Prevalence and time trends of symptoms of allergic rhinitis and rhinoconjunctivitis in Spanish children: Global Asthma Network (GAN) study

Introduction: The time trends of the prevalence of rhinitis, rhinoconjunctivitis and nasal allergy previously described in the ISAAC (International Study of Asthma and Allergies in Childhood) in 2002 are unknown; or if the geographical or age differences in Spain persist. Objective: To describe the prevalence of rhinitis, rhinoconjunctivitis and nasal allergy in different Spanish geographical areas and compare them with those of the ISAAC. Methods: Cross-sectional study of the prevalence of rhinitis, rhinoconjunctivitis and nasal allergy, carried out in 2016-2019 on 19943 adolescents aged 13-14 years and 17215 schoolchildren aged 6-7 years from six Spanish areas (Cartagena, Bilbao, Cantabria, La Coruña, Pamplona, and Salamanca), through a questionnaire based on the Global Asthma Network (GAN) protocol. Results: The prevalences of recent rhinitis and rhinoconjunctivitis (last 12 months), and nasal allergy/hay fever were 35.1%, 17.6%, and 14.6% in the adolescents and 20%, 8.5%, and 8.9% in the schoolchildren, respectively, with rhinoconjunctivitis in adolescents varying from 20.9% in Bilbao to 13.4% in Cartagena; and in schoolchildren, from 9.8% in La Coruña to 6.4% in Pamplona. These prevalences of rhinoconjunctivitis and nasal allergy in adolescents were higher than those described in the ISAAC (16.3% and 13%) and similar in schoolchildren to the ISAAC (9% and 9.4%). Conclusions: There has been a stabilisation of rhinitis, rhinoconjunctivitis and nasal allergy in schoolchildren that slows the previous upward trend of ISAAC; and a slight non-significant increase in rhinoconjunctivitis and nasal allergy in adolescents. The variability found in adolescents would require local research to be better understood (AU)

Prevalencia y evolución temporal de síntomas de asma en España. Estudio Global Asthma Network (GAN) / Prevalence and temporal evolution of asthma symptoms in Spain. Global Asthma Network (GAN) study

Introducción: Se desconoce la evolución temporal de la prevalencia de asma descrita en el ISAAC (International Study of Asthma and Allergies in Childhood) en 2002 o si las diferencias geográficas o por edades se mantienen en España. Objetivo: Describir la prevalencia de los síntomas de asma en distintas áreas geográficas españolas y compararla con la de aquellos centros que participaron en el ISAAC. Métodos: Estudio transversal de prevalencia de asma, realizado en 2016-2019 a 19.943 adolescentes de 13-14 años y 17.215 escolares de 6-7 años de seis áreas geográficas españolas (Cartagena, Bilbao, Cantabria, La Coruña, Pamplona y Salamanca). Los síntomas de asma se recogieron mediante un cuestionario escrito y videocuestionario según el protocolo Global Asthma Network (GAN). Resultados: La prevalencia de sibilancias recientes (últimos 12 meses) fue del 15,3% a los 13-14 años y del 10,4% a los 6-7 años, con variaciones en los adolescentes, desde un 19% en Bilbao, hasta un 10,2% en Cartagena; y en los escolares, desde un 11,7% en Cartagena, hasta un 7% en Pamplona. Estas prevalencias fueron superiores a las del ISAAC (10,6% en adolescentes y 9,9% en los escolares). Un 21,3% de adolescentes y un 12,4% de los escolares refirieron asma alguna vez. Conclusiones: Existe una alta prevalencia de síntomas asmáticos con un incremento en los adolescentes y una estabilización en los escolares españoles con respecto al ISAAC. No se aprecian tan claramente variaciones geográficas en la prevalencia de asma, pero las áreas que tenían prevalencias elevadas mantienen cifras altas. (AU)

