1. Which population level environmental factors are associated with asthma, rhinoconjunctivitis and eczema? Review of the ecological analyses of ISAAC Phase One
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L. Soininen, T. U. Aripova, Bonnie Sibbald, F. D. Borges, A. Blanco Quirós, Adrian Bauman, Barry J Taylor, Richard Beasley, R. M. Maheshwari, B. S. Quah, E. Cortez, Giuseppe Maria Corbo, Muthita Trakultivakorn, C. Soto-Quirós, M. Kajosaari, Hywel C Williams, K. H. Teh, Giovannino Ciccone, M. Innes Asher, Isabelle Romieu, A. D. Rubio, C. R. Grainger, I. Sanchez, Franca Rusconi, Moyes Cd, P. G M Bezerra, Javier Mallol, M A Riikjärv, U. A. Pai, G. Jayaraj, Sergio Bonini, Juha Pekkanen, A. R. Asensio, Enea Bonci, D. Charpin, Fernando J. Martinez, Zulfiqar A Bhutta, Yu-Lung Lau, Dirceu Solé, M. H. Shamssain, Alberto Arnedo-Pena, Neil Pearce, R. M. Busquets, G. J. Redding, Philip Pattemore, D. Barry, P. Godard, I. Annesi-Maesano, J. A. al-Momen, J. Riedler, Fabian Esamai, S. I. Lee, Ulrich Keil, M. I. Asher, Gerald Haidinger, N. I. Kjellman, M. Biocca, Alistair W. Stewart, P. Vermeire, Amiran Gamkrelidze, Gabriel Anabwani, L. Chetoni, K. H. Chen, E. von Mutius, L. W. Yeong, Francisco Guillén-Grima, Tadd Clayton, Harald Nelson, K. Chopra, B. O. Onadeko, Renato T. Stein, K. Raghavan, D. P. Strachan, Y. Z. Chen, Richard Mackay, Ed A. Mitchell, M. Bao-Shan, B. W. Lee, K. C. Jain, Luke Clancy, R. Ronchetti, D. Jeffs, L. Kumar, Christina Gratziou, Z. Bouayad, G. Lis, Malcolm R. Sears, V. Persky, P. V. Powell, Nadia Aït-Khaled, N. Somu, A. Bezzaoucha, D. Holgado, Pakit Vichyanond, Alfred Priftanji, J. Peat, J. A. Guggiari-Chase, Alexander Krämer, S. Rajajee, G. Cukier, N. S. Zhong, Stephan K. Weiland, T. Foucard, Hugh Ross Anderson, Carlos Nunes, Mario Calvo, Dan L. Dumitrascu, Elizabeth Renzoni, L. deFreitas Souza, M. K. Joshi, Christopher K.W. Lai, Luis Garcia-Marcos, C. Kopferschmitt, David P. Strachan, N. Khetsuriani, J. M. Lopesdos Santos, Joseph Odhiambo, Luigi Bisanti, Julian Crane, F. M. Ramadan, Pascual Chiarella, P. K. Kar, K. H. Hsieh, Michael Leslie Burr, M. Leja, K. Baratawidjaja, A. L. Boner, María Morales-Suárez-Varela, J. E. Rosado Pinto, K. W. Chum, T. A. Koivikko, Mohammad Reza Masjedi, Elisabetta Chellini, Stephen Montefort, Sankei Nishima, A. Taytard, B. M S Al Riyami, K. Melaku, Philippa Ellwood, N. Salmun, L. Amarales, V. A. Khatav, Jayant Shah, F. Cua-Lim, Declan Kennedy, M. L. Xiao, Silvano Piffer, L. Landau, Francesco Forastiere, N. M. Hanumante, Nelson Rosario, Bengt Björkstén, B. Seyoum, T. U. Sukumaran, A. Brêborowicz, Colin F. Robertson, Khaitov Rakhim M, J. de Bruyne, and A. Bennis
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Pulmonary and Respiratory Medicine ,Male ,medicine.medical_specialty ,Internationality ,Eczema - epidemiology ,education ,Prevalence ,Eczema ,Comorbidity ,Review ,Risk Assessment ,Environmental Illness ,Age Distribution ,Conjunctivitis, Allergic - epidemiology ,Risk Factors ,Epidemiology ,Medicine ,Humans ,Asthma - epidemiology ,Sex Distribution ,Socioeconomic status ,health care economics and organizations ,Rhinitis ,Asthma ,Conjunctivitis, Allergic ,Proportional Hazards Models ,lcsh:RC705-779 ,business.industry ,Ecology ,Public health ,Incidence ,Rhinitis, Allergic, Seasonal ,Environmental exposure ,lcsh:Diseases of the respiratory system ,Environmental Exposure ,medicine.disease ,Eczema in children ,Causality ,Asthma in children ,Paracetamol ,Environmental Illness - epidemiology ,Environmental Exposure - statistics & numerical data ,Hay fever ,Trans fatty acid ,Female ,business ,Risk assessment - Abstract
The authors are indebted to the collaborators in the participating centres and all parents, children, teachers and other school staff who participated in the surveys. There are many field workers and funding agencies who supported data collection and national, regional and international meetings, including the meetings of the ISAAC Steering Committee. Unfortunately, these are too numerous to mention (they are acknowledged elsewhere) but the authors particularly wish to thank the funders who supported the ISAAC International Data Centre including the Health Research Council of New Zealand, the Asthma and Respiratory Foundation of New Zealand, the National Child Health Research Foundation, the Hawke’s Bay Medical Research Foundation, the Waikato Medical Research Foundation, Glaxo Wellcome New Zealand and Astra New Zealand, as well as Glaxo Wellcome International Medical Affairs for finding the regional coordinating centres. The International Data Centre is now supported by a grant from the BUPA Foundation., The International Study of Asthma and Allergies in Childhood (ISAAC) Phase One showed large worldwide variations in the prevalence of symptoms of asthma, rhinoconjunctivitis and eczema, up to 10 to 20 fold between countries. Ecological analyses were undertaken with ISAAC Phase One data to explore factors that may have contributed to these variations, and are summarised and reviewed here. In ISAAC Phase One the prevalence of symptoms in the past 12 months of asthma, rhinoconjunctivitis and eczema were estimated from studies in 463,801 children aged 13 - 14 years in 155 centres in 56 countries, and in 257,800 children aged 6-7 years in 91 centres in 38 countries. Ecological analyses were undertaken between symptom prevalence and the following: Gross National Product per capita (GNP), food intake, immunisation rates, tuberculosis notifications, climatic factors, tobacco consumption, pollen, antibiotic sales, paracetamol sales, and outdoor air pollution. Symptom prevalence of all three conditions was positively associated with GNP, trans fatty acids, paracetamol, and women smoking, and inversely associated with food of plant origin, pollen, immunisations, tuberculosis notifications, air pollution, and men smoking. The magnitude of these associations was small, but consistent in direction between conditions. There were mixed associations of climate and antibiotic sales with symptom prevalence. The potential causality of these associations warrant further investigation. Factors which prevent the development of these conditions, or where there is an absence of a positive correlation at a population level may be as important from the policy viewpoint as a focus on the positive risk factors. Interventions based on small associations may have the potential for a large public health benefit., peer-reviewed
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- 2009