Effect of socioeconomic status on allergic diseases and atopy in school children

Sipahi, Sevgi; Nacaroğlu, Hikmet Tekin; Can, Demet; Günay, İlker; Ünsal-Karkıner, Canan Şule; Kamalı, Hacer; Özdemır, Ahmet; Günay, Türkan

doi:10.24953/turkjped.2017.06.008

Cited by 5 publications

(4 citation statements)

References 15 publications

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“…With the objective to document EDN levels, the slightly higher education level and proportion of allergic diseases among the parents in the PreventADALL cohort than in the general population 24 limit the generalizability of our observations to similar populations, as disease burden, 38 and thereby likely EDN levels, may differ with socioeconomic status. Children sensitized to allergens such as tree nuts will not have been identified at 3 years, but the potential impact on observed associations is likely to be small.…”

Section: Discussionmentioning

confidence: 99%

Eosinophil‐derived neurotoxin levels in early childhood and association with preschool asthma – A prospective observational study

Färdig,

Lie,

Borres

et al. 2023

Clin Experimental Allergy

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IntroductionEosinophil‐derived neurotoxin (EDN) is related to childhood asthma, while normal values are lacking. We aimed to document serum EDN levels at 1 and 3 years in general and in non‐atopic children, and explore if EDN levels differed by sex or were associated with preschool asthma at 3 years.MethodsFrom the PreventADALL birth cohort, we included 1233 children with EDN analysed using ImmunoCAP at 1 and/or 3 years. Non‐atopic children had no history of wheeze, asthma, allergic sensitization or atopic dermatitis. Preschool asthma was defined as having ≥3 episodes of bronchial obstruction between 2 and 3 years, plus doctor diagnosed asthma and/or asthma medication use by 3 years. The upper limit of normal (ULN) of EDN was defined as the 95th percentile. With Youden Index we calculated EDN cut‐off levels for risk of preschool asthma.ResultsThe overall median (ULN) EDN levels were 27.4 (121) μg/L at 1 year (n = 787), and 20.1 (87.8) μg/L at 3 years (n = 857). Non‐atopic children had EDN levels of 24.0 (107) μg/L at 1 year (n = 147), and 17.3 (84.6) μg/L at 3 years (n = 173). EDN levels were higher in boys compared to girls; 32.0 (133) versus 24.5 (97.0) μg/L at 1 year, and 20.9 (96.3) versus 19.0 (72.4) μg/L at 3 years. Preschool asthma was observed in 109/892 (12.2%) children. Higher EDN levels at 1 (>26.7 μg/L) and 3 (≥20.5 μg/L) years were associated with preschool asthma; adjusted OR (95% CI) 2.20 (1.09, 4.41) and 4.68 (2.29, 9.55), respectively.Conclusion and Clinical RelevanceWe report EDN values in early childhood, demonstrating higher levels at 1 compared to 3 years and in boys compared to girls at both ages. Higher EDN levels at both ages were associated with preschool asthma. However, EDN cut‐off levels for preschool asthma were overall lower than the ULN of non‐atopic children, limiting translation into clinical practice.

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Section: Discussionmentioning

confidence: 99%

Eosinophil‐derived neurotoxin levels in early childhood and association with preschool asthma – A prospective observational study

Färdig,

Lie,

Borres

et al. 2023

Clin Experimental Allergy

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“…As a result, the socioeconomic status of an individual, which affects their burden of spending on such care services, was identified as a specific factor contributing to the poor utilization of healthcare services. Numerous studies have reported that SES is associated with healthcare utilization according to parental education and household income [9,12,17,18,24,27]. Another study reported that the burden of medical expenses for preschool children is lower than in other nations due to universal medical insurance and regional government subsidies for children's medical expenses [28].…”

Section: Discussionmentioning

confidence: 99%

“…Reportedly, hospital utilization is higher in urban than rural areas, and hospitals in rural areas typically have less resources than the facilities in urban areas. Furthermore, since the health disparities related to the association between gender and age have already been studied in children [11][12][13][14][15][16][17][18], there is a need for research on the health disparities related to the association between SES and healthcare utilization. This study assumed that healthcare utilization might vary depending on SES categories.…”

Section: Introductionmentioning

confidence: 99%

Association between Socioeconomic Status and Healthcare Utilization for Children with Allergic Diseases: Korean National Health and Nutritional Examination Survey (2015–2019)