Introduction: The temporal evolution of the prevalence of asthma described in the International Study of Asthma and Allergies in Childhood (ISAAC) in 2002 is unknown, or if the geographical or age differences are maintained in Spain. Objective: To describe the prevalence of asthma symptoms in different Spanish geographical areas and compare it with that of those centers that participated in the ISAAC. Methods: Cross-sectional study of asthma prevalence, carried out in 2016–2019 with 19,943 adolescents aged 13–14 years and 17,215 schoolchildren aged 6–7 years from six Spanish geographical areas (Cartagena, Bilbao, Cantabria, La Coruña, Pamplona and Salamanca). Asthma symptoms were collected using a written questionnaire and video questionnaire according to the Global Asthma Network (GAN) protocol. Results: The prevalence of recent wheezing (last 12 months) was 15.3% at 13–14 years and 10.4% at 6–7 years, with variations in adolescents, from 19% in Bilbao to 10.2% in Cartagena; and in schoolchildren, from 11.7% in Cartagena to 7% in Pamplona. These prevalences were higher than those of the ISAAC (10.6% in adolescents and 9.9% in schoolchildren). About 21.3% of adolescents and 12.4% of schoolchildren reported asthma at some time. Conclusions: There is a high prevalence of asthmatic symptoms with an increase in adolescents and a stabilization in Spanish schoolchildren with respect to the ISAAC. Geographical variations in asthma prevalence are not so clearly appreciated, but areas with high prevalences maintain high numbers. (AU)

Prevalence and temporal evolution of asthma symptoms in Spain. Global Asthma Network (GAN) study.

INTRODUCTION: The temporal evolution of the prevalence of asthma described in the ISAAC (International Study of Asthma and Allergies in Childhood) in 2002 is unknown, or if the geographical or age differences are maintained in Spain. OBJECTIVE: To describe the prevalence of asthma symptoms in different Spanish geographic areas and compare it with that of those centers that participated in the ISAAC. METHODS: Cross-sectional study of asthma prevalence, carried out in 2016-2019 with 19,943 adolescents aged 13-14 years and 17,215 schoolchildren aged 6-7 years from 6 Spanish geographical areas (Cartagena, Bilbao, Cantabria, La Coruña, Pamplona and Salamanca). Asthma symptoms were collected using a written questionnaire and video questionnaire according to the Global Asthma Network (GAN) protocol. RESULTS: The prevalence of recent wheezing (last 12 months) was 15.3% at 13-14 years and 10.4% at 6-7 years, with variations in adolescents, from 19% in Bilbao to 10.2% in Cartagena; and in schoolchildren, from 11.7% in Cartagena to 7% in Pamplona. These prevalences were higher than those of the ISAAC (10.6% in adolescents and 9.9% in schoolchildren). 21.3% of adolescents and 12.4% of schoolchildren reported asthma at some time. CONCLUSIONS: There is a high prevalence of asthmatic symptoms with an increase in adolescents and a stabilization in Spanish schoolchildren with respect to the ISAAC. Geographic variations in asthma prevalence are not so clearly appreciated, but areas with high prevalences maintain high numbers.

Oral immunotherapy in severe cow's milk allergic patients treated with omalizumab: Real life survey from a Spanish registry.

BACKGROUND: Oral immunotherapy is a frequent treatment for the management of food allergies, but adverse events (AE) are common. This study assessed the outcome of cow's milk oral immunotherapy (MOIT) in severe cow`s milk-allergic patients treated with omalizumab in a real-life setting. METHODS: OmaBASE was a national, multicenter, open, and observational registry that collected clinical, immunologic, and treatment from patients with food allergy receiving omalizumab. RESULTS: Data derived from 58 patients aged 10.3 years (IQR 6.3-13.2) and median milk-specific IgE 100 kUA /L at the start of omalizumab treatment. Most had experienced anaphylaxis by accidental exposures (70.7%) and had asthma (81.0%). Omalizumab in monotherapy induced tolerance to ≥6000 mg of cow's milk protein (CMP) to 34.8% of patients tested by oral food challenge. Omalizumab combined with MOIT conferred desensitization to ≥6000 mg of CMP to 83.0% of patients. Omalizumab withdrawal triggered more AE (P = .013) and anaphylaxis (P = .001) than no discontinuation. Anaphylaxis was observed in 36.4% of patients who discontinued omalizumab, and more in those with sudden (50.0%) rather than progressive (12.5%) discontinuation. At database closure, 40.5% of patients who had completed follow-up tolerated CMP without omalizumab (7.2% 1500-4500 mg; 33.3% ≥6000 mg). CONCLUSION: Milk oral immunotherapy initiated under omalizumab allows the desensitization of subjects with severe cow's milk allergy even after omalizumab discontinuation. However, discontinuation of omalizumab can lead to severe AE and should be carefully monitored.

