compare our data with those of the Impact-RSV Study Group., Materials and Methods: Descriptive studying based on analysis of the perinatal data of all neonates and patients hospitalized for bronchiolitis during a 3-year period., Results: Among 12,895 newborn infants, 455 (3.52 %) required hospitalization for bronchiolitis. The hospitalization rate for bronchiolitis was 3.18 % among term infants, 8.6 % among preterm infants, 9.8 % among infants with congenital heart disease and 21.1 % among preterm infants who required mechanical ventilation during the neonatal period. Intensive care unit admission was associated with postnatal age under 6 weeks (OR: 1.68; 95 % CI: 1.04-8.19; p 5 0.04) and prematurity (OR: 2,67; 95 % CI: 1.01-7.56; p 5 0.006). The hospitalization rate for bronchiolitis was 40 % lower in our neonatal population than in that of the Impact-RSV Study Group. When infants with bronchopulmonary dysplasia, congenital heart disease and mechanical ventilation during the neonatal period were excluded, the hospitalization rate for respiratory syncytial virus (RSV) was not significantly different between infants born at < weeks' gestation and those born at < 32 weeks' gestation and those born at 32-35 weeks' gestation (3.4% vs 4.3%; p>0.10)., Conclusions: Neonatal mechanical ventilation, bronchopulmonary dysplasia and congenital heart disease are more closely associated with hospitalization for RSV(1) bronchiolitis and mean length of stay than with gestational age.