Systematisch überhöhte Angaben atopischer Symptome („overreporting“) zum Risikofaktor „Tierstallnähe“

Abstract

Background

In Lower Saxony there is an ongoing discussion on potential health effects caused by environmental exposures to livestock emissions. The relationship between intensive livestock facilities in the neighborhood and respiratory or allergic diseases in five- to six-year-old children was investigated.

Methods

Within the cross-sectional epidemiologic AABEL study a standardized questionnaire for respiratory and allergic symptoms and corresponding risk factors was used. Additionally, flexural eczema was examined in these children (n = 3,752) to identify potential overreporting with respect to dermatitis symptoms in different study groups.

Results

A probable overreporting was identified for the group of parents who did not live near livestock production facilities, but complained about agricultural odor annoyance (homogeneity of odds ratios not fulfilled; p-value < 0.05): they reported twice as often skin symptoms (“itchy skin condition during the last year” 50.7% vs. 21.5–26.1% for the other groups), whereas the prevalence rate of visible signs of dermatitis hardly varied between the different strata of exposure (mean overall 5.8%). The investigation of elevated IgE levels and reported hay fever symptoms also yielded probable overreporting.

Conclusion

Taking the odor annoyance into account there is a strong hint for an overreporting by a small population group (3.2% of all). Furthermore, complementary objective medical examinations seem to be necessary to identify potential sources of bias in the reported symptoms, particularly when issues of environmental health are dealt with.