Faculty of Medicine

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    Acetaminophen Use and Risk of Asthma, Rhinoconjunctivitis, and Eczema in Adolescents
    (American Thoracic Society, 2011-01-15)
    Beasley, Richard W.
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    Clayton, Tadd O.
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    Crane, Julian
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    Lai, Christopher K. W.
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    Montefort, Stephen R.
    Rationale: There is epidemiological evidence that the use of acetaminophen may increase the risk of developing asthma. Objectives: To investigate the risk of asthma and other allergic disorders associated with the current use of acetaminophen in 13- to 14-year-old children in different populations worldwide. Methods :As part of the International Study of Asthma and Allergies in Childhood (ISAAC) Phase Three, 13- to 14-year-old children completed written and video questionnaires obtaining data on current symptoms of asthma, rhinoconjunctivitis, and eczema, and a written environmental questionnaire obtaining dataon putative risk factors, including acetaminophen use in the past 12 months. Measurements and Main Results: The primary outcome measure was the odds ratio (OR) of current asthma symptoms associated with acetaminophen use calculated by logistic regression. A total of 322,959 adolescent children from 113 centers in 50 countries participated. In the multivariate analyses the recent use of acetaminophen was associated with an exposure-dependent increased risk of current asthmasymptoms(OR, 1.43 [95%confidenceinterval, 1.33–1.53] and 2.51 [95% confidence interval, 2.33–2.70] for medium and high versus no use, respectively). Acetaminophen use was also associated with an exposure-dependent increased risk of current symptoms of rhinoconjunctivitis and eczema. Conclusions: Acetaminophen use may represent an important risk factor for the development and/or maintenance of asthma, rhinoconjunctivitis, and eczema in adolescent children.
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    Global variations in prevalence of eczema symptoms in children from ISAAC Phase Three
    (Elsevier BV, 2009-12)
    Odhiambo, Joseph A
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    Williams, Hywel C
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    Clayton, Tadd O
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    Robertson, Colin F
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    Asher, M Innes
    Background: In 1999, The International Study of Asthma and Allergies in Childhood (ISAAC) Phase One reported the prevalence of eczema symptoms in 715,033 children from 154 centers in 56 countries by using standardized epidemiologic tools. Objective: To update the world map of eczema prevalence after 5 to 10 years (ISAAC Phase Three) and include additional data from over 100 new centers. Methods: Cross-sectional surveys using the ISAAC questionnaire on eczema symptoms were completed by adolescents 13 to 14 years old and by parents of children 6 to 7 years old. Current eczema was defined as an itchy flexural rash in the past 12 months and was considered severe eczema if associated with 1 or more nights per week of sleep disturbance. Results: For the age group 6 to 7 years, data on 385,853 participants from 143 centers in 60 countries showed that the prevalence of current eczema ranged from 0.9% in India to 22.5% in Ecuador, with new data showing high values in Asia and Latin America. For the age group 13 to 14 years, data on 663,256 participants from 230 centers in 96 countries showed prevalence values ranging from 0.2% in China to 24.6% in Columbia with the highest values in Africa and Latin America. Current eczema was lower for boys than girls (odds ratio, 0.94 and 0.72 at ages 6 to 7 years and 13 to 14 years, respectively). Conclusion:ISAAC Phase Three provides comprehensive global data on the prevalence of eczema symptoms that is essential for public health planning. New data reveal that eczema is a disease of developing as well as developed countries.
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    Translation of questions: the International Study of Asthma and Allergies in Childhood (ISAAC) experience
    (International Union Against Tuberculosis and Lung Disease, 2009-09)
    Ellwood, P
    ;
    Williams, H
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    Aït-Khaled, N
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    Björkstén, B
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    Robertson, C
    OBJECTIVE: To explore the consequences of translating the International Study of Asthma and Allergies in Childhood (ISAAC) English core questionnaires on asthma, rhinitis and eczema symptoms into other languages. DESIGN: ISAAC Phase III developed 49 language translations for adolescents and 42 for children following standardised guidelines, which included back-translating the questionnaires into English to check their accuracy and meaning. Language deviations were categorised and analysed with regard to infl uences on the reported symptom prevalence. RESULTS: Category 1 deviations for one or more questions were found in seven translations (14%) for adolescents and in three translations (7%) for children. Data for these questions were excluded from the worldwide analyses. Category 2 deviations were identifi ed in the publications, and Category 3 deviations were ignored. CONCLUSIONS: Translations of questionnaires should follow a consistent protocol in global epidemiological research. Cultural norms need to be considered when evaluating back-translations into English, as disease labels are not available in every language, nor are they understood in the same way. Deviations from literal translations of English should be permitted if the intent of the original meaning is retained. A web-based tool of medical terminology would be useful for international research requiring the use of translations.
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    Socioeconomic status hypothesis in asthma and eczema in young adolescents
    (The Balkan Societies of Allergology and Clinical Immunology, 2006)
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    Stavric, Katerina
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    Seckova, Lidija
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    Kimovska, Milica
    Background: As studies in different populations have shown conflicting results about the relationship between asthma and socioeconomic status and its association with eczema has been less extensively studied, the study was aimed to explore the socioeconomic status hypothesis in asthma and eczema in young adolescents in the Republic of Macedonia. Methods: The self-reported data from 3026 children aged 13/14 years from randomly selected schools in Skopje, the capital of Macedonia, were obtained through the standardized International Study of Asthma and Allergies in Childhood Phase Three written questionnaires. Family size, mother’s educational level, tobacco smoke at home, wood/coal/oil heating at home and body mass index, as some socioeconomic status measures, were statistically correlated to asthma and eczema symptoms by odds ratios with 95% confidence interval (OR, 95% CI) in binary logistic regression. Results: Small families and overweight significantly increased the risk of ever-diagnosed asthma (OR 2.160, 95% CI 1.110-4.203 P=0.023 and OR 2.085, 95% CI 1.109-3.922 P=0.023, respectively). As well overweight was significantly associated with increased risk of current night cough (OR 1.365, 95% CI 1.053-1.771 P=0.019), while mother’s university education with decreased risk of the same symptom (OR 0.759, 95% CI 0.620-0.930 P=0.008). A significant association between the severity of asthma, eczema and investigated measures of socioeconomic status was not found. Conclusion: The results support the positive association between socioeconomic status and asthma only, without any effect of socioeconomic status on asthma severity and eczema.