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E von Mutius

Publications and source records attributed to E von Mutius.

At least 91 records · Page 5Linked to original sources
PubMed1998

Reproducibility of skin prick test results in epidemiologic studies: a comparison of two devices.

The reproducibility of skin prick tests under field conditions is essential for comparing prevalences between centers in epidemiologic multicenter studies. This study aimed to evaluate and compare the reproducibility of two widely used skin prick test devices: the Multi-Test and the ALK lancet. The subjects were 28 children, aged 6-14 years, with known sensitivities to Dermatophagoides pteronyssinus (D. pter.). Both devices were applied to each subject on two occasions, 1 week apart, by different, randomly assigned fieldworkers, using histamine, negative control, and the D. pter. allergen extract. For all three tested solutions, mean wheal sizes were larger for the Multi-Test than for the ALK lancet. The coefficient of variation for histamine was 21.8% for the Multi-Test and 17.3% for the ALK lancet. The coefficients of variation for the allergen D. pter. amounted to 47.4% for the Multi-Test and to 24.6% for the ALK lancet. The percentage of concordant test results was 92.6% for the Multi-Test and 100.0% for the ALK lancet for a cutoff point of wheal size equal to or greater than 1 mm. The results of this study suggest that the single ALK lancet performs slightly better than the Multi-Test device with respect to reproducibility under conditions of epidemiologic field studies.

Adolescent↗
PubMed1998

Effect of dampness at home in childhood on bronchial hyperreactivity in adolescence.

BACKGROUND: Relatively little is known about risk factors for the persistence of asthma and respiratory symptoms from childhood into adolescence, and few studies have included objective measurements to assess outcomes and exposure. METHODS: From a large cross sectional study of all 4th grade school children in Munich (mean age 10.2 years), 234 children (5%) with active asthma were identified. Of these, 155 (66%) were reinvestigated with lung function measurements and bronchial provocation three years later (mean age 13.5 years). RESULTS: At follow up 35.5% still had active asthma. Risk factors for persisting asthma symptoms in adolescence were more severe asthma (OR 4.94; CI 1.65 to 14.76; p = 0.004) or allergic triggers (OR 3.54; CI 1.41 to 8.92; p = 0.007) in childhood. Dampness was associated with increased night time wheeze and shortness of breath but not with persisting asthma. Risk factors for bronchial hyperreactivity in adolescence were bronchial hyperreactivity in childhood (p = 0.004), symptoms triggered by allergen exposure (OR 5.47; CI 1.91 to 25.20; p = 0.029), and damp housing conditions (OR 16.14; CI 3.53 to 73.73; p < 0.001). In a subgroup in whom house dust mite antigen levels in the bed were measured (70% of the sample), higher mite antigen levels were associated with bronchial hyperreactivity (OR per quartile of mite antigen 2.30; CI 1.03 to 5.12; p = 0.042). Mite antigen levels were also significantly correlated with dampness (p = 0.05). However, the effect of dampness on bronchial hyperreactivity remained significant when adjusting for mite allergen levels (OR 5.77; CI 1.17 to 28.44; p = 0.031). CONCLUSION: Dampness at home is a significant risk factor for the persistence of bronchial hyperreactivity and respiratory symptoms in children with asthma. This risk is only partly explained by exposure to house dust mite antigen.

Adolescent↗
PubMed1997

Pollution and the development of allergy: the East and West Germany story.

Allergic diseases are partly genetically determined, but environmental factors have a strong influence on the expression of allergic symptoms in genetically predisposed subjects. In particular, outdoor air pollution has received widespread attention as a potential manifestation factor. The unification of Germany provided a unique opportunity to study the impact of radically different environmental and social conditions on the development of allergies in two genetically homogeneous populations. A high car density and NO2 exposure were typical for many West German cities. Severe pollution due to heavy industrialization and private coal burning for heating purposes were the main sources of air pollution in East German cities. We assessed the prevalence of asthma and allergic disorders in 9-11 year old children in in East Germany (Leipzig and Halle) and in West Germany (Munich). All fourth grade pupils in Munich (n = 7,445) were compared with those in Leipzig and Halle 1991 (n = 3,105). Hay fever, skin test reactivity to common aeroallergens and asthma were considerably more prevalent in West Germany as compared to East Germany. When atopy was taken into account, there was no longer a significant difference in the prevalence of asthma between the two parts of the country.

