Increased house dust mite allergen in synthetic pillows may explain increased wheezing.
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Animals↗
Biomedical subjects
J Crane
Publications and source records attributed to J Crane.
Under the volcano: fire, ash and asthma?
AIMS: To investigate the prevalence of respiratory symptoms in known asthmatics, following exposure to airborne volcanic ash particles caused by the eruptions of Mount Ruapehu, New Zealand, commencing September 1995. METHOD: A one page postal questionnaire was sent to 1392 previously identified asthmatics 2 months after the first major eruption. RESULTS: Two hundred and thirty seven subjects had moved from the area, died or gone overseas since the original contact 4 years previously; therefore the target population was 1155 subjects of whom 361 lived in the exposed area and 794 in the nonexposed areas. The response rates were 246 (68.1%) in the exposed group and 477 (60.1%) in the nonexposed group making a total of 723 individuals. The prevalence of nocturnal shortness of breath in the last two months was 29.3% in the exposed group and 24.7% in the nonexposed (OR = 1.26, 95% CI; 0.83-1.78). Similarly 30.9% of the exposed group had an asthma attack in the last 2 months compared to 31.9% of the nonexposed group (OR = 0.96, 95% CI; 0.69-1.33). Finally, 48.4% of the exposed group used asthma medication in the 2 months following the eruption in comparison to 53% of the nonexposed group (OR = 0.83, 95%, CI; 0.61-1.12). CONCLUSIONS: The study showed no association between living in an area exposed to volcanic ash particles and either asthma symptoms or the use of asthma medication. There was a small but nonsignificant increase in nocturnal shortness of breath in the exposed group.
Acute Disease↗
International trends in asthma mortality.
Throughout the 20th century many different patterns of asthma mortality have been observed. Following relatively stable asthma mortality rates during the first half of this century, there has been a gradual increase in asthma mortality in many countries over the last 50 years. Although a number of possible explanations have been proposed to explain this trend-including increases in asthma prevalence, increases in exposure to factors that trigger asthma attacks and changes in asthma management-their relative contribution in different countries is uncertain. Another pattern is that of sudden marked increases in asthma mortality occurring in at least seven countries in the 1960s and in New Zealand in the 1970s. Available evidence indicates that the cause of these 'epidemics' was the use of high dose preparations of two specific beta-agonist drugs, namely isoprenaline forte and fenoterol. The most recent trend observed in a number of western countries during the last decade has been a gradual reduction in asthma mortality; this may relate to improvements in the management of asthma.
Asthma↗
The effectiveness of sweeping membranes at term: a randomized trial.
OBJECTIVE: To determine whether sweeping or stripping membranes at 38-40 weeks' gestation leads to spontaneous labor within 7 days. METHODS: One hundred fifty antenatal low-risk patients at 38-40 weeks' gestation were assigned randomly to sweeping or control (ie, Bishop score only) groups and stratified based on the ability to pass a finger through the internal os. The primary outcome was the rate of spontaneous labor within 7 days. Major secondary outcomes included the spontaneous labor rate before 41 weeks and the overall spontaneous labor rate. Other outcomes included maternal and neonatal morbidity. The sample size was calculated based on doubling of the spontaneous labor rate within 7 days from 28% to 56% (alpha = 0.05, beta = 0.10). RESULTS: The subjects were demographically similar between the groups. There were no differences between the groups in the primary outcome of spontaneous labor within 7 days (33% sweeping, 38% control; P = .39) or in the secondary outcomes of spontaneous labor before 41 weeks (P = .66) or the overall spontaneous labor rate (P = .09). The Bishop score predicted spontaneous labor within 7 days (P = .003), and gestational age at enrollment predicted spontaneous labor before 41 weeks (P = .008) and the overall spontaneous labor rate (P = .008), using logistic regression to control for potential confounders. CONCLUSIONS: Sweeping membranes once at 38-40 weeks' gestation does not significantly increase the proportion of women who begin spontaneous labor within 7 days.
Adult↗
House dust mite allergen levels in public places in New Zealand.