Las formulaciones anti-COVID-19 con ácido ribonucleico mensajero en la clasificación general de las vacunas antivirales

RESUMEN Las vacunas representan un hito fundamental para la prevención y el control de las enfermedades infectocontagiosas, con repercusión excepcional en la salud mundial. Su valor es incuestionable para evitar la aparición de numerosos padecimientos y muertes cada año. Existen numerosas clasificaciones de las vacunas, según se atienda a diferentes aspectos de su composición, síntesis o naturaleza. En este artículo se presenta una clasificación de los diseños actuales en que se sustentan las diversas plataformas tecnológicas de las vacunas antivirales. Se hace especial énfasis en las basadas en genes, entre ellas las vacunas de ácido ribonucleico mensajero que han recibido un impulso especial en su desarrollo desde el comienzo de la pandemia de la COVID-19. Las implicaciones de la respuesta satisfactoria de las vacunas de ácido ribonucleico mensajero podrían ir más allá de la actual pandemia de la COVID-19. Su éxito podría allanar el camino para el uso generalizado de esta plataforma tecnológica tanto para los patógenos emergentes como para los ya establecidos.

ABSTRACT Although the use of vaccines for disease prevention and control is a relatively recent social and health event, it has no doubt become one of the main tools of modern medicine to fight infectious diseases. The paper presents a classification of current designs substantiating the various technological platforms of antiviral vaccines, with special emphasis on those based on genes, among them messenger ribonucleic acid vaccines, which have experienced considerable development since the start of the COVID-19 pandemic. The implications of the successful response of messenger ribonucleic acid vaccines could go beyond the current COVID-19 pandemic. Its success could pave the way for the widespread use of this technology platform for both emerging and established pathogens.

La formulación de los objetivos instructivos en el contexto del currículo docente / Formulation of instructional objectives in the educational curriculum

La necesidad de lograr la formación de personas capaces de insertarse en la sociedad y, a la vez, desempeñarse al ritmo de sus cambios, es una demanda cada vez más marcada que exige, esta misma sociedad, a las instituciones encargadas del desarrollo de los procesos docente-educativos. Estos requieren, como toda actividad humana, una rigurosa planificación y control. Dentro de este sistema, los objetivos instructivos determinan el caudal de conocimientos que los estudiantes deben adquirir para el desarrollo de las habilidades que se aspira posean como egresados y que les permitan enfrentarse a los problemas básicos existentes en la producción y los servicios y resolverlos exitosamente, demostrando con ello independencia y creatividad. La determinación y enunciación de los objetivos instructivos deviene, entonces, como un aspecto vital dentro del contexto del currículo docente. Los autores describen cada uno de los elementos que deben estar presentes al momento de redactarlos y proponen una guía para su formulación.

Attaining the formation of individuals capable of integrating into the society and at the same time, of performing well at the rate of changes is increasingly demanded by the society from the institutions in charge of the development of the teaching-educational processes. Like others human activities, these processes require strict planning and control. The instructional objectives determine the wealth of knowledge that students should acquire for the development of the skills that they should have as medical graduates. These skills will allow them to face the basic problems in the field of production and services, and successfully solve them using their independent thinking and creativeness. The drawing up and the enunciation of instructional objectives then turn into vital aspects within the context of the educational curriculum. The authors of this paper described each of the elements that should be present at the time of drawing up and submitting a guideline for the formulation of objectives.

La formulación de los objetivos instructivos en el contexto del currículo docente / Formulation of instructional objectives in the educational curriculum

La necesidad de lograr la formación de personas capaces de insertarse en la sociedad y, a la vez, desempeñarse al ritmo de sus cambios, es una demanda cada vez más marcada que exige, esta misma sociedad, a las instituciones encargadas del desarrollo de los procesos docente-educativos. Estos requieren, como toda actividad humana, una rigurosa planificación y control. Dentro de este sistema, los objetivos instructivos determinan el caudal de conocimientos que los estudiantes deben adquirir para el desarrollo de las habilidades que se aspira posean como egresados y que les permitan enfrentarse a los problemas básicos existentes en la producción y los servicios y resolverlos exitosamente, demostrando con ello independencia y creatividad. La determinación y enunciación de los objetivos instructivos deviene, entonces, como un aspecto vital dentro del contexto del currículo docente. Los autores describen cada uno de los elementos que deben estar presentes al momento de redactarlos y proponen una guía para su formulación(AU)