Air Pollution↗
PubMed1997

Towards prevention.

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Anti-Inflammatory Agents↗
PubMed1997

Worldwide variations in prevalence of symptoms of allergic rhinoconjunctivitis in children: the International Study of Asthma and Allergies in Childhood (ISAAC).

BACKGROUND: As part of the International Study of Asthma and Allergies in Childhood (ISAAC), prevalence surveys were conducted among representative samples of school children from locations in Europe, Asia, Africa, Australia, North and South America. SUBJECTS: 257,800 children aged 6-7 years from 91 centres in 38 countries, and 463,801 children aged 13-14 years from 155 centres in 56 countries. METHODS: Written symptom questionnaires were translated from English into the local language for self-completion by the 13-14-year-olds and completion by the parents of the 6-7-year-olds. Rhinitis was described as a problem with sneezing, or a runny, or blocked nose when you (your child) DID NOT have a cold or the flu. Additional questions were asked about rhinitis associated with itchy-watery eyes, interference with activities and a history of hay fever ever. RESULTS: The prevalence of rhinitis with itchy-watery eyes ("rhinoconjunctivitis") in the past year varied across centres from 0.8% to 14.9% in the 6-7-year-olds and from 1.4% to 39.7% in the 13-14-year-olds. Within each age group, the global pattern was broadly consistent across each of the symptom categories. In centres of higher prevalence there was great variability in the proportion of rhinoconjunctivitis labelled as hay fever. The lowest prevalences of rhinoconjunctivitis were found in parts of eastern Europe, south and central Asia. High prevalences were reported from centres in several regions. CONCLUSION: These results suggest substantial worldwide variations in the prevalence and labelling of symptoms of allergic rhinoconjunctivitis which require further study. These differences, if real, may offer important clues to environmental influences on allergy.

Adolescent↗
PubMed1996

Relation of indoor heating with asthma, allergic sensitisation, and bronchial responsiveness: survey of children in south Bavaria.

OBJECTIVE: To investigate the relation between different types of heating and the prevalence of atopic diseases, skin test reactivity, and bronchial hyperresponsiveness. DESIGN: Cross sectional survey among school-children aged 9-11 years. Skin prick tests, pulmonary function tests, and bronchial challenge in the children and self completion of a written questionnaire by the children's parents. SUBJECTS: 1958 children in a rural area in southern Bavaria, Germany. MAIN OUTCOME MEASURES: Prevalence of asthma, hay fever, and atopic dermatitis as determined by parents' answers to a questionnaire; the atopic status of the child assessed by skin prick tests; and bronchial responsiveness to cold air challenge in the children. RESULTS: After possible confounders were controlled for, the risk of developing hay fever (odds ratio = 0.57; 95% confidence interval 0.34 to 0.98), atopy defined as at least one positive reaction to a panel of common aeroallergens (0.67; 0.49 to 0.93), sensitisation to pollen (0.60; 0.41 to 0.87), and of bronchial hyperresponsiveness (0.55; 0.34-0.90) was significantly lower in children living in homes where coal or wood was used for heating than in children living in homes with other heating systems. CONCLUSIONS: Factors directly or indirectly related to the heating system used in rural Bavarian homes decrease the susceptibility of children to becoming atopic and to developing bronchial hyperresponsiveness.

Asthma↗
PubMed1996

Respiratory hypersensitivity and environmental factors: East and West Germany.

We assessed the prevalence of asthma and allergic disorders in 9-11 year old children in Leipzig and Halle in East Germany, and Munich, West Germany. Both East German cities were heavily polluted due to private coal burning and industrial emissions, whereas Munich has moderate industry but heavy car traffic. All fourth grade pupils in Munich (n = 7445) were compared with those in Leipzig, 1990 (n = 1429) and Leipzig and Halle, 1991 (n = 3105). The prevalence of hay fever and skin test reactivity to common aeroallergens was considerably higher in West Germany as compared to East Germany. Furthermore, the prevalence of asthma was also higher in the West German study area. However, when atopy was taken into account, there was no longer a significant difference in the prevalence of asthma between the two parts of the country.

Air Pollutants↗
PubMed1996

Psychosocial characteristics of asthma.

