Hay fever, eczema, and wheeze: a nationwide UK study (ISAAC, international study of asthma and allergies in childhood)

Abstract

Objectives-To describe the prevalence of atopic symptoms in children throughout the UK. Method-A questionnaire survey of 12-14 year olds throughout England, Wales, Scotland, and the Scottish Islands using the international study of asthma and allergies in childhood (ISAAC) protocol. Results-A total of 27 507 (86%) children took part. Recent rhinoconjunctivitis was reported by 18.2%, with 6.2% reporting symptoms between March and September; 16.4% reported itchy flexural rash in the past 12 months. The prevalence of atopic symptoms was higher in girls and subjects born within the UK. The prevalence of severe wheeze was highest in subjects reporting perennial rhinoconjunctivitis, as opposed to summertime only symptoms. Winter rhinoconjunctivitis was associated with severe wheeze and severe flexural rash. One or more current symptoms were reported by 47.6% of all children and 4% reported all three symptoms. Conclusion-In general, geographical variations were small but the prevalence of symptoms was significantly higher in Scotland and northern England. The study demonstrates the importance of atopic diseases both in their own right and in association with asthma. (Arch Dis Child 1999;81:225-230) Keywords: international study of asthma and allergies in childhood; hay fever; eczema; epidemiology; atopic diseaseThe prevalence of childhood hay fever shows wide variation throughout the world, ranging from 1.4% to 39.7%.1 The literature suggests that the prevalence of atopy has increased throughout the UK over the past five decades. In terms of eczema, the national British birth cohort study showed a rise in prevalence from 5.1% in 6 year olds born in 1946 to 12.2% for children born in 1970 and assessed at 5 years of age, 2 whereas data from the Welsh study of 12 year olds by Burr et al showed a rise from 5% in 1973 to 16% in 1988. 3 Similarly, the prevalence of hay fever in the same Welsh study rose from 9% to 15% over the 15 year period, whereas for Scottish children Russell reported a rise over a 25 year period from 3.2% in 1964 to 12.7% in 1994. 4 5 Ross and Fleming examined general practice data, which showed that the prevalence of hay fever was maximal in the age group 5-14 years and did not show any significant diVerences in geographical distribution throughout England or Wales. 6 Prevalence studies in diVerent geographical areas are often diYcult to compare because of variations in methodology. In addition, the term atopy, meaning a predisposition to develop type I hypersensitivity demonstrated by skin prick testing and assay of IgE, is often used in relation to atopic diseases such as hay fever and eczema. Many of these diYculties have been overcome by the protocol developed for the international study of asthma and allergies in childhood (ISAAC), which standardises both methodology and terminology. The distribution of hay fever and eczema are of interest not only in their own right, but also as an indicator of the pattern of atopy, which contributes to the burden of asthma. The literature demons...

Prevalence of Asthma among Qatari Schoolchildren: International Study of Asthma and Allergies in Childhood, Qatar

“…[1][2][3] The prevalence of asthma and allergies in some Western countries has reached alarming proportions, affecting more than onethird of children within the general population. [4][5][6] The prevalence rates of childhood asthma, allergic rhinitis, and eczema show geographical variation, but generally with an increase worldwide through the latter half of the 20th century. [7][8][9] Apart from a recent study done in Scotland, 10 which showed a flattening off of the trend, there is general agreement on the increasing prevalence of asthma and allergies in Western countries.…”

“…[2][3][4] This trend might reflect changes in severity, changes in medical care practices, and changes in the diagnostic labeling of these disorders, as well as a true increase in prevalence. 11,12 Moreover, despite extensive research, [4][5][6][7][8][9][10][11][12][13] the specific causes of these increases have not been found.…”

“…Furthermore, the increase in prevalence has occurred not only in Western countries, [1][2][3][4][5][6][7][8][9][10][11][12][13] but also in Asian-Pacific areas. 14,15 It is a general impression that bronchial asthma is much less common in developing countries than in industrialized countries, especially among children, [1][2][3][4][5][6][7][8][9][10][11][12][13] but the prevalence of asthma in Oman (20.7%) 16 appears to be similar to that in industrialized or Western countries.…”

A programme of research to set priorities and reduce uncertainties for the prevention and treatment of skin disease

“…4 NO. 18 We found five studies including 191 patients that reported deaths as a result of SCC, 547,585,[588][589][590] with an average of 9.1% of patients dying from their disease on pooled analysis (95% CI 1.4% to 22.8%; I 2 = 79%) 23,67,[70][71][72] ( Figure 43). The greatest proportion of deaths was observed in a study of advanced T4 tumours in which two of three patients with eligible SCCs died (66%, 95% CI 9.4% to 99.1%) 590 during a mean follow-up period of 14 months.…”

Omalizumab for childhood asthma

“…Not only is there a continuing increase in prevalence [3], but there is also concern about over-use of b-agonists, whether short-or long-acting, leading to subsensitization of the b receptors and the side effects of inhaled steroids, which are amplified in the many patients who have comorbid allergic problems such as hayfever and eczema. Indeed, based on the UK International Study of Asthma and Allergies in Childhood (ISAAC) study in 1995, 14.4% of the entire 12-14-year-old population has either hayfever, eczema or both in addition to asthma [4]. Finally, none of the pharmacotherapies hitherto available for the control of asthma have been shown to modify long-term natural history or to ever achieve a cure.…”