Abstract
Background Aim of this study was to examine the effect of hay fever in childhood for asthma onset from childhood to adulthood in a prospective cohort of 3,199 asthma-free children, initially aged 5–13 years, which were followed for up to 12 years in East-Germany. Methods Crude and adjusted incidence rate ratios (IRR) of asthma onset due to hay fever at baseline were calculated by a generalized estimation equation approach accounting for person years at risk, age at study entry, parental asthma, and gender. Results Overall 142 incident cases of asthma were observed. Prevalence of hay fever at baseline was 4%. Crude and adjusted IRR were essentially the same and showed overall and in each age group a substantial higher risk of asthma onset due to hay fever. The adjusted IRR was 4 overall and ranged between 3 and 5 within the three age groups. Restricting the analysis to those participants, who were 17–25 years of age at the end of follow-up resulted in similar IRR. Conclusion Hay fever in childhood is a strong predictor of asthma onset later in life up to adulthood. The preventive potential of early and efficient treatment of allergic rhinitis to avoid asthma development needs to be investigated.
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Abbreviations
- IR:
-
Incidence rate
- IRR:
-
Incidence rate ratio
- OR:
-
Odds ratio
- PY:
-
Person years at risk
References
Bousquet J, Van Cauwenberge P, Khaltaev N. Allergic rhinitis and its impact on asthma. J Allergy Clin Immunol. 2001;108:S147–S334.
Bousquet J, Vignola AM, Demoly P. Links between rhinitis and asthma. Allergy. 2003;58:691–706.
Braunstahl GJ, Fokkens W. Nasal involvement in allergic asthma. Allergy 2003;58:1235–1243.
Koh YY, Kim CK. The development of asthma in patients with allergic rhinitis. Curr Opin Allergy Clin Immunol. 2003;3:159–164.
Passalacqua G, Ciprandi G, Pasquali M, Guerra L, Canonica GW. An update on the asthma-rhinitis link. Curr Opin Allergy Clin Immunol. 2004;4:177–183.
Spergel JM. Atopic march: link to upper airways. Curr Opin Allergy Clin Immunol. 2005;5:17–21.
Togias A. Rhinitis and asthma: evidence for respiratory system integration. J Allergy Clin Immunol. 2003;111:1171–1183.
Volcheck GW. Does rhinitis lead to asthma? Evidence for the one-airway hypothesis. Postgrad Med. 2004;115:65–68.
King ME, Mannino DM, Holguin F. Risk factors for asthma incidence. A review of recent prospective evidence. Panminerva Med. 2004;46:97–110.
Guerra S, Sherrill DL, Martinez FD, Barbee RA. Rhinitis as an independent risk factor for adult-onset asthma. J Allergy Clin Immunol. 2002;109:419–425.
Gustafsson D, Sjoberg O, Foucard T. Development of allergies and asthma in infants and young children with atopic dermatitis—a prospective follow-up to 7 years of age. Allergy 2000;55:240–245.
Huovinen E, Kaprio J, Laitinen LA, Koskenvuo M. Incidence and prevalence of asthma among adult Finnish men and women of the Finnish Twin Cohort from 1975 to 1990, and their relation to hay fever and chronic bronchitis. Chest 1999;115:928–936.
Leynaert B, Bousquet J, Neukirch C, Liard R, Neukirch F. Perennial rhinitis: an independent risk factor for asthma in nonatopic subjects: results from the European Community Respiratory Health Survey. J Allergy Clin Immunol. 1999;104:301–304.
Linneberg A, Henrik NN, Frolund L, Madsen F, Dirksen A, Jorgensen T. The link between allergic rhinitis and allergic asthma: a prospective population-based study. The Copenhagen Allergy Study. Allergy 2002;57:1048–1052.
Marogna M, Falagiani P, Bruno M, Massolo A, Riva G. The allergic march in pollinosis: natural history and therapeutic implications. Int Arch Allergy Immunol. 2004;135:336–342.
Plaschke PP, Janson C, Norrman E, Bjornsson E, Ellbjar S, Jarvholm B. Onset and remission of allergic rhinitis and asthma and the relationship with atopic sensitization and smoking. Am J Respir Crit Care Med. 2000;162:920–924.
Settipane RJ, Hagy GW, Settipane GA. Long-term risk factors for developing asthma and allergic rhinitis: a 23-year follow-up study of college students. Allergy Proc. 1994;15:21–25.