BACKGROUND: House dust mite allergens are a risk factor for asthma in New Zealand, and levels in domestic dwellings have been found to be high compared with levels in most other countries. Studies in other countries have demonstrated lower levels of Dermatophagoides pteronyssinus allergens in public places compared with levels in domestic dwellings. OBJECTIVES: The purpose of this study was to measure reservoir Der p 1 levels in public places in New Zealand and to examine determinants of these levels. METHODS: Reservoir dust was obtained in the two centers (Christchurch and Wellington) from hotels, hospitals, rest homes, churches, primary schools, childcare centers, cinemas, bank head offices, and airplanes; samples were also obtained from ski lodges. Single measurements of temperature and relative humidity were taken with thermohygrometers and an average humidity over 2 weeks was estimated with use of waxed wooden sticks. Information was collected on building construction, type of heating, and frequency of cleaning. Der p 1 levels (micrograms per gram of fine dust) for floor (n = 202), bed (n = 65), and seat (n = 24) samples in public places were expressed as geometric means (95% confidence intervals). RESULTS: Der p 1 levels in public places were significantly lower than domestic levels in both Wellington and Christchurch. Both floor and bed levels were higher in hotels than in other public places. After controlling for potential confounders, floor Der p 1 levels were higher with carpeted floors (p < 0.0001) and lower with recent cleaning (p = 0.02) and bed Der p 1 levels were higher with timber wall construction (p = 0.03). Other building, heating, or cleaning characteristics did not show significant association with allergen levels. CONCLUSION: Der p 1 levels were much lower in public places than in domestic dwellings with floor levels primarily affected by floor covering.
Allergens↗
The effects of temperature and buffer on the extraction of Der p 1 from dust.
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Allergens↗
Cat allergen (Fel d 1) levels on school children's clothing and in primary school classrooms in Wellington, New Zealand.
BACKGROUND: New Zealand has a high prevalence of the major allergic diseases including asthma, rhinitis, and eczema, and cat ownership is common, with more than 50% of homes containing a cat. OBJECTIVE: The study was designed to examine the levels of cat allergen (Fel d 1) in the primary school environment, both on floors and on children's clothing. METHODS: We collected and analyzed dust samples from 11 school classrooms and from 202 children's garments using vacuum sampling and two-site monoclonal antibody ELISA, respectively. Environmental variables were identified by questionnaire. RESULTS: The geometric mean level of Fel d 1 in classrooms was 2.61 micro/gm (95% confidence interval, 1.28 to 3.84); however, seven classrooms had a floor sample with Fel d 1 greater than 8 microg/m2. Carpeted floor levels at 2.21 microg/gm (1.28 to 3.84) were considerably higher than those on uncarpeted floors, at 0.33 microg/gm (0.1 to 1.14). Floor levels and pupil cat ownership rates were positively correlated (r2 = 0.93, p = 0.0003). Children from homes with cats carried allergen on their clothes (mean Fel d 1, 6.10 microg per garment compared with non-cat owners (0.72 microg per garment). Wool and polyester garments contained more Fel d 1 than cotton clothing. Girls' clothing had significantly higher levels of allergen than did that of boys, even after controlling for cat status and fabric differences. CONCLUSIONS: Carpeting should be discouraged in environments such as schools and child care centers, where children spend considerable time. Transport of Fel d 1 on clothing from the domestic to the school environment is a major source of classroom cat allergen.
Adult↗
Perinatal factors and atopic disease in childhood.
BACKGROUND: Recent work has suggested possible linkages between perinatal factors and notably, head circumference and risks of subsequent atopic illness. OBJECTIVE: To examine the linkages between perinatal factors and risks of atopic conditions in a birth cohort of New Zealand children studied to the age of 16. METHODS: Measures of atopic illness including asthma, eczema, and other allergies were assessed prospectively during the course of a 16 year longitudinal study of a birth cohort of 1265 New Zealand children. In the initial stage of this research, measures of perinatal variables including birthweight, gestational age, head circumference and length at birth were obtained from hospital record data. RESULTS: Children with head circumference at birth of 37 cm or greater had (unadjusted) odds of asthma that were 1.8 (P < 0.01) to 3.0 (P < 0.0001) times higher than the odds for children of lesser head circumference. However, risks of asthma were not related to other perinatal measures including birthweight, gestational age or length or ratios of these measures. There were no consistent associations between perinatal measures and other measures of childhood atopy including eczema, allergic rhinitis and other allergies. The associations between head circumference and asthma risks persisted when due allowance was made for potentially confounding social and perinatal factors. CONCLUSIONS: It is concluded that large head circumference at birth may be associated with increased risks for the development of asthma. Possible explanations for the linkages between head circumference and asthma risks are considered.
Adolescent↗
The effect of season-of-response to ISAAC questions about asthma, rhinitis and eczema in children.
