Psychological Distress and Perceived Burden in Parents of Korean Children With IgE-Mediated Food Allergy

Background@#Food allergy (FA) can have a profound effect on quality of life (QoL), stress, and anxiety in the family. We aimed to validate the Korean version of the Food Allergy Quality of Life-Parental Burden (FAQL-PB) and identify factors related to the parental psychosocial burden of caring for children with FAs. @*Methods@#Parents of children aged between 6 months and 17 years with immunoglobulin E (IgE)-mediated FAs from the Pediatric Allergy Department of five university hospitals in Korea were enrolled in the study. Parents were asked to complete the FAQL-PB, Food Allergy Independent Measure-Parent Form (FAIM-PF), Child Health Questionnaire-Parents Form 28 (CHQ-PF28), Beck’s Anxiety Inventory, Connor-Davidson Resilience Scale, and Patient Health Questionnaire-9 for depression. Statistical analyses included internal consistency, test-retest reliability, concurrent validity, discriminative validity, and logistic regression analyses. @*Results@#A total of 190 parents were enrolled. Social activity limitation was the item with the highest FAQL-PB scores. The Cronbach’s α for each item was higher than 0.8. The test-retest reliability was good (intra-class correlation coefficient, 0.716; 95% confidence interval [CI], 0.100–0.935). An increase in the FAQL-PB was significantly associated with an increase in the FAIM-PF (β = 0.765, P < 0.001) (concurrent validity). There was a positive correlation between parental burden, anxiety, and depression, while resilience was inversely correlated with parental burden (all P < 0.001). The total FAQL-PB score in parents of children who had experienced anaphylaxis was significantly higher than that in parents of children who did not experience it (P = 0.008). When adjusting for age, sex, and underlying diseases, anaphylaxis β = 9.32; 95% CI, 2.97 to 15.68), cow’s milk (CM) allergy (β = 8.24; 95% CI, 2.04 to 14.44), soybean allergy (β = 13.91; 95% CI, 1.62 to 26.20), higher anxiety (β = 1.05; 95% CI, 0.07 to 1.41), higher depression (β = 2.15; 95% CI, 1.61 to 2.69), and lower resilience (β = −0.42; 95% CI, −0.61 to −0.2) were significantly associated with greater parental burden in children with IgE-mediated FAs. @*Conclusion@#FAQL-PB is a reliable and valid tool for use in Korea. Anaphylaxis, CM or soybean allergies, more anxiety and depression symptoms, and lower resilience are associated with poorer QoL in parents of children with FAs.

Assessment of relationship between the use of household products and atopic dermatitis in Seoul: focused on products with associated risks

The purpose of this study was to evaluate the relationship between the use of certain household products (HPs) at home and atopic dermatitis (AD) in adults. The study was conducted on 1,500 households in Seoul, South Korea. We obtained information on general characteristics, the use of HPs, and AD through an online panel survey in July 2018. HPs were selected as 23 kinds of products with associated risks that are management targets of the Ministry of Environment. The international study of asthma and allergies in childhood was used for the AD questionnaires. Logistic regression analysis was used to identify AD affected by the use of HPs. Average number of used HPs was 13.44 out of 23, and average usage frequency of HPs was 3.52 times a month at home in Seoul for the last 1 year. Compared with subjects with a low number of HPs used (reference), subjects with a high number of used HPs (4th quartile) were more likely to have lifetime diagnosis of AD (odds ratio (OR) = 1.77, 95% confidence interval (CI); 1.23-2.54), symptoms of AD in the last 12 months (OR = 2.66, 95% CI; 1.92-3.70), and treatment of AD in the last 12 months (OR = 2.37, 95% CI; 1.48-3.80). Compared with subjects with a low HPs usage frequency (reference), subjects with a high HPs usage frequency (4th quartile) were more likely to have lifetime diagnosis of AD (OR = 1.88, 95% CI; 1.31-2.70), symptoms of AD in the last 12 months (OR = 2.14, 95% CI; 1.54-2.96), and treatment of AD in the last 12 months (OR = 2.23, 95% CI; 1.39-3.60). Therefore, the use of HPs was significantly associated with AD. The findings of this study might be useful as basic data for managing allergic diseases and establishing preventive measures.