Kim

et al. 2023

Healthcare

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This study aimed to investigate the association between socioeconomic status (SES) and healthcare utilization by children with allergic diseases. We determined SES based on parental occupation and household income. A cross-sectional study was conducted using the Korean National Health and Nutritional Examination Survey (KNHANES) between 2015 and 2019 with participants who were under 18 years of age. The presence of allergic conditions was determined by a self-reported survey of parental response and healthcare utilization data (such as inpatient and outpatient visits). Moreover, we categorized SES into four quantiles (Q1–Q4) based on household income per annum. Then, the data were analyzed using chi-square tests and multivariate logistic regression analysis with confidence intervals (CIs) of 95%, and p < 0.05 was considered significant. A total of 3250 participants were involved in this study. The percentage of allergic diseases was 67.9% for allergic asthma and 32.1% for atopic dermatitis. It was found that the participants who were over 13 years old had atopic dermatitis and were more likely to visit the hospital than younger children. Additionally, the highest SES group in Q4 demonstrated higher healthcare utilization (OR = 1.58; 95% CI, 1.14–1.76) than other SES groups. Our study reveals that parental socioeconomic characteristics are related to the use of healthcare services for children with allergic disorders in Korea. These results highlight the need for public health actions and research to overcome the SES gap among children with allergic diseases.

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“…16 Potential confounding variables were proposed based on the existing literature on air pollution and/or allergic sensitisation or diseases. [23][24][25][26][27][28][29][30] Two minimal su cient adjustment sets of confounders were identi ed based on a directed acyclic graph (DAG) using DAGitty v3.0 (Figure S1). 31 The rst one, selected for our primary analysis, included three variables: maternal education (≤ year 12 vs. > year 12), child age in months at the time of the blood collection, and Index of Relative Socio-economic Disadvantage (IRSD) decile of the household.…”

Section: Covariatesmentioning

confidence: 99%

Exposure to air pollution concentrations of various intensities in early life and allergic sensitisation later in childhood

Ziou

Cao

Wheeler

et al. 2023

Preprint

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BACKGROUND Evidence on the relationship between air pollution and allergic sensitisation in childhood is inconsistent, and this relationship has not been investigated in the context of smoke events that are predicted to increase with climate change. Thus, we aimed to evaluate associations between exposure in two early life periods to severe levels of particulate matter with an aerodynamic diameter < 2.5µm (PM2.5) from a mine fire, background PM2.5, and allergic sensitisation later in childhood. METHODS We measured specific immunoglobulin E (IgE) levels for seven common aeroallergens as well as total IgE levels in a cohort of children who had been exposed to the Hazelwood coal mine fire, either in utero or during their first two years of life, in a regional area of Australia where ambient levels of PM2.5 are generally low. We estimated personal exposure to fire-specific emissions of PM2.5 based on a high-resolution meteorological and pollutant dispersion model and detailed reported movements of pregnant mothers and young children during the fire. We also estimated the usual background exposure to PM2.5 at the residential address at birth using a national satellite-based land-use regression model. Associations between both sources of PM2.5 and sensitisation to dust, cat, fungi, and grass seven years after the fire were estimated with logistic regression, while associations with total IgE levels were estimated with linear regression. RESULTS No association was found between the levels of exposure at either developmental stage to fire-related PM2.5 and allergic sensitisation seven years after the event. However, levels of background exposure were positively associated with sensitisation to dust (OR = 1.89, 95%CI = 1.11,3.20 per 1 µg/m3). CONCLUSIONS Chronic but low exposure to PM2.5 in early life could be more strongly associated with allergic sensitisation in childhood than time-limited high exposure levels, such as the ones experienced during landscape fires.

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Effect of socioeconomic status on allergic diseases and atopy in school children

Cited by 5 publications

References 15 publications

Eosinophil‐derived neurotoxin levels in early childhood and association with preschool asthma – A prospective observational study

Eosinophil‐derived neurotoxin levels in early childhood and association with preschool asthma – A prospective observational study

Association between Socioeconomic Status and Healthcare Utilization for Children with Allergic Diseases: Korean National Health and Nutritional Examination Survey (2015–2019)

Exposure to air pollution concentrations of various intensities in early life and allergic sensitisation later in childhood

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