Ronmark E, Perzanowski M, Platts-Mills T, Lundback B. Incidence rates and risk factors for asthma among school children: a 2-year follow-up report from the obstructive lung disease in Northern Sweden (OLIN) studies. Respir Med. 2002;96:1006–1013.
Strachan DP, Butland BK, Anderson HR. Incidence and prognosis of asthma and wheezing illness from early childhood to age 33 in a national British cohort. BMJ. 1996;312:1195–1199.
Niggemann B, Jacobsen L, Dreborg S, Ferdousi HA, Halken S, Host A, Koivikko A, Koller D, Norberg LA, Urbanek R, Valovirta E, Wahn U, Moller C. Five-year follow-up on the PAT study: specific immunotherapy and long-term prevention of asthma in children. Allergy. 2006;61:855–859.
Heinrich J, Hoelscher B, Frye C, Meyer I, Pitz M, Cyrys J, Wjst M, Neas L, Wichmann HE. Improved air quality in reunified Germany and decreases in respiratory symptoms. Epidemiology. 2002;13:394–401.
Heinrich J, Hoelscher B, Wjst M, Ritz B, Cyrys J, Wichmann H. Respiratory diseases and allergies in two polluted areas in East Germany. Environ Health Perspect. 1999;107:53–62.
Heinrich J, Hoelscher B, Wichmann HE. Decline of ambient air pollution and respiratory symptoms in children. Am J Respir Crit Care Med. 2000;161:1930–1936.
Zou G. A modified poisson regression approach to prospective studies with binary data. Am J Epidemiol. 2004;159:702–706.
Martinez FD, Wright AL, Taussig LM, Holberg CJ, Halonen M, Morgan WJ. Asthma and wheezing in the first six years of life. The Group Health Medical Associates. N Engl J Med. 1995;332:133–138.
Wright AL, Holberg CJ, Martinez FD, Halonen M, Morgan W, Taussig LM. Epidemiology of physician-diagnosed allergic rhinitis in childhood. Pediatrics. 1994;94:895–901.
Illi S, von Mutius E, Lau S, Nickel R, Gruber C, Niggemann B, Wahn U. The natural course of atopic dermatitis from birth to age 7 years and the association with asthma. J Allergy Clin Immunol. 2004;113:925–931.
Lau S, Nickel R, Niggemann B, Gruber C, Sommerfeld C, Illi S, Kulig M, Forster J, Wahn U, Groeger M, Zepp F, Kamin W, Bieber I, Tacke U, Wahn V, Bauer CP, Bergmann R, von Mutius E. The development of childhood asthma: lessons from the German Multicentre Allergy Study (MAS). Paediatr Respir Rev. 2002;3:265–272.
Heinrich J, Hoelscher B, Frye C, Meyer I, Wjst M, Wichmann HE. Trends in prevalence of atopic diseases and allergic sensitization in children in Eastern Germany. Eur Respir J. 2002;19:1040–1046.
Lash TL, Fink AK. Semi-automated sensitivity analysis to assess systematic errors in observational data. Epidemiology. 2003;14(4):451–458.
Hederos CA, Hasselgren M, Hedlin G, Bornehag CG. Comparison of clinically diagnosed asthma with parental assessment of children’s asthma in a questionnaire. Pediatr Allergy Immunol. 2007;18(2):135–141.
Acknowledgments
We wish to thank Dr. Helgard Bach, Dr Horst Adam, Dr. Bernhard Wilde, Dr. Hannelore Wolff, Dr. Doris Bodesheim, Dr. Irina Hörhold, Dr. Ingo Keller, Dr. Gerd Burmester, Dr. Johannes Rudzinski, Brigitte Hollstein, Helga Machander, Regina Müller, Doris Albrecht, and Christa Boettcher for gathering regional data and local assistance; Hubert Schneller for data handling; all teachers in Hettstedt, Zerbst and Bitterfeld, and the local school authorities and health care centers for their support; all parents and children for their participation. The fieldwork of this study was supported exclusively by a governmental funding source, the Federal Environmental Agency (Umweltbundesamt) Grant Numbers 11609002, 116002/02, and 29861724.
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Rzehak, P., Schoefer, Y., Wichmann, HE. et al. A prospective study on the association between hay fever among children and incidence of asthma in East Germany. Eur J Epidemiol 23, 17–22 (2008). https://doi.org/10.1007/s10654-007-9205-3
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DOI: https://doi.org/10.1007/s10654-007-9205-3