Growing disparities in atopy between the Finns and the Russians: A comparison of 2 generations

Hertzen, Leena von; Mäkelä, Mika J.; Petäys, Tuula; Jousilahti, Pekka; Kosunen, Timo U.; Laatikainen, Tiina; Vartiainen, Erkki; Haahtela, Tari

doi:10.1016/j.jaci.2005.07.028

Cited by 96 publications

(120 citation statements)

References 32 publications

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“…under Soviet conditions, and were, thus, exposed in their first years of life, and for a large majority throughout their childhood, to an environment and lifestyle likely to be protective against the development of allergic diseases in childhood and potentially later in life [9][10][11]13]. In studies conducted in children, wheezing was less associated with atopy in Estonia and in Russian Karelia compared with Sweden or Finland [9,33]. Precise data are lacking in the literature (especially in adults) and no allergy marker was available in the current study.…”

Section: Discussionmentioning

confidence: 99%

“…As in other eastern European countries that were formerly part of the Soviet Union [9,10], a lower prevalence of atopy and asthma was observed in Estonia compared with western Europe in the 1990s [11,12]. The degree of westernisation, and associated environmental and lifestyle-related exposures [9][10][11]13] were suggested to explain these differences.…”

Section: Introductionmentioning

confidence: 92%

“…The degree of westernisation, and associated environmental and lifestyle-related exposures [9][10][11]13] were suggested to explain these differences. However, by contrast with most other countries, the rate of asthma and allergy has remained low in Estonia [14].…”

Section: Introductionmentioning

confidence: 99%

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Occupational irritants and asthma: an Estonian cross-sectional study of 34 000 adults

et al. 2014

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Occupational exposures make important contributions to asthma morbidity. The role of low/ moderate level irritant exposures remains unclear. We aimed to determine which occupational exposures are associated with asthma in an eastern European country with low asthma prevalence.The Estonian Genome Center of University of Tartu collected data from 50 077 adults in 2002-2011. Asthma was assessed through a questionnaire regarding diagnosed diseases, current health status and medication. Exposures to 22 agents during the current and longest held jobs were estimated using an asthma-specific job-exposure matrix.Analyses included 34 015 subjects (aged 18-65 years, 67.0% females), of which 1209 (3.6%) reported asthma (608 with physician-confirmed diagnosis). After adjusting for age, sex and smoking habits, lifetime occupational exposure to known asthmagens (20.4%) was significantly associated with physician-diagnosed asthma (OR 1.28, 95% CI 1.03-1.59), especially high molecular weight agents (flour: OR 2.36, 95% CI 1.31-4.27; animals: OR 1.62, 95% CI 1.00-2.60). Exposure to low/moderate levels of irritants (17.4%) was associated with physician-diagnosed asthma (OR 1.88, 95% CI 1.48-2.37). More pronounced associations were observed in subjects reporting current treated asthma.Beyond confirming the effect of known asthmagens (which are well-known, mostly from observations in western countries), the results provide evidence for a role of low/moderate exposure to irritants. This finding, observed in a country with a low prevalence of asthma and atopy, provides new insight into the understanding of asthma heterogeneity. @ERSpublications Increased asthma risk was associated with occupational exposure to moderate levels of irritants in an Estonian study

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 92%

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Occupational irritants and asthma: an Estonian cross-sectional study of 34 000 adults

et al. 2014

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“…Prevalence of wheeze ranges 26-43% [10,13,14], and that of doctor-diagnosed asthma (DDA) 12-29% [9,10,12,14,15]. This is generally higher than in children (8.8%) [16] and adults (6%) [17]. Additionally, pulmonary function (PF) abnormalities, mostly mild restrictive disease [14,18,19], occur after repair of OA in childhood [14], adolescence [9,18,20,21] and adulthood [12,19,21].…”

mentioning

confidence: 99%

Repaired oesophageal atresia: respiratory morbidity and pulmonary function in adults

Sistonen¹,

Malmberg²,

Malmström³

et al. 2010

Eur Respir J

117

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Although after oesophageal atresia (OA) repair in infancy, respiratory problems are common, their natural history remains unclear. We assessed morbidity, pulmonary function (PF), and bronchial hyperresponsiveness (BHR) in adults with repaired OA respiratory.588 patients who underwent surgery for OA during 1947-1985 were identified and those 262 who were alive and had their native oesophagus were included. Respiratory symptoms and respiratory symptom-related quality of life (RSRQoL) were assessed by questionnaire and interview, and the patients underwent spirometry, a histamine challenge test, and an exhaled nitric oxide test. For the questionnaires, we added 287 carefully matched general populationderived controls.Among the 101 (58 male) patients, median age 36 yrs (range 22-56 yrs), respiratory morbidity was significantly increased compared to controls. Patients had more respiratory symptoms and infections, as well as asthma and allergies, and more often impaired RSRQoL (p,0.001 for all). PF tests revealed restrictive ventilatory defect in 21 (21%) patients, obstructive ventilatroy defect in 21 (21%) patients, and both in 36 (36%) patients. A total of 41 (41%) had BHR, and in 15 (15%), it was consistent with asthma. The most significant risk factors for restrictive ventilatory defect were thoracotomy-induced rib fusions (OR 3.4, 95% CI 1.3-8.7; p50.01) and oesophageal epithelial metaplasia (OR 3.0, 95% CI 1.0-8.9; p50.05).After repair of OA, respiratory-related morbidity, restrictive ventilatory defect and BHR extended into adulthood. Nearly half the patients had BHR and over half had a restrictive ventilatory defect. Thoracotomy-induced rib fusions and gastro-oesophageal reflux-associated oesophageal epithelial metaplasia were the strongest risk factors for restrictive ventilatory defect.

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“…The allergy substudy of the National FINRISK Study and the Karelia Allergy Study, both carried out in North Karelia, Finland, and the Pitkä ranta region, Russia, revealed a significantly higher occurrence of asthma and atopic diseases on the Finnish side, the disparity showing a growing generational trend [2,3]. Despite the geographical neighbourhood, the sensitisation rates for airborne allergens, determined with skin-prick tests or specific immunoglobulin (Ig)E levels, were four-fold in children and two-to three-fold in adults from Finnish Karelia, which may be attributed to the higher level of urbanisation, western type of living conditions and poor microbial environment [4].…”

Section: Exhaled Nitric Oxide In Contrasting Population Samples Of Fimentioning

confidence: 99%

Exhaled nitric oxide in contrasting population samples of Finnish and Russian Karelia: Table 1—

Malmberg¹,

Laatikainen²,

Hertzen³

et al. 2010

Eur Respir J

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Growing disparities in atopy between the Finns and the Russians: A comparison of 2 generations

Cited by 96 publications

References 32 publications

Occupational irritants and asthma: an Estonian cross-sectional study of 34 000 adults

Occupational irritants and asthma: an Estonian cross-sectional study of 34 000 adults

Repaired oesophageal atresia: respiratory morbidity and pulmonary function in adults

Exhaled nitric oxide in contrasting population samples of Finnish and Russian Karelia: Table 1—

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