Attaining the formation of individuals capable of integrating into the society and at the same time, of performing well at the rate of changes is increasingly demanded by the society from the institutions in charge of the development of the teaching-educational processes. Like others human activities, these processes require strict planning and control. The instructional objectives determine the wealth of knowledge that students should acquire for the development of the skills that they should have as medical graduates. These skills will allow them to face the basic problems in the field of production and services, and successfully solve them using their independent thinking and creativeness. The drawing up and the enunciation of instructional objectives then turn into vital aspects within the context of the educational curriculum. The authors of this paper described each of the elements that should be present at the time of drawing up and submitting a guideline for the formulation of objectives(AU)

The impact of atmospheric pollutants on the prevalence of atopic eczema in 6-7-year-old schoolchildren in Spain; ISAAC Phase III.

Atopic Eczema (AE) is a chronic inflammatory skin disease that affects children and adults, and alters quality of life with a high morbidity rate and severe economic burden. The objective of the present work was to analyse specific atmospheric pollutants (O3, NO, PM10 and SO2) affecting the prevalence of diagnosed AE and its symptoms among 6-7-year-old schoolchildren.The participants included 21311 schoolchildren aged 6-7 years from 8 Spanish regions, whose parents completed the ISAAC Phase III questionnaire to ascertain AE diagnosis and symptoms. The mean levels (µg/m3) of O3, NO, PM10 (particles 10 micrometers or less in diameter) and SO2 were determined in each geographical area. Participating in this study.According to these mean levels, three levels of exposure to each pollutant were considered: level 1 (percentiles 0-25); level 2 (percentiles 26-74); level 3 (percentiles 75-100). Exposure to O3 was associated with increased prevalence of rashes (exposure level 2, Odds Ratio (OR): 1.22, 95% Confidence Interval (95%CI): 1.02-1.45; level 3 OR: 1.33, 95%CI: 1.10-1.61) and diagnosed AE (level 2, OR: 1.27, 95%CI: 1.17-1.39; level 3 OR: 1.27, 95%CI: 1.15-1.41). An association was found between the level of NO and a drop in the prevalence of diagnosed AE (exposure level 2, OR: 0.88, 95%CI: 0.81-0.95; level 3 OR: 0.85, 95%CI: 0.74-0.97). There was also an association between the highest exposure level to PM10 and a reduced prevalence of rashes (level 3 OR: 0.42, 95%CI: 0.22-0.81) and diagnosed AE (level 3 OR: 0.53, 95%CI: 0.38-0.75). Future studies into exposure to O3 and its relationship with allergic diseases may be conducted in order to prevent this association.

Is acetaminophen use associated with atopic eczema and other allergic diseases in adolescents?

Atopic Eczema (AE) is a chronic inflammatory skin disease that affects children and adults, and alters quality of life. Previous studies have suggested several socio-demographic and environmental factors related to the prevalence of AE and other allergic diseases, including acetaminophen use. In the present study, we report the rates of isolated AE, AE associated with asthma and AE associated with rhinitis among 13- to 14-year-old Spanish adolescents and the level of association of these conditions with the use of acetaminophen. We analyzed Spanish data from a cross-sectional Phase 3 study within ISAAC. A total of 28,717 adolescents completed the Phase 3 written questionnaire by answering questions for acetaminophen use and on asthma, rhinitis and AE symptoms.We observed an association between acetaminophen use and AE among the adolescents who had used acetaminophen in the previous month. Furthermore, the prevalence rate increased with the number of allergic processes: for AE alone, the adjusted Prevalence Ratio (aPR) was 1.81 and for AE associated with rhinitis or with asthma, aPRs were 2.20 and 3.03, respectively.We conclude that acetaminophen use in childhood may be an important factor associated with development and/or maintenance of AE and other allergic diseases.

El cambio climático y la defensa nacional en Cuba / Climate change and national defense in Cuba

Variadas son las repercusiones que el cambio climático puede inducir sobre la salud humana, por lo que las respuestas para su mitigación deben cubrir una amplia gama de posibles perjuicios. En Cuba existen un conjunto de predicciones sobre el grado de deterioro que este evento puede ocasionar, directa o indirectamente, sobre la salud y las condiciones de vida de la población, lo que ha posibilitado el desarrollo de todo un conjunto de instrumentos jurídicos en los que es importante identificar las acciones encaminadas a mitigar el impacto de estas alteraciones del ambiente. Estos han demandado un cuidadoso diseño y preparación de planes de contingencia para disminuir el efecto perjudicial de tales fenómenos adversos sobre los recursos humanos y materiales del país, que son la clave de la política de defensa nacional que, en opinión de los autores, presenta una correspondencia entre las previsiones que establecen y los posibles percances que el cambio climático puede ocasionar en el territorio nacional, con un conjunto de medidas fundamentadas en las vulnerabilidades del país y encaminadas a mitigar los efectos adversos de estos sucesos

Many are the ways in which climate change may affect human health. Therefore, mitigation measures should cover a wide range of potential negative effects. A number of forecasts have been developed in Cuba about the way in which climate change may directly or indirectly affect health and the living conditions of the population as well as the degree of deterioration to be expected. Based on such forecasts, legal instruments have been created which include actions aimed at mitigating the impact of such environmental alterations. These instruments have been carefully designed and contingency plans have been developed to reduce the damaging effect of adverse environmental phenomena on the country's human and material resources, an essential component of the national defense policy. It is the authors' opinion that there is a correspondence between the forecasts and the potential negative impact of climate change on the national territory, with a number of measures based on the country's vulnerabilities and aimed at mitigating the adverse effects of climate change events

El cambio climático y la defensa nacional en Cuba / Climate change and national defense in Cuba

Variadas son las repercusiones que el cambio climático puede inducir sobre la salud humana, por lo que las respuestas para su mitigación deben cubrir una amplia gama de posibles perjuicios. En Cuba existen un conjunto de predicciones sobre el grado de deterioro que este evento puede ocasionar, directa o indirectamente, sobre la salud y las condiciones de vida de la población, lo que ha posibilitado el desarrollo de todo un conjunto de instrumentos jurídicos en los que es importante identificar las acciones encaminadas a mitigar el impacto de estas alteraciones del ambiente. Estos han demandado un cuidadoso diseño y preparación de planes de contingencia para disminuir el efecto perjudicial de tales fenómenos adversos sobre los recursos humanos y materiales del país, que son la clave de la política de defensa nacional que, en opinión de los autores, presenta una correspondencia entre las previsiones que establecen y los posibles percances que el cambio climático puede ocasionar en el territorio nacional, con un conjunto de medidas fundamentadas en las vulnerabilidades del país y encaminadas a mitigar los efectos adversos de estos sucesos(AU)

Many are the ways in which climate change may affect human health. Therefore, mitigation measures should cover a wide range of potential negative effects. A number of forecasts have been developed in Cuba about the way in which climate change may directly or indirectly affect health and the living conditions of the population as well as the degree of deterioration to be expected. Based on such forecasts, legal instruments have been created which include actions aimed at mitigating the impact of such environmental alterations. These instruments have been carefully designed and contingency plans have been developed to reduce the damaging effect of adverse environmental phenomena on the country's human and material resources, an essential component of the national defense policy. It is the authors' opinion that there is a correspondence between the forecasts and the potential negative impact of climate change on the national territory, with a number of measures based on the country's vulnerabilities and aimed at mitigating the adverse effects of climate change events(AU)

Prevalence of asthma symptoms in schoolchildren, and climate in west European countries: an ecologic study.

The aim of the present study was to estimate the associations between the prevalence of asthma symptoms in schoolchildren and meteorological variables in west European countries that participated in the International Study of Asthma and Allergies in Children (ISAAC), Phase III 1997-2003. An ecologic study was carried out. The prevalence of asthma was obtained from this study from 48 centers in 14 countries, and meteorological variables from those stations closest to ISAAC centers, together with other socioeconomic and health care variables. Multilevel mixed-effects linear regression models were used. For schoolchildren aged 6-7 years, the prevalence rate of asthma decreased with an increase in mean annual sunshine hours, showed a positive association with rainy weather, and warm temperature, and a negative one with relative humidity and physician density (PD). Current wheeze prevalence was stronger in autumn/winter seasons and decreased with increasing PD. Severe current wheeze decreased with PD. For schoolchildren aged 13-14 years, the prevalence rates of asthma and current wheeze increased with rainy weather, and these rates decreased with increased PD. Current wheeze, as measured by a video questionnaire, was inversely associated with sunny weather, and nurse density. Severe current wheeze prevalence was stronger during autumn/winter seasons, decreased with PD, and indoor chlorinated public swimming pool density, and increased with rainy weather. Meteorological factors, including sunny and rainy weather, and PD may have some effect on the prevalence rates of asthma symptoms in children from west European countries.

