Pediatr Allergy Respir Dis.  2012 Dec;22(4):374-382.

Prevalence and Risk Factors of Asthma and Allergic Rhinitis in Elementary School Children in Jinan-Gun

• Kim DS
• Park MR
• Yu JS
• Lee HS
• Lee JH
• Suh J
• Kim J
• Han Y
• Lee SI
• Ahn K

Abstract

PURPOSE
The aim of this study was to evaluate the prevalence and risk factors associated with asthma and allergic rhinitis in rural elementary school children.
METHODS
Children in 12 elementary schools in Jinan-gun, Jeollabuk-do, a typical rural area in Korea, were enrolled. We conducted cross-sectional survey using a Korean version of International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire.
RESULTS
A total of 947 questionnaires out of 1,062 were completed and the response rate was 89.1%. The symptom prevalence of asthma and allergic rhinitis (AR) in the last 12 months was 7.4% and 28.1%. The prevalence of physician-diagnosed asthma and AR was 7.2% and 22.2%. Male, passive smoking, visible mold at home, and use of antibiotics during infancy more than 3 times were associated with higher prevalence of asthma diagnosis (adjusted odds ratio [aOR] 2.35, 95% confidence interval [CI] 1.30 to 4.26; aOR 2.49, 95% CI 1.38 to 4.48; aOR 2.19, 95% CI 1.23 to 3.89; and aOR 8.45, 95% CI 4.23 to 16.59). Parental history of allergic diseases, children without siblings, use of antibiotics during infancy more than 3 times were associated with higher prevalence of AR (aOR 4.89, 95% CI 3.37 to 7.10; aOR 5.20, 95% CI 2.38 to 11.35; and aOR 2.39, 95% CI 1.36 to 4.19).
CONCLUSION
In Jinan-gun, the symptom prevalence of asthma and AR in the last 12 months was 7.4% and 28.1%. The environmental factors such as passive smoking, visible mold at home, use of antibiotics during infancy and number of siblings are associated with asthma and allergic rhinitis.

Keyword

Asthma; Allergic rhinitis; Prevalence; Risk factors

MeSH Terms

Anti-Bacterial Agents
Asthma
Child
Cross-Sectional Studies
Fungi
Humans
Hypersensitivity
Korea
Male
Odds Ratio
Parents
Prevalence
Surveys and Questionnaires
Rhinitis
Rhinitis, Allergic, Perennial
Risk Factors
Siblings
Tobacco Smoke Pollution
Anti-Bacterial Agents
Tobacco Smoke Pollution

Reference

1. Asher MI, Montefort S, Bjorksten B, Lai CK, Strachan DP, Weiland SK, et al. Worldwide time trends in the prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and eczema in childhood: ISAAC Phases One and Three repeat multicountry cross-sectional surveys. Lancet. 2006. 368:733–743.

2. Asher MI, Weiland SK. ISAAC Steering Committee. The International Study of Asthma and Allergies in Childhood (ISAAC). Clin Exp Allergy. 1998. 28:Suppl 5. 52–66.

3. Lee SI, Shin MH, Lee HB, Lee JS, Son BK, Koh YY, et al. Prevalences of symptoms of asthma and other allergic diseases in korean children: a nationwide questionnaire survey. J Korean Med Sci. 2001. 16:155–164.

4. Jee HM, Kim KW, Kim CS, Sohn MH, Shin DC, Kim KE. Prevalence of asthma, rhinitis and eczema in Korean children using the International Study of Asthma and Allergies in Childhood (ISAAC) Questionnaires. Pediatr Allergy Respir Dis. 2009. 19:165–172.

5. Hong SJ, Lee MS, Sohn MH, Shim JY, Han YS, Park KS, et al. Self-reported prevalence and risk factors of asthma among Korean adolescents: 5-year follow-up study, 1995-2000. Clin Exp Allergy. 2004. 34:1556–1562.

6. Lee SI. Prevalence of childhood asthma in Korea: international study of asthma and allergies in childhood. Allergy Asthma Immunol Res. 2010. 2:61–64.

7. Kim EJ, Kim HO, Park YM. A study on quality of life and economic burden in Korean patients with atopic dermatitis and their parents. Korean J Dermatol. 2008. 46:160–170.

8. Genuneit J. Exposure to farming environments in childhood and asthma and wheeze in rural populations: a systematic review with meta-analysis. Pediatr Allergy Immunol. 2012. 23:509–518.

9. Lodge CJ, Allen KJ, Lowe AJ, Hill DJ, Hosking CS, Abramson MJ, et al. Perinatal cat and dog exposure and the risk of asthma and allergy in the urban environment: a systematic review of longitudinal studies. Clin Dev Immunol. 2012. 2012:176484.

10. Marra F, Marra CA, Richardson K, Lynd LD, Kozyrskyj A, Patrick DM, et al. Antibiotic use in children is associated with increased risk of asthma. Pediatrics. 2009. 123:1003–1010.

11. Montefort S, Ellul P, Montefort M, Caruana S, Grech V, Agius Muscat H. The effect of cigarette smoking on allergic conditions in Maltese children (ISAAC). Pediatr Allergy Immunol. 2012. 23:472–478.

