Search

Background An association between dampness at home and respiratory conditions has been convincingly demonstrated in children. Fewer studies have been performed in adults, and data are lacking for chronic rhinosinusitis ( CRS). With a prevalence of 10.9% in Europe, CRS imposes a significant burden on quality of life, as well as economy. Objective Our aim was to study CRS and other respiratory conditions in relation to dampness at home in a representative sample of adults. Methods The Swedish GA2 LEN questionnaire was answered by 26 577 adults (16-75 years) and included questions on respiratory symptoms, smoking, education and environmental exposure. CRS was defined according to the EP3 OS criteria. Dampness was defined as reporting water damage, floor dampness or visible moulds in the home during the last 12 months. The dampness score was ranked from 0 to 3, counting the number of signs of dampness reported. Results Dampness at home was reported by 11.3% and was independently related to respiratory conditions after adjustment for demographic and socio-economic factors and smoking: CRS odds ratio ( OR) 1.71; allergic rhinitis OR 1.24; current asthma OR 1.21; wheeze OR 1.37; nocturnal dyspnoea OR 1.80; nocturnal coughing OR 1.34; and chronic bronchitis OR 1.64. The risk of CRS and most of the other respiratory conditions was further elevated in subjects reporting multiple signs of dampness. Conclusions and Clinical Relevance This study demonstrated an independent association between dampness at home and CRS in adults. The high burden of this and the other respiratory conditions studied is a strong argument in favour of countering indoor dampness by improving building standards. [ABSTRACT FROM AUTHOR]

The author reflects on the results of the European Community Respiratory Health Survey (ECRHS) which investigates the prevalence of dampness and moulds in homes in Europe. The author states that 24 percent of survey respondents that they had never seen mould in their current homes, while 27 percent reporter water damage. The author mentions that 13.6 percents of homes have moulds and 18.2 percent have damp spots.

Background: Allergic asthma is consistently associated with increased FENO levels whereas divergence exists regarding the use of exhaled nitric oxide (NO) as marker of inflammation in nonallergic asthma and in asthmatic smokers. The aim of this study is to analyze the effect of having allergic or nonallergic asthma on exhaled nitric oxide levels, with special regard to smoking history. Methods: Exhaled NO measurements were performed in 695 subjects from Turin (Italy), Gothenburg and Uppsala (both Sweden). Current asthma was defined as self-reported physician-diagnosed asthma with at least one asthma symptom or attack recorded during the last year. Allergic status was defined by using measurements of specific immunoglobulin E (IgE). Smoking history was questionnaire-assessed. Results: Allergic asthma was associated with 91 (60, 128) % [mean (95% CI)] increase of FENO while no significant association was found for nonallergic asthma [6 (–17, 35) %] in univariate analysis, when compared to nonatopic healthy subjects. In a multivariate analysis for never-smokers, subjects with allergic asthma had 77 (27, 145) % higher FENO levels than atopic healthy subjects while subjects with nonallergic asthma had 97 (46, 166) % higher FENO levels than nonatopic healthy subjects. No significant asthma-related FENO increases were noted for ex- and current smokers in multivariate analysis. Conclusions: Both allergic and nonallergic asthma are related to increased FENO levels, but only in never-smoking subjects. The limited value of FENO to detect subjects with asthma among ex- and current smokers suggests the predominance of a noneosinophilic inflammatory phenotype of asthma among ever-smokers. [ABSTRACT FROM AUTHOR]