BACKGROUND: To examine whether responses to questions about the lifetime prevalence and 12-month period prevalence of symptoms of asthma and allergies are affected by the season in which the questions are asked. METHODS: The international Study of Asthma and Allergies in Childhood (ISAAC) Phase One was undertaken in six New Zealand centres; in three centres the effect of season was studied. Over three school terms at least 3000 children were studied in each of two age groups per centre (6-7 years; 13-14 years), one-third in each term respectively. The ISAAC standardized written questionnaires were used to identify asthma, rhinitis and eczema symptoms. The written questionnaire in the younger age group was completed by the parent/guardian. The older age group self-completed the written questionnaire and also a video questionnaire about asthma symptoms. RESULTS: The total number of respondents was 21,437, approximately half in each age group. The season of responding had no effect on the level of response to eczema questions. For the written asthma questionnaire no season-of-response effect was present for 6-7 year olds; for 13-14 year olds there was a trend to a higher rate of positive responses by those responding in winter, but in only one question did this reach statistical significance. With the video questionnaire there was a similar trend for a higher rate of positive responses when questions were asked in winter, but this did not reach statistical significance. For rhinitis symptoms there was a statistically significant season-of-response effect in both age groups with two questions; the fewest positive responses by the winter responders. CONCLUSIONS: There was no significant effect of season-of-response to questions on eczema symptoms, and most questions on asthma symptoms. There was a season-of-response effect on responses to questions on rhinitis symptoms suggesting a recall bias relating to recency of symptoms.
Adolescent↗
Is infant immunization a risk factor for childhood asthma or allergy?
The Christchurch Health and Development Study comprises 1,265 children born in 1977. The 23 children who received no diphtheria/pertussis/tetanus (DPT) and polio immunizations had no recorded asthma episodes or consultations for asthma or other allergic illness before age 10 years; in the immunized children, 23.1% had asthma episodes, 22.5% asthma consultations, and 30.0% consultations for other allergic illness. Similar differences were observed at ages 5 and 16 years. These findings do not appear to be due to differential use of health services (although this possibility cannot be excluded) or con-founding by ethnicity, socioeconomic status, parental atopy, or parental smoking.
Adolescent↗
Determinants of house dust mite allergen in homes in Wellington, New Zealand.
OBJECTIVES: To measure levels of the major Dermatophagoidespteronyssinus allergen (Der p 1) in homes in Wellington, New Zealand, and to examine factors which affect these levels. METHODS: As part of a study of risk factors for asthma among 474 8-10-year-old children, standard procedures were used to collect reservoir dust and to measure Der p 1 levels on the living room floor and child's bedroom floor and bedding. Der p 1 levels were analysed both as geometric mean microg/g of fine dust and as microg/m2. Questionnaires collected information about factors which might influence these levels, and an average relative humidity in the bed and on the bedroom floor was also measured. RESULTS: Similar geometric mean levels of Der p 1 were found at each floor site - 25.5 microg/g (95% CI: 22.8-28.5) in the living room and 26.4 microg/g (95% CI: 23.7-29.3) on the child's bedroom floor. The geometric mean level of Der p 1 in the child's bed was 46.6 microg/g (95% CI: 42.3-51.3). After controlling for possible confounders, geometric mean living room and bedroom floor Der p 1 levels were significantly higher in households with older carpet than households with no carpets or newer carpets, and higher in the autumn. Households with three or more children had higher levels of Der p 1 than households with fewer children. Bedding levels were significantly higher in beds with kapok or inner sprung mattresses, or wool underlays and at relative humidities above the mean (51%). CONCLUSION: The very high levels of house dust mite allergen (Der p 1) found in Wellington are likely to be due to a variety of life-style and climatic factors. However, the type and age of floor covering appears to be the single most important factor.
Allergens↗
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↗
Occupational asthma in New Zealanders: a population based study.