Assessment of relationship between the use of household products and atopic dermatitis in Seoul: focused on products with associated risks

The purpose of this study was to evaluate the relationship between the use of certain household products (HPs) at home and atopic dermatitis (AD) in adults. The study was conducted on 1,500 households in Seoul, South Korea. We obtained information on general characteristics, the use of HPs, and AD through an online panel survey in July 2018. HPs were selected as 23 kinds of products with associated risks that are management targets of the Ministry of Environment. The international study of asthma and allergies in childhood was used for the AD questionnaires. Logistic regression analysis was used to identify AD affected by the use of HPs. Average number of used HPs was 13.44 out of 23, and average usage frequency of HPs was 3.52 times a month at home in Seoul for the last 1 year. Compared with subjects with a low number of HPs used (reference), subjects with a high number of used HPs (4th quartile) were more likely to have lifetime diagnosis of AD (odds ratio (OR) = 1.77, 95% confidence interval (CI); 1.23-2.54), symptoms of AD in the last 12 months (OR = 2.66, 95% CI; 1.92-3.70), and treatment of AD in the last 12 months (OR = 2.37, 95% CI; 1.48-3.80). Compared with subjects with a low HPs usage frequency (reference), subjects with a high HPs usage frequency (4th quartile) were more likely to have lifetime diagnosis of AD (OR = 1.88, 95% CI; 1.31-2.70), symptoms of AD in the last 12 months (OR = 2.14, 95% CI; 1.54-2.96), and treatment of AD in the last 12 months (OR = 2.23, 95% CI; 1.39-3.60). Therefore, the use of HPs was significantly associated with AD. The findings of this study might be useful as basic data for managing allergic diseases and establishing preventive measures.

Risk factors for food allergy among children in Seoul: focusing on dietary habits and environmental factors / 한국영양학회지

PURPOSE: This study examined the prevalence of food allergies and allergenic factors in a selected sample of children living in Seoul, Korea, along with their dietary habits, environmental factors, and diseases as risk factors for food allergy. The results of this study will provide basic data for addressing food allergies.METHODS: We selected 3,004 pre-school and school-age children, aged 0 ~ 12, in the 25 districts of Seoul as the study sample. Structured self-report questionnaires were administered over a two-month period in July-August 2018, and the children's parents recorded the answers on their children's behalf. The research tools in this study included the Korean version of the questionnaire from the International Study of Asthma and Allergies in Childhood (ISAAC).RESULTS: The physician-diagnosed prevalence rate of food allergies was 14.2%, while 20.4% of the children experienced allergic symptoms at least once and 17.4% reported symptoms within the previous 12 months. The children's symptoms included skin problems (88.1%), gastrointestinal issues (19.2%), oral issues (16.7%), respiratory issues (12.7%), and systemic issues (1.3%). The causes of allergies included eggs, peaches, milk, peanuts, and shrimps. The factors influencing the experience of food allergies were the consumption of cereal (aOR, 1.52; 95% CI, 1.09 ~ 2.10; p = 0.013), potatoes (aOR, 1.88; 95% CI, 1.33 ~ 2.65; p < 0.001), and fast food (aOR, 1.73; 95% CI, 1.10 ~ 2.72; p = 0.017). Having food allergy symptoms was associated with a higher risk of experiencing asthma (aOR, 4.22 95% CI, 3.10 ~ 5.76; p < 0.001), allergic rhinitis (aOR, 2.53; 95% CI, 2.03 ~ 3.15; p < 0.001), and atopic dermatitis symptoms (aOR, 3.56; 95% CI, 2.88 ~ 4.40; p < 0.001).CONCLUSION: Episodes of food allergies warrant examining regular food consumption and placing dietary restrictions through early diagnosis as these episodes may imply the presence of other allergies. Our findings offer basic insights into the patterns, prevalence and symptoms of children's food allergies in Seoul, and our findings will contribute to identifying effective interventions for food allergies.

Assessment of relationship between the use of household products and atopic dermatitis in Seoul: focused on products with associated risks

The purpose of this study was to evaluate the relationship between the use of certain household products (HPs) at home and atopic dermatitis (AD) in adults. The study was conducted on 1,500 households in Seoul, South Korea. We obtained information on general characteristics, the use of HPs, and AD through an online panel survey in July 2018. HPs were selected as 23 kinds of products with associated risks that are management targets of the Ministry of Environment. The international study of asthma and allergies in childhood was used for the AD questionnaires. Logistic regression analysis was used to identify AD affected by the use of HPs. Average number of used HPs was 13.44 out of 23, and average usage frequency of HPs was 3.52 times a month at home in Seoul for the last 1 year. Compared with subjects with a low number of HPs used (reference), subjects with a high number of used HPs (4th quartile) were more likely to have lifetime diagnosis of AD (odds ratio (OR) = 1.77, 95% confidence interval (CI); 1.23-2.54), symptoms of AD in the last 12 months (OR = 2.66, 95% CI; 1.92-3.70), and treatment of AD in the last 12 months (OR = 2.37, 95% CI; 1.48-3.80). Compared with subjects with a low HPs usage frequency (reference), subjects with a high HPs usage frequency (4th quartile) were more likely to have lifetime diagnosis of AD (OR = 1.88, 95% CI; 1.31-2.70), symptoms of AD in the last 12 months (OR = 2.14, 95% CI; 1.54-2.96), and treatment of AD in the last 12 months (OR = 2.23, 95% CI; 1.39-3.60). Therefore, the use of HPs was significantly associated with AD. The findings of this study might be useful as basic data for managing allergic diseases and establishing preventive measures.

Parental burden of food-allergic children's parents and influencing factors / 한국영양학회지

PURPOSE: Recently, there has been a worldwide increase in the prevalence of food allergies in children and it may cause nutritional imbalance and poor quality of life for growing children due to dietary restrictions. This study was conducted to quantitatively measure the life burden and related factors of mothers who are the primary caretakers of food-allergic children. Moreover, we generated data for use as a scientific basis for the development of a disease management program to reduce the burden on life from raising food-allergic children. METHODS: Mothers of 2,005 children aged 2 years or older and enrolled in Seoul Metropolitan Atopy Free Schools in 2016 who have had diagnosis of food allergy in their lifetime were surveyed. The burden on life of parents with food-allergic children was measured using 17 questions from the Food Allergy Quality of Life-Parental Burden (FAQL-PB) questionnaire, and subjects were asked to respond with a scale of 1 ~ 7. RESULTS: We analyzed the effects of sociodemographic factors of parents and children and the accompanying allergic disease factors on the lives of parents. The number of restricted food items due to food allergy of a child and accompanying diagnosis of atopic dermatitis had a positive (+) effect on the life burden of the parents. CONCLUSION: Accurate oral food challenge for food allergies should be administered to prevent excessive restriction of food intake. Moreover, efforts should be taken to prevent morbidity accompanying food allergy and relieve symptoms of asthma, allergic rhinitis and atopic dermatitis.

Trends in the Prevalence of Childhood Asthma in Seoul Metropolitan City, Korea: The Seoul Atopy ∙ Asthma-friendly School Project / 예방의학회지

OBJECTIVES: The project Seoul Atopy ∙ Asthma-friendly School investigated the current status of childhood asthma to enable formulation of a preventative policy. We evaluated the current prevalence of childhood asthma in Seoul and its trends and related factors. METHODS: The project was conducted annually from 2011 to 2016 and involved around 35 000 children aged 1-13 years. Based on the International Study of Asthma and Allergies in Childhood guidelines, the survey involved parents. The associations of the particulate matter (PM10) concentration, and the number of days on which the daily air quality guidance level was exceeded in the 25 districts of Seoul, with the prevalence of asthma were assessed. RESULTS: The age-standardized asthma prevalence in 2011 and 2016 was 6.74 and 4.02%, respectively. The prevalence of lifetime asthma treatment and treatment during the last 12 months tended to decrease from 2011 to 2016. Asthma treatment was significantly correlated with the number of days on which the daily air quality guidance level was exceeded, but not with the PM10 concentration. CONCLUSIONS: This study reports the prevalence of asthma among children in Seoul and confirmed the relationship between childhood asthma and known risk factors in a large-scale survey.

The effects of a newsletter on bedding control on house dust mite allergen concentrations in childcare centers in Korea

OBJECTIVES: Bedding in childcare centers (CCCs) can hold house dust mite (HDM) allergens. This study examined whether HDM allergen levels can be reduced through the distribution of an educational newsletter on bedding control to parents of CCC children in Korea. METHODS: All 38 CCCs were measured for Der 1 (sum of Der f 1 and Der p 1) concentrations on classroom floors and bedding before the intervention. Educational newsletters on children’s bedding control were sent to 21 CCCs by mail, and teachers were asked to distribute the newsletters to the parents of the children (intervention group). The remaining 17 CCCs were not sent newsletters (control group). The measurement of Der 1 concentrations in 38 CCCs was repeated after the intervention. Dust samples were collected with a vacuum cleaner and analyzed using enzyme-linked immunosorbent assay methods. RESULTS: The Der 1 concentrations on the bedding were significantly higher than those on the floors in 38 CCCs at baseline (p<0.05). Although changes of the Der 1 concentrations for the control group (n=17) were not significant, Der 1 concentrations for the intervention group (n=21) decreased significantly from 2077.9 ng/g dust to 963.5 ng/g dust on the floors and from 3683.9 ng/g dust to 610.4 ng/g dust on bedding (p<0.05). CONCLUSIONS: The distribution of educational newsletters on bedding control to parents may be an effective means of controlling HDMs in CCCs.

The effects of a newsletter on bedding control on house dust mite allergen concentrations in childcare centers in Korea

OBJECTIVES: Bedding in childcare centers (CCCs) can hold house dust mite (HDM) allergens. This study examined whether HDM allergen levels can be reduced through the distribution of an educational newsletter on bedding control to parents of CCC children in Korea. METHODS: All 38 CCCs were measured for Der 1 (sum of Der f 1 and Der p 1) concentrations on classroom floors and bedding before the intervention. Educational newsletters on children’s bedding control were sent to 21 CCCs by mail, and teachers were asked to distribute the newsletters to the parents of the children (intervention group). The remaining 17 CCCs were not sent newsletters (control group). The measurement of Der 1 concentrations in 38 CCCs was repeated after the intervention. Dust samples were collected with a vacuum cleaner and analyzed using enzyme-linked immunosorbent assay methods. RESULTS: The Der 1 concentrations on the bedding were significantly higher than those on the floors in 38 CCCs at baseline (p<0.05). Although changes of the Der 1 concentrations for the control group (n=17) were not significant, Der 1 concentrations for the intervention group (n=21) decreased significantly from 2077.9 ng/g dust to 963.5 ng/g dust on the floors and from 3683.9 ng/g dust to 610.4 ng/g dust on bedding (p<0.05). CONCLUSIONS: The distribution of educational newsletters on bedding control to parents may be an effective means of controlling HDMs in CCCs.

Association between exposure to antimicrobial household products and allergic symptoms

OBJECTIVES: Antimicrobial chemicals are used in a variety of household and personal care products. Exposure to antimicrobial household products has been hypothesized to lead to allergic diseases in children. METHODS: We investigated antimicrobial household product exposure and allergic symptoms in Korean children. An antimicrobial exposure (AE) score was derived. To examine the symptoms of allergic diseases (current wheeze, current rhinitis, and current eczema) in the past 12 months, we used a questionnaire based on the core module of the International Study of Asthma and Allergies in Children. Complete data for the analysis were available for 25,805 of the 35,590 (72.5%) children. RESULTS: The prevalence of current allergic diseases was as follows: wheeze, 5.6%; allergic rhinitis, 32.6%; and eczema, 17.7%. The mean (standard deviation) AE score was 14.3 (9.3) (range: 0-40). Compared with subjects with a low AE score (reference), subjects with a high AE score (fourth quartile) were more likely to have symptoms of wheezing and allergic rhinitis (adjusted odds ratio [aOR] for wheezing 1.24, 95% confidence interval [CI], 1.05-1.45, p for trend=0.24; aOR for allergic rhinitis 1.30, 95% CI, 1.20-1.40, p<0.01). CONCLUSIONS: These findings suggest that frequent use of antimicrobial household products was associated with current wheeze and current allergic rhinitis.

Job Stress and Musculoskeletal Disorder in Seoul City's School Foodservice Employees / 한국직업건강간호학회지

PURPOSE: School foodservice employees (SFEs) could be exposed to the risk of musculoskeletal disease and of job stress due to their job characteristics. This study was to evaluate the level of job stress and the prevalence of work-related musculoskeletal symptoms (WRMS) in Seoul city's SFEs, and to determine associations between job stress and WRMS. METHODS: The study design was cross-sectional, and 975 SFEs were recruited. Self-administered questionnaire included the 'Korean occupational stress scale-short form' and the 'KOSHA GUIDE H-9-2012' instrument to evaluate the job stress and WRMS, respectively. SFEs' medians of job stress were compared to the reference values of published study in Korean workers. RESULTS: The participants reported greater levels of job demand and physical environment than the general Korean population. WRMS were reported in 89.0% of participants at any body part, and 41.1% were presumed to need for medical intervention. High levels of job demand and of physical environment were significantly associated with WRMS. CONCLUSION: Subscales of job demand and physical environment were relatively high in SFEs and those were related to the occurrence of WRMS. To reduce the WRMS prevalence, a job stress management program focused on job demand and physical environment may be required.

Job Stress and Musculoskeletal Disorder in Seoul City's School Foodservice Employees / 산업간호학회지

PURPOSE: School foodservice employees (SFEs) could be exposed to the risk of musculoskeletal disease and of job stress due to their job characteristics. This study was to evaluate the level of job stress and the prevalence of work-related musculoskeletal symptoms (WRMS) in Seoul city's SFEs, and to determine associations between job stress and WRMS. METHODS: The study design was cross-sectional, and 975 SFEs were recruited. Self-administered questionnaire included the 'Korean occupational stress scale-short form' and the 'KOSHA GUIDE H-9-2012' instrument to evaluate the job stress and WRMS, respectively. SFEs' medians of job stress were compared to the reference values of published study in Korean workers. RESULTS: The participants reported greater levels of job demand and physical environment than the general Korean population. WRMS were reported in 89.0% of participants at any body part, and 41.1% were presumed to need for medical intervention. High levels of job demand and of physical environment were significantly associated with WRMS. CONCLUSION: Subscales of job demand and physical environment were relatively high in SFEs and those were related to the occurrence of WRMS. To reduce the WRMS prevalence, a job stress management program focused on job demand and physical environment may be required.