Background There are few published studies on geographical variation in prevalence of eczema in adults or its association with recognised risk factors for allergic disease. Objective To describe the geographical variation in prevalence of eczema in adults, assess the associations with sociodemographic risk factors, serum-specific IgE and IgG, and exposure to allergen. Methods A community-based sample of 8206 adults aged 27–56 years, in 25 European centres and Portland, USA, provided questionnaire information on symptoms of eczema. Serum-specific IgE to house dust mite (HDM), cat, grass and Cladosporium, and IgG and IgG4 to HDM and cat were measured. Mattress levels of mite and cat allergen were assessed. Results Overall prevalence of eczema was 7.1% (range between countries of 2.2–17.6%). Eczema was associated with female gender [odds ratio (OR) 1.25; 95% confidence interval (CI) (1.01–1.55)], family history of atopic disease (OR 1.43; 95% CI 1.18–1.74), IgE sensitization to at least one allergen (OR 1.50; 95% CI 1.19–1.90), particularly Cladosporium (OR 3.65; 95% CI 1.81–7.37), and total IgE. Eczema was negatively associated with age and no clear associations were observed with sibship size, mattress mite and cat allergen levels or with cat and HDM-specific IgG or IgG4. Conclusions There is geographical variation in the prevalence of eczema in adults both within and between countries. Although the disease is associated with IgE sensitization, in this study it was not related to mattress mite or cat allergen levels. [ABSTRACT FROM AUTHOR]

Background: There is growing concern about the respiratory health aspects of the indoor air quality in schools. Methods: A standardized investigation, including nasal lavage (NAL), measurement of the nasal cavity by acoustic rhinometry, and hygienic measurements of airborne pollutants was performed in classrooms, outside the pollen season. All 279 school personnel working in the main buildings of 12 randomly selected primary schools in an urban community in central Sweden (Uppsala) were invited to enroll in the study; 234 (84%) participated. Eosinophil cationic protein (ECP), myeloperoxidase (MPO), lysozyme, and albumin were analyzed in NAL. Crude statistical analysis, as well as multiple regression analysis, was performed, controlling for room temperature, age, sex, current smoking, and a history of atopy. Results: Most classrooms (83%) did not meet the Swedish ventilation standards. A lower degree of nasal patency was found at higher concentrations of respirable dust, nitrogen dioxide (NO2), formaldehyde, and total molds, and in the presence of Aspergillus sp. in the classroom air. The most consistent findings were observed for formaldehyde, NO2, and Aspergillus sp., related to both decreased nasal patency and increase of ECP and lysozyme in NAL. The presence of yeast was associated with an increase of ECP and lysozyme in NAL, but was not related to nasal patency. Conclusions: Ventilation flow was below current hygienic standards in the classrooms. Air pollutants in the classroom air may influence nasal patency and inflammatory response in the nasal mucosa. [ABSTRACT FROM AUTHOR]

As a part of a worldwide investigation on the prevalence of respiratory symptoms, we have performed a study on the relationship between the indoor environment and asthma-like symptoms in the population of a central Swedish municipality. The study comprised R8 individuals, aged 20-45 years who underwent a structured interview, spirometry, a methacholine provocation test, skin-prick tests and blood samples for measurements of serum concentrations of eosinophil cationic protein (S-ECP), blood eosinophil count arid total immunoglobulin E (S-lgE). En the homes, the room temperature. air humidity. respirable dust, house dust mites (HDM) and airborne micro-organisms were measured. The relative humidity in all the homes was found to be above 33%. HDM were found in 13% of homes. In the homes of the 47 subjects with asthma related symptoms, significantly higher total levels of bacteria and mould (P < 0.05) and a higher proportion of detected HI)M (OR = 5.3) was found than in subjects with no asthma related symptoms, after adjustment for age, sex, smoking. indoor temperature and air humidity. HDM were found to be an independent risk factor for asthma related symptoms (OR = 7.9) and nocturnal breathlessness (OR = 6.2) (P < 0.05), while the total level of bacteria was a risk factor for asthma related symptoms and wheezing (P < 005). We conclude that although HDM is relatively infrequently found in the homes of central-Sweden, the presence of HDM is related to asthmatic symptoms. A relation between levels of airborne bacteria and asthma related symptoms was also found. [ABSTRACT FROM AUTHOR]

Editorial. Discusses the nature of buckwheat allergy. Prevalence of buckwheat allergy in Asia, Europe and North America; Cases of occupational buckwheat allergy; Immunologic aspects of the allergy.

