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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The association between BMI, vigorous physical activity and television viewing and the risk of symptoms of asthma, rhinoconjunctivitis and eczema in children and adolescents: ISAAC Phase Three
(Wiley, 2013-01)
Mitchell, E A
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Beasley, R
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Björkstén, B
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Crane, J
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García-Marcos, L
Background: Several studies have observed an association between obesity and asthma, but whether or not there is an association with rhinoconjunctivitis or eczema is unclear. Aims To examine the relationship between body mass index categories (underweight, overweight and obesity), vigorous physical activity and television viewing and the risk of symptoms of asthma, rhinoconjunctivitis and eczema. Methods: As part of International Study of Asthma and Allergies in Childhood (ISAAC) Phase Three, parents or guardians of children aged 6–7 years completed written questionnaires about symptoms of asthma, rhinoconjunctivitis and eczema, and several potential risk factors, such as vigorous physical activity and television viewing, and other information such as the child’s height and weight. Adolescents aged 13–14 years self-completed the questionnaires on these symptoms and potential risk factors and reported their own height and weight. For 28% of children and 24% of adolescents, the height and weight was objectively measured. Results: A total of 76 164 children aged 6–7 years (from 29 centres and 17 countries) and 201 370 adolescents aged 13–14 years (from 73 centres and 35 countries) provided data meeting the inclusion criteria. There were associations between overweight and obesity, but not underweight, and symptoms of asthma and eczema but not rhinoconjunctivitis. Vigorous physical activity was positively associated with symptoms of asthma, rhinoconjunctivitis and eczema in adolescents, but not children. Viewing television for five or more hours/day was associated with an increased risk of symptoms of asthma, rhinoconjunctivitis and eczema in adolescents and symptoms of asthma in children. Conclusions and Clinical Relevance: This study has confirmed the association between overweight and obesity and symptoms of asthma. It has extended these observations to include significant associations with symptoms of eczema, but not rhinoconjunctivitis. There are complex relationships between obesity, vigorous physical activity and sedentary behaviour and the symptoms of asthma, rhinoconjunctivitis and eczema in 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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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.
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Do household tobacco smoking habits influence asthma, rhinitis and eczema among 13-14 year-old adolescents?
(Elsevier BV, 2011)
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Stavric, Katerina
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Seckova, Lidija
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Kimovska, Milica
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BACKGROUND: Although the harmful impact of environmental tobacco smoke on respiratory health in early childhood is well known, its effect in adolescence is still ambiguous. This study aims to examine if parents' and household tobacco smoking habits influence asthma, rhinitis and eczema in early adolescence in The Republic of Macedonia, as a country with a very high rate of household tobacco smoke exposure despite the smoking cessation campaign, and low prevalence rates of asthma, rhinitis and eczema. METHODS: Children aged 13-14 years (n=3026) from randomly selected schools in Skopje, the capital of Macedonia, completed by themselves the standardised International Study of Asthma and Allergies in Childhood (ISAAC) Phase Three written questionnaires on asthma, rhinitis, eczema and potential environmental risk factors. Maternal and paternal tobacco smoking habits and the number of smokers in households were separately correlated to current and ever-diagnosed asthma, rhinitis and eczema by odds ratios (OR, 95% CI) with and without adjustments for potential confounders using binary logistic regression. RESULTS: The maternal smoking habit was significantly positively associated only with current night dry cough apart from chest infection (aOR: 1.26; 1.03-1.54; p=0.026). No significant association was observed in relation to the other studied variables with either parental smoking habits or the number of smokers in the household. CONCLUSION: Household tobacco smoking habits were not found to have a significant influence on asthma, rhinitis and eczema in young adolescents. The established results point out the dominant influence of maternal smoking on cough as an unspecific asthma symptom.
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The self-reported density of truck traffic on residential streets and the impact on asthma, hay fever and eczema in young adolescents
(Elsevier BV, 2014)
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Stavric, Katerina
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Seckova, Lidija
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Kimovska Hristova, Milica
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BACKGROUND: Conflicting results have been reported, mostly in developed countries, on the relationship between exposure to traffic and allergic diseases. This study aims to examine the impact of truck traffic on asthma, rhinitis and eczema in early adolescence in Skopje, the capital of the Republic of Macedonia, as a developing country with a lower middle rate of high truck traffic exposure and low prevalence rates of allergic diseases. METHODS: Self-reported data was used, obtained through the International Study of Asthma and Allergies in Childhood Phase 3 written questionnaires, from 3026 adolescents aged 13-14 years from Skopje. Truck traffic density on the street of residence on weekdays was correlated to current and ever-diagnosed asthma, rhinitis and eczema by odds ratios (OR, 95% CI) in binary logistic regression, with and without adjustments for potential confounding factors separately and for their joint effect. RESULTS: A positive association of truck traffic density appeared to be limited to current dry night cough (aOR: 1.63; 1.07-2.47; aOR: 2.17; 1.40-3.35; and aOR: 2.33; 1.43-3.79 for truck traffic seldom, frequently through the day, and almost the whole day, respectively) with an exposure-response relationship and to current wheeze only for truck traffic almost the whole day (aOR: 1.87; 1.02-3.42). CONCLUSION: The findings suggest an aggravating effect of truck traffic on current asthma symptoms, but not on asthma, allergic rhinitis and eczema diagnoses. It seems that it probably has an impact as a direct respiratory irritant in early adolescence.

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