The objective of this study was to compare psychosocial characteristics of children with asthma and children with bronchial hyperreactivity with those of normal children. A population-based study of 2634 children (mean age, 10 years) was carried out. Pulmonary function tests of children were performed in children before and after cold air hyperventilation challenge to determine bronchial hyperreactivity. Parental assessment of children's behavior was evaluated with 15 questions about school/learning habits, level of activity, communication/affection, and sleeping patterns. A factor analysis was performed and the factor loading adjusted for confounders compared in the different groups. Asthmatic children sleep less well than normal and hyperreactive children (p < 0.001). Unexpectedly, however, all other single items did not differ significantly. As a result of the factorial analysis we obtained two factors. On the first factor, measuring school behavior and learning, there was a small difference between asthmatic and normal children, which could not be found on the second factor indicating activity and communication. We conclude that psychosocial differences of asthmatic children are less remarkable than expected. As a result of the examination of the hyperreactive children it is likely that asthmatic children are influenced more by secondary psychosocial factors than by any primary effect of asthmatic disease.

Asthma↗
PubMed1996

Progression of allergy and asthma through childhood to adolescence.

The reduction in asthma symptoms and bronchial hyperresponsiveness in adolescence is not well understood. Nor can the differences in asthma prevalence and severity between the sexes, which reverse at puberty, be explained. It has been suggested that the improvement in asthma during adolescence may result from diminished clinical and immunological responsiveness directly related to hormonal changes and that the effect of age on the prevalence of asthma in each sex may relate to differences in hormonal status, potentially influencing airway size, inflammation, and smooth muscle and vascular functions. However, few comprehensive studies are available. In summary, all wheezing is not asthma. Non-asthmatic wheezing illnesses may in part be attributable to anatomical abnormalities of the lung (transient early wheezing, premature birth). Little is known about the genetic and environmental determinants of childhood asthma, and factors related to the development of atopic sensitisation, such as exposure to allergens, infectious diseases, or tobacco smoke early in life, and dietary habits may be important, whereas the relevance of air pollution remains to be established. Unfortunately, we still do not know how to prevent the manifestation of childhood asthma.

Adolescent↗
PubMed1996

Familial aggregation of asthma in a South Bavarian population.

There is considerable evidence for a significant hereditary component in the pathogenesis of asthma and allergic diseases. The objective of this study was to investigate familial influences unique to the expression of asthma. School children (n = 9,403), 9 to 11 yr of age, were enrolled in a cross-sectional survey in southern Germany. The prevalence of asthma and allergic diseases in parents and children was assessed through parental questionnaires. Atopic sensitization was measured by skin prick tests, and bronchial responsiveness was determined by cold air hyperventilation challenge. The prevalence of asthma alone, i.e., without concomitant hay fever or atopic eczema, increased strongly if nearest of kin suffered from asthma alone (4.7 versus 11.7%, p < 0.0001). A family history of hay fever or atopic dermatitis, excluding asthma, was unrelated to asthma in the offspring (4.7 versus 3.9%). These relations did not change when stratifying for skin prick test reactivity (STR) and bronchial hyperresponsiveness (BHR). STR alone and BHR alone (i.e., without manifestation of disease) were unrelated to a family history of asthma or allergy. The results strongly suggest a separate genetic factor controlling the development of asthma. Skin test positivity and BHR to cold, dry air are unlikely to be the underlying mechanisms through which the inheritance of childhood asthma is transmitted.

Asthma↗
PubMed1995

Air pollution and upper respiratory symptoms in children from East Germany.

Whereas evidence of adverse effects of air pollution on lower respiratory tract illnesses in children is increasing, little is known about the effects of high and moderate levels of air pollution on the incidence of upper respiratory illnesses. 9 to 11 year old schoolchildren (n = 1,854) living in Leipzig, East Germany were studied. The presence of upper respiratory symptoms was documented by a physician. Daily mean and maximum concentrations of SO2, particulate matter (PM) and NOx, as well as temperature and humidity, were measured. Furthermore, a self-administered questionnaire was distributed to the parents to assess confounding factors. Parents of 1,500 (81%) children returned the questionnaire. When controlling for paternal education, passive smoke exposure, number of siblings, temperature and humidity, increased risks for the development of upper respiratory symptoms were found in the winter months for SO2 mean concentrations (odds ratio (OR) = 1.72; 95% confidence interval (95% CI) 1.19-2.49). NOx mean concentrations (OR = 1.53; 95% CI 1.01-2.31) and PM maximum values (OR = 1.62; 95% CI 1.08-2.45). In the summer months, only NOx mean concentrations were associated with a significantly increased risk (OR = 1.82; 95% CI 1.21-2.73). A combination of high mean levels of different pollutants resulted in the highest risk (OR = 2.10; 95% CI 1.30-3.37 in the winter, and OR = 2.16; 95% CI 1.23-3.81 in the summer). We conclude that high concentrations of SO2, and moderate levels of particulate matters and NOx are associated with an increased risk of developing upper respiratory symptoms in childhood.(ABSTRACT TRUNCATED AT 250 WORDS)

Air Pollutants↗
PubMed1995

Aerosol bolus dispersion and effective airway diameters in mildly asthmatic children.