Background: Associations between stress measured by the demands-control model, iso-strain model, and stress-related symptoms among cabin crew were studied., Methods: A questionnaire about psychosocial work environment and symptoms was answered by 918 (82%) flight attendants, stewards, and pursers at one airline company in 2005. Adjustment was made for age, gender, smoking, job category, and flight length using multiple logistic regression., Results: Weekly headaches, concentration difficulties, fatigue, and gastrointestinal symptoms were reported at rates of 18%, 10%, 56%, and 13%, respectively. Pursers scored higher on control than the others and they had lower associations between the strain measured by the demands-control model and symptoms than stewards and flight attendants. All symptoms were more common in the high strain situation than in the low strain (reference). An active situation was related to an excess of symptoms. Low social support in the iso-strain model increased risk of symptoms., Conclusions: Demands-control and iso-strain models are useful in studying stress-related symptoms in cabin crews. The dimension of social support adds explanatory value., (2010 Wiley-Liss, Inc.)

Background: Inhalation incidents are an important cause of acute respiratory symptoms, but little is known about how these incidents affect chronic respiratory health., Methods: We assessed reported inhalation incidents among 3,763 European Community Respiratory Health Survey (ECRHS) participants with and without cough, phlegm, asthma, wheezing or bronchial hyperresponsiveness. We then examined whether inhalation incidents during the 9-year ECRHS follow-up period were associated with a new onset of any of these respiratory outcomes among 2,809 participants who were free of all five outcomes at the time of the baseline ECRHS survey., Results: Inhalation incidents were reported by 5% of participants, with higher percentages reported among individuals with asthma-related outcomes at the time of the baseline survey. Among participants without symptoms at baseline, our analyses generated non-statistically significant elevated estimates of the risk of cough, phlegm, asthma and wheezing and a non-statistically significant inverse estimate of the risk of bronchial hyperresponsiveness among participants who reported an inhalation incident compared to those without such an event reported., Discussion: Our findings provide limited evidence of an association between inhalation incidents and asthma-related symptoms. These data could be affected by differences in the reporting of inhalation incidents according to symptom status at the time of the baseline survey; they should thus be interpreted with caution., ((c) 2008 Wiley-Liss, Inc.)

Background: Allergic asthma is consistently associated with increased FE(NO) levels whereas divergence exists regarding the use of exhaled nitric oxide (NO) as marker of inflammation in nonallergic asthma and in asthmatic smokers. The aim of this study is to analyze the effect of having allergic or nonallergic asthma on exhaled nitric oxide levels, with special regard to smoking history., Methods: Exhaled NO measurements were performed in 695 subjects from Turin (Italy), Gothenburg and Uppsala (both Sweden). Current asthma was defined as self-reported physician-diagnosed asthma with at least one asthma symptom or attack recorded during the last year. Allergic status was defined by using measurements of specific immunoglobulin E (IgE). Smoking history was questionnaire-assessed., Results: Allergic asthma was associated with 91 (60, 128) % [mean (95% CI)] increase of FE(NO) while no significant association was found for nonallergic asthma [6 (-17, 35) %] in univariate analysis, when compared to nonatopic healthy subjects. In a multivariate analysis for never-smokers, subjects with allergic asthma had 77 (27, 145) % higher FE(NO) levels than atopic healthy subjects while subjects with nonallergic asthma had 97 (46, 166) % higher FE(NO) levels than nonatopic healthy subjects. No significant asthma-related FE(NO) increases were noted for ex- and current smokers in multivariate analysis., Conclusions: Both allergic and nonallergic asthma are related to increased FE(NO) levels, but only in never-smoking subjects. The limited value of FE(NO) to detect subjects with asthma among ex- and current smokers suggests the predominance of a noneosinophilic inflammatory phenotype of asthma among ever-smokers.