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Asthma and Respiratory Symptoms in Nordic Countries, Environmental and Personal Risk Factors
Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Medical Sciences.
2006 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The overall aims of our studies were to identify risk factors for respiratory symptoms and asthma in indoor environment but even to look at some personal risk factors such as body mass index and gastroesophageal reflux. The study population is based on participants of the European Community Respiratory Health Survey I and II.

In the first study, water damage and visible moulds were reported in 7.4% and 17% of the homes respectively. The combination of water damage and visible moulds was independently associated with attacks of breathlessness when resting and after activity and also to long term cough. In the second study, the prevalence of nocturnal GER increased with higher BMI and the same pattern could be seen for habitual snoring. Reported onset of asthma, wheeze and night-time symptoms increased in prevalence along with the BMI gradient. In the multivariable analysis, obesity and nocturnal GER were independent risk factors for onset of asthma, wheeze and night-time symptoms. Habitual snoring was an independent risk factor for onset of wheeze and night-time symptoms, but not for onset of asthma. In the third study, a total of 18% of the subjects reported indoor dampness in the last 12 months and 27% of the subjects reported indoor dampness since the previous survey. Respiratory symptoms and asthma were significantly more prevalent in individuals exposed to indoor dampness and indoor dampness was a risk factor for respiratory symptoms and asthma after adjusting for possible confounders. Indoor dampness was an independent risk factor for onset of respiratory symptoms but not for asthma onset. Remission of respiratory symptoms was less likely to occur if subjects reported indoor dampness. In the fourth study, the lowest prevalence of atopy and the lowest levels of all indoor allergens, bacteria and moulds were found in Iceland. A positive association was found, between cat allergen exposure and asthma symptoms and between bronchial hyperresponsiveness and the amount of viable mould in indoor air.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis , 2006. , p. 73
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 159
Keywords [en]
Medicine, epidemiology, asthma, respiratory symptoms, prevalence, incidence, indoor dampness, body mass index, gastroesophageal reflux, snoring, indoor allergens, house dust mites, moulds, bacteria
Keywords [sv]
Medicin
Identifiers
URN: urn:nbn:se:uu:diva-7076ISBN: 91-554-6614-1 (print)OAI: oai:DiVA.org:uu-7076DiVA, id: diva2:168618
Public defence
2006-09-22, Robergsalen, ingång 40, Akademiska Sjukhuset, Uppsala, 09:15
Opponent
Supervisors
Available from: 2006-09-01 Created: 2006-09-01Bibliographically approved
List of papers
1. The relationship between indoor dampness and respiratory health in young Swedish adults
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2003 In: Respiratory Medicine, Vol. 97, p. 302-307Article in journal (Refereed) Published
Identifiers
urn:nbn:se:uu:diva-94671 (URN)
Available from: 2006-09-01 Created: 2006-09-01Bibliographically approved
2. Obesity and nocturnal gastroesophageal reflux are related to the onset of asthma and respiratory symptoms
Open this publication in new window or tab >>Obesity and nocturnal gastroesophageal reflux are related to the onset of asthma and respiratory symptoms
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2004 In: European Respiratory Journal, Vol. 24, p. 116-121Article in journal (Refereed) Published
Identifiers
urn:nbn:se:uu:diva-94672 (URN)
Available from: 2006-09-01 Created: 2006-09-01Bibliographically approved
3. Prevalence and incidence of respiratory symptoms and asthma in relationship to indoor dampness
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2006 In: Thorax, Vol. 61, p. 221-225Article in journal (Refereed) Published
Identifiers
urn:nbn:se:uu:diva-94673 (URN)
Available from: 2006-09-01 Created: 2006-09-01Bibliographically approved
4. Indoor environment in three North European cities in relationship to atopy and respiratory symptoms
Open this publication in new window or tab >>Indoor environment in three North European cities in relationship to atopy and respiratory symptoms
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2009 (English)In: Clinical Respiratory Journal, ISSN 1752-6981, Vol. 3, no 2, p. 85-94Article in journal (Refereed) Published
Abstract [en]

In the European Community Respiratory Health Survey (ECRHS) I, the lowest prevalence of asthma and atopy was found in Reykjavik (Iceland)  and Tartu (Estonia). The aim of this study was to compare home environments in Reykjavik and Tartu to a town with a higher prevalence of asthma and atopy (Uppsala, Sweden) in an attempt to identify factors   in the indoor environment that could explain these differences. A random sample of 129 ECRHS II participants was included in this analysis at each of the three study centres. The subjects answered a questionnaire, blood was analysed for specific immunoglobulin E, a   methacholine test was performed and home indoor measurements were taken. The prevalence of atopy was 11.9% in Reykjavik, 35.5% in Uppsala and   28.2% in Tartu (P < 0.04). The level of indoor cat allergen was significantly lower in Reykjavik compared with Uppsala (P = 0.05). No mite allergens were identified in the 41 homes investigated in   Reykjavik, while this was the case in 16% and 72% of the households in Uppsala and Tartu, respectively (P = 0.001). A positive association was found between asthma symptoms and cat allergen levels [odds ratio 1.53 (95% confidence interval 1.04-2.24)], while the levels of viable moulds were significantly associated with increased bronchial responsiveness.   Indoor exposure to allergens, moulds and bacteria was lower in Reykjavik than in the Swedish and Estonian centres. This finding indicates that the lower prevalence of allergic sensitization in Reykjavik may partly be related to lower indoor allergen exposure. Please cite this paper as: Gunnbjornsdottir MI, NorbAck D, Bjornsson E, Soon A, Jarvis D, Jogi R, Gislason D, Gislason T and Janson C. Indoor environment in three North European cities in relationship to atopy and respiratory symptoms. The Clinical Respiratory Journal 2009; 3: 85-94.

Keywords
atopy, bacteria and mould, epidemiology, indoor allergens, respiratory symptoms
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-94674 (URN)10.1111/j.1752-699X.2008.00122.x (DOI)000264163400006 ()20298383 (PubMedID)
Available from: 2006-09-01 Created: 2006-09-01 Last updated: 2010-08-13Bibliographically approved

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