The contribution of aerosol techniques, the estimation of aerosol bolus dispersion and effective airway dimensions, to the clinical diagnosis of paediatric asthma was studied. In 47 children, aged 11 +/- 2 yrs, with mild asthma (forced expiratory volume in one second (FEV1) 83 +/- 9% of forced vital capacity (FVC)) effective airway diameters were derived from the recovery of inhaled 1 micron sebacate droplets. Intrapulmonary dispersion of inhaled boluses of 0.4 micron droplets was studied, by characterizing the concentration distributions of droplets in the exhaled air by their standard deviation and skewness. Effective airway diameters increased in asthmatic subjects with increasing body size, and did not differ from those obtained in 16 healthy children of similar age and height. Standard deviation and skewness of particle boluses exhaled from shallow lung depths were higher in the asthmatic children than the healthy children (e.g. standard deviation 91 +/- 17 ml vs 79 +/- 15 ml, skewness 0.38 +/- 0.16 vs 0.23 +/- 0.16, respectively, for boluses in 140 ml lung depth). The sensitivity and specificity of bolus dispersion to detect alterations in lung function was comparable to that of FEV1/FVC, the most sensitive conventional lung function parameter in the present study. There was no correlation between body height or lung function and bolus parameters. We conclude that aerosol measurements do not provide an obvious benefit for the clinical diagnosis of mild paediatric asthma, but bolus dispersion supplies additional information on alterations in convective gas transport in the diseased lung.

Aerosols↗
PubMed1994

Skin test reactivity and number of siblings.

OBJECTIVE: To investigate the relation between skin test reactivity in children and number of siblings. DESIGN: Cross sectional survey among schoolchildren aged 9-11 years. Skin prick tests in the children and self completion of written questionnaire by their parents. SUBJECTS: 5030 children in Munich and 2623 children in Leipzig and Halle, Germany. MAIN OUTCOME MEASURES: Atopic status assessed by skin prick tests. RESULTS: After possible confounders were controlled for, the prevalence of atopic sensitisation decreased linearly with increasing number of siblings (odds ratio = 0.96 for one sibling, 0.67 for five or more siblings; P = 0.005). In atopic children the severity of the skin test reaction as assessed by the weal size was not associated with the number of siblings. CONCLUSIONS: Factors directly or indirectly related to the number of siblings may decrease the susceptibility of children to become atopic. Thus, declining family size may in part contribute to the increased prevalence of atopic diseases reported in Western countries over the past few decades.

Child↗
PubMed1994

Bronchial hyperreactivity and history of wheezing in children.

UNLABELLED: The objective of this analysis was to determine the relationship between wheezing at different age groups in children and the prevalence of bronchial hyperreactivity at the age of 10. A population-based cross-sectional study was conducted in Leipzig and the region around Halle in Germany. Of 3105 10-year-old children, 2658 questionnaires (85.6%) were returned. In addition 2279 (73.4%) pulmonary function tests were performed before and after cold air challenge. 658 children (24.8%) had recurrent wheezing during their lifetime. In 579 children the individual time course could be evaluated (46 children with and 533 without a physician-confirmed diagnosis of asthma). Wheezing began most frequently in the 1st year of life (44.1% of all wheezing children) with the highest annual prevalence in the 3rd year (71.0% of all wheezing children). Wheezing which started in the first 2 years of life, had disappeared in most of the children by the age of 10. However, if wheezing began later than the 3rd year it was more persisting. Bronchial hyperreactivity measured after cold air challenge was higher in the group with recurrent wheezing (24.1%) than in the group without wheezing (18.8%, P = 0.004). CONCLUSION: Wheezing is a very common symptom in childhood and only partly associated with later bronchial hyperreactivity. On the other hand, asthma is often not diagnosed despite bronchial hyperreactivity and many years of wheezing.

Age Factors↗