12. Jeong SH, Kim JH, Son BK, Hong SC, Kim SY, Lee GH, et al. Comparison of air pollution and the prevalence of allergy-related diseases in Incheon and Jeju City. Korean J Pediatr. 2011. 54:501–506.

13. Lee SY, Kwon JW, Seo JH, Song YH, Kim BJ, Yu J, et al. Prevalence of atopy and allergic diseases in Korean children: associations with a farming environment and rural lifestyle. Int Arch Allergy Immunol. 2012. 158:168–174.

14. Morcos MM, Morcos WM, Ibrahim MA, Shaheen MA. Environmental exposure to endotoxin in rural and urban Egyptian school children and its relation to asthma and atopy. Minerva Pediatr. 2011. 63:19–26.

15. Downs SH, Marks GB, Mitakakis TZ, Leuppi JD, Car NG, Peat JK. Having lived on a farm and protection against allergic diseases in Australia. Clin Exp Allergy. 2001. 31:570–575.

16. Jinan Country Office. The Jinan statistical yearbook 2010 [Internet]. c2012. cited 2012 Jun 11. Jinan: Jinan Country Office;Available from: http://www.jinan.go.kr/board/list.sko?boardId=ADb01&menuCd=MM04002001000&contentsSid115.

17. Choi SW, Ju YS, Kim DS, Kim JY, Kwon HJ, Kang DH, et al. Reliability and validity of the Korean Version of ISAAC Questionnaire. Korean J Prev Med. 1998. 31:361–371.

18. Aberg N. Asthma and allergic rhinitis in Swedish conscripts. Clin Exp Allergy. 1989. 19:59–63.

19. Riedler J, Eder W, Oberfeld G, Schreuer M. Austrian children living on a farm have less hay fever, asthma and allergic sensitization. Clin Exp Allergy. 2000. 30:194–200.

20. Von Ehrenstein OS, Von Mutius E, Illi S, Baumann L, Bohm O, von Kries R. Reduced risk of hay fever and asthma among children of farmers. Clin Exp Allergy. 2000. 30:187–193.

21. von Mutius E, Vercelli D. Farm living: effects on childhood asthma and allergy. Nat Rev Immunol. 2010. 10:861–868.

22. Ma Y, Zhao J, Han ZR, Chen Y, Leung TF, Wong GW. Very low prevalence of asthma and allergies in schoolchildren from rural Beijing, China. Pediatr Pulmonol. 2009. 44:793–799.

23. Viinanen A, Munhbayarlah S, Zevgee T, Narantsetseg L, Naidansuren Ts, Koskenvuo M, et al. The protective effect of rural living against atopy in Mongolia. Allergy. 2007. 62:272–280.

24. Strachan DP. Hay fever, hygiene, and household size. BMJ. 1989. 299:1259–1260.

25. Wickens K, Ingham T, Epton M, Pattemore P, Town I, Fishwick D, et al. The association of early life exposure to antibiotics and the development of asthma, eczema and atopy in a birth cohort: confounding or causality? Clin Exp Allergy. 2008. 38:1318–1324.

26. Kusel MM, de Klerk N, Holt PG, Sly PD. Antibiotic use in the first year of life and risk of atopic disease in early childhood. Clin Exp Allergy. 2008. 38:1921–1928.

27. Droste JH, Wieringa MH, Weyler JJ, Nelen VJ, Vermeire PA, Van Bever HP. Does the use of antibiotics in early childhood increase the risk of asthma and allergic disease? Clin Exp Allergy. 2000. 30:1547–1553.

28. Celedon JC, Fuhlbrigge A, Rifas-Shiman S, Weiss ST, Finkelstein JA. Antibiotic use in the first year of life and asthma in early childhood. Clin Exp Allergy. 2004. 34:1011–1016.

29. Karmaus W, Botezan C. Does a higher number of siblings protect against the development of allergy and asthma? A review. J Epidemiol Community Health. 2002. 56:209–217.

30. Harris JM, White C, Moffat S, Mills P, Newman Taylor AJ, Cullinan P. New pregnancies and loss of allergy. Clin Exp Allergy. 2004. 34:369–372.

31. Motika CA, Papachristou C, Abney M, Lester LA, Ober C. Rising prevalence of asthma is sex-specific in a US farming population. J Allergy Clin Immunol. 2011. 128:774–779.

32. Ghosh S, Pahwa P, Rennie DC, Janzen B. Gender-related interactive effect of smoking and rural/urban living on asthma prevalence: a longitudinal Canadian NPHS study. J Asthma. 2009. 46:988–994.

33. Burke H, Leonardi-Bee J, Hashim A, Pine-Abata H, Chen Y, Cook DG, et al. Prenatal and passive smoke exposure and incidence of asthma and wheeze: systematic review and meta-analysis. Pediatrics. 2012. 129:735–744.

34. Jaakkola JJ, Hwang BF, Jaakkola N. Home dampness and molds, parental atopy, and asthma in childhood: a six-year population-based cohort study. Environ Health Perspect. 2005. 113:357–361.

35. Reponen T, Lockey J, Bernstein DI, Vesper SJ, Levin L, Khurana Hershey GK, et al. Infant origins of childhood asthma associated with specific molds. J Allergy Clin Immunol. 2012. 130:639–644.e5.