OBJECTIVES: To examine the effect of occupation on respiratory symptoms in a randomly selected adult population aged 20-44 years. METHODS: It is based on the phase II sampling of the New Zealand part of the European Community respiratory health survey. 1609 people (63.9% response rate) completed a detailed respiratory questionnaire. Of those responding, 1174 (73%) underwent skin tests and 1126 (70%) attended to undergo methacholine bronchial challenge. Current occupation was recorded and a previous occupation was also recorded if it had led to respiratory problems. 21 occupational groups were used for analysis for the five definitions of asthma wheezing in the previous 12 months; symptoms related to asthma; bronchial hyperresponsiveness (BHR); BHR with wheezing in the previous 12 months; and BHR with symptoms related to asthma. RESULTS: Prevalence odds ratios (ORs) were significantly increased for farmers and farm workers (OR 4.16, 95% confidence interval (95% CI) 1.33 to 13.1 for the combination of wheezing and BHR). Increased risks of prevalence of asthma were also found for laboratory technicians, food processors (other than bakers), chemical workers, and plastic and rubber workers. Workers had also been divided into high and low risk exposure categories according to relevant publications. The prevalence of wheezing was greater in the high risk group (OR 1.57, 95% CI 0.83 to 2.95) than in the low risk group. Atopy was associated with asthma, but the prevalence of atopy did not differ significantly between occupational exposure groups. The attributable risk of wheezing that occurred after the age of 15 years and that was estimated to be due to occupational exposure (based on the defined high risk group) was 1.9%, but this increased to 3.1% when farmers and food processors (other than bakers) were also included in the high risk group. CONCLUSIONS: This population based study has identified certain occupations significantly associated with combinations of asthmatic symptoms and BHR.
Adult↗
Chronic bronchitis, shortness of breath, and airway obstruction by occupation in New Zealand.
The objectives of this study were to measure the population prevalence of symptoms of chronic obstructive lung disease and mild airway obstruction and to compare these between occupational groups. There were 1,609 subjects (63.9% response rate) who completed a respiratory questionnaire. Of these, 1,132 (70.4%) underwent pulmonary function testing (FEV1 and FVC). Twenty-one categories of current occupation were used for analysis. Four definitions of chronic obstructive pulmonary disease (COPD) were used: (1) chronic bronchitis, (2) chronic bronchitis with airway obstruction, (3) shortness of breath, and (4) shortness of breath with airway obstruction. For chronic bronchitis, adjusted prevalence odds ratios were significantly elevated for food processors other than bakers (OR = 2.83; 95% CI, 1.27 to 6.29) and chemical processors (OR = 18.84; 3.71 to 95.64). The combination of chronic bronchitis and mild airway obstruction (FEV1/FVC < 0.75) was associated with bakers (OR = 25.5; 3.86 to 168.53) and spray painters (OR = 14.40; 2.85-72.69). Shortness of breath was associated with hairdressers (OR = 2.75; 0.80 to 9.42) and bakers (OR = 6.72; 0.57 to 79.66), and nursing was associated with lower levels of shortness of breath (OR = 0.42; 0.16 to 1.15). Working ever with vapors, gases, dust, or fumes was significantly associated with chronic bronchitis and airway obstruction (OR = 3.13; 1.07 to 9.12). This population-based study has identified certain occupations with increased prevalence of chronic bronchitis and COPD.
Adult↗
Comparison of reported prevalences of recent asthma in longitudinal and cross-sectional studies.
A potential source of bias in prevalence rates reported for symptoms and diagnoses of asthma in longitudinal studies could arise if repeated questioning of subjects or previous experience of lung function and airway responsiveness tests increased awareness of respiratory symptoms. We wished to determine the extent of any such bias by comparing reported prevalence rates from a longitudinal and cross-sectional study within similar populations. The prevalences of wheezing in the last year, waking with chest tightness, waking with shortness of breath, waking with coughing, having an attack of asthma in the last year, and current use of medications for asthma were determined using identical questions in two populations. Self-completed questionnaire responses of 946 subjects, 21 yrs of age, participating in the seventh respiratory assessment in the longitudinal Dunedin Multidisciplinary Health and Development Research Study were compared with responses provided by 991 subjects, aged 20-22 yrs, completing a postal questionnaire on one occasion only for the New Zealand section of the European Community Respiratory Health Study. The prevalence rates were not significantly different between the two populations, for all of the reported symptoms and for medication use. Differences in responses between genders were similar in each study, with all responses being more common in females. We conclude that repeated questioning regarding respiratory symptoms and repeated lung function and bronchial challenge testing in a longitudinal study of asthma did not bias prevalence rates compared with those obtained in a similar population of the same age studied on only one occasion.
Adult↗
Fenoterol, asthma deaths, and asthma severity.
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Adolescent↗
Fenoterol, asthma deaths, and asthma severity: confounding or confusion?
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Acute Disease↗
House dust mite allergen in pillows.
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Allergens↗