Atopic dermatitis and indoor use of energy sources in cooking and heating appliances.

BACKGROUND: Atopic dermatitis (AD) prevalence has considerably increased worldwide in recent years. Studying indoor environments is particularly relevant, especially in industrialised countries where many people spend 80% of their time at home, particularly children. This study is aimed to identify the potential association between AD and the energy source (biomass, gas and electricity) used for cooking and domestic heating in a Spanish schoolchildren population. METHODS: As part of the ISAAC (International Study of Asthma and Allergies in Childhood) phase III study, a cross-sectional population-based survey was conducted with 21,355 6-to-7-year-old children from 8 Spanish ISAAC centres. AD prevalence, environmental risk factors and the use of domestic heating/cooking devices were assessed using the validated ISAAC questionnaire. Crude and adjusted odds ratios (cOR, aOR) and 95% confidence intervals (CIs) were obtained. A logistic regression analysis was performed (Chi-square test, p-value < 0.05). RESULTS: It was found that the use of biomass systems gave the highest cORs, but only electric cookers showed a significant cOR of 1.14 (95% CI: 1.01-1.27). When the geographical area and the mother's educational level were included in the logistic model, the obtained aOR values differed moderately from the initial cORs. Electric heating was the only type which obtained a significant aOR (1.13; 95% CI: 1.00-1.27). Finally, the model with all selected confounding variables (sex, BMI, number of siblings, mother's educational level, smoking habits of parents, truck traffic and geographical area), showed aOR values which were very similar to those obtained in the previous adjusted logistic analysis. None of the results was statistically significant, but the use of electric heating showed an aOR close to significance (1.14; 95% CI: 0.99-1.31). CONCLUSION: In our study population, no statistically significant associations were found between the type of indoor energy sources used and the presence of AD.

Sunny hours and variations in the prevalence of asthma in schoolchildren according to the International Study of Asthma and Allergies (ISAAC) Phase III in Spain.

The objective of this study was to estimate the relationship between the prevalence of asthma in schoolchildren aged 6-7 years and 13-14 years and the mean annual sunny hours (MASH) in Spain, and to explore predictive models for asthma prevalence. The prevalence of asthma was obtained from the International Study of Asthma and Allergies (ISAAC) Phase III 2002-2003, and climate and socio-economic variables from official sources. Nine centres were studied and a further four centres, two of which are in ISAAC, to test the predictive models. Logistic regression was used to estimate adjusted prevalence rates of asthma for each centre, and multiple regression models to study the effects of MASH and other meteorological and socio-economic variables. The adjusted prevalence rate of asthma decreased 0.6% [95% confidence interval (CI) 0.4-0.8%] for the 6-7 years group and 1.1% (95% CI 0.8-1.3%) for the 13-14 years group with an increase in the MASH of 100 h. Relative humidity was negatively associated with asthma in the older age group, and gross province product per capita (GPP) was positively associated with asthma in the younger age group. The predictive models, which included MASH, gender, relative humidity, and GPP, anticipated prevalence rates of asthma without significant differences between the levels observed and those expected in 9 of the 11 measurements carried out. The results indicate that sunny hours have a protective effect on the prevalence of asthma in schoolchildren.

Early exposure to paracetamol or to antibiotics and eczema at school age: modification by asthma and rhinoconjunctivitis.

The association between early exposure to paracetamol or to antibiotics and eczema is conflicting. This study aims to know whether the early exposure to those drugs is associated with eczema at school age, and whether the strength of the association is modified by the presence of asthma or rhinoconjunctivitis. Children aged 6-7 (n = 13908) from the International Study of Asthma and Allergies in Childhood in Spain provided data about current asthma, rhinoconjunctivitis and eczema. Parent-reported information was also obtained on paracetamol and antibiotic consumption during the first year of life. Logistic regression analysis with eczema as outcome and including exposure to paracetamol or to antibiotics, together with possible confounders, was carried out in the whole sample of children and in five different strata: no respiratory symptom and any respiratory symptom further subdivided into: asthma with rhinoconjunctivitis, asthma without rhinoconjunctivitis and rhinoconjunctivitis without asthma. In the whole sample, exposure to paracetamol was associated with eczema (aOR 1.56 [1.36-1.80]) as was antibiotic consumption (aOR 1.66 [1.43-1.92]). These associations did not substantially change after additionally adjusting for the other drug. A similar pattern was found among children without respiratory symptoms. In children with symptoms, adjusting for the other drug modified the association with paracetamol (aOR from 1.32 [1.03-1.71] to 1.09 [0.83-1.43]) but did not change that with antibiotics (aOR from 1.80 [1.38-2.35] to 1.81 [1.37-2.39]). Early exposure to paracetamol or to antibiotics is associated with an increased prevalence of eczema at school age. Asthma and/or rhinoconjunctivitis substantially modifies this association.

Contaminación del aire y síntomas recientes de asma, rinitis alérgica y eccema atópico en escolares de 6 y 7 años / Air Pollution and Recent Symptoms of Asthma, Allergic Rhinitis, and Atopic Eczema in Schoolchildren Aged Between 6 and 7 Years

Introducción: El objetivo del estudio ha sido analizar la relación entre contaminantes del aire y la prevalencia de síntomas recientes de asma, rinitis alérgica y eccema atópico, en escolares de 6 y 7 años.Pacientes y métodos: La prevalencia de síntomas de enfermedades alérgicas recientes (últimos 12 meses) se obtuvo mediante el cuestionario del estudio ISAAC (International Study of Asthma and Allergies in Childhood) España, con la participación de 7 centros (Asturias, Barcelona, Bilbao, Cartagena, La Coruña, Madrid y Valencia) y 20.455 escolares de 6 y 7 años, durante 2002–2003. De los sistemas de detección de contaminantes de los centros citados se obtuvieron datos de las concentraciones anuales medias de dióxido de azufre (SO2), dióxido de nitrógeno (NO2), monóxido de carbono (CO) y total de partículas en suspensión.Resultados: La concentración media anual (CMA) de SO2 se asoció significativamente con una mayor prevalencia de asma grave reciente (odds ratio ajustada [ORa], nivel 3 sobre nivel 1 de contaminación=1,32; intervalo de confianza [IC] del 95%, 1,01–1,73), rinitis (ORa=1,56; IC del 95%, 1,39–1,75) y rinoconjuntivitis (ORa=1,70; IC del 95%, 1,45–2,00). La CMA de CO se asoció con una prevalencia más alta de rinitis (ORa=1,65; IC del 95%, 1,34–2,04), rinoconjuntivitis (ORa=1,76; IC del 95%, 1,31–2,37) y eccema atópico (ORa=1,55; IC del 95%, 1,17–2,04). Las CMA de NO2 y de total de partículas en suspensión presentaron asociaciones inversas con la prevalencia de tos seca nocturna.Conclusiones: Se indica qué contaminantes del aire, como SO2 y CO, incrementan el riesgo de síntomas recientes de asma y rinitis alérgica en escolares de 6 y 7 años de nuestro medio(AU)

Objective: The objective of the study was to analyze the relationship between air pollutants and the prevalence of recent symptoms of asthma, allergic rhinitis, and atopic eczema in schoolchildren aged between 6 and 7 years.Patients and Methods: The prevalence of recent (previous 12 months) symptoms of allergic diseases was obtained by means of the questionnaire of the International Study of Asthma and Allergies in Childhood (ISAAC), Spain, with the participation of 7 centers (Asturias, Barcelona, Bilbao, Cartagena, La Coruña, Madrid, and Valencia) and 20 455 schoolchildren aged between 6 and 7 years, from 2002 to 2003. The pollutant detection systems of the aforementioned centers provided the mean annual concentrations of sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO), and total suspended particulate matter.Results: The annual average concentration of SO2 showed a significant association with a higher prevalence of recent severe asthma (adjusted odds ratio [aOR] between level-1 and level-3 pollution, 1.32; 95% confidence interval [CI], 1.01–1.73), rhinitis (aOR, 1.56; 95% CI, 1.39–1.75), and rhinoconjunctivitis (aOR, 1.70; 95% CI, 1.45–2.00). The annual average concentration of CO was associated with a higher prevalence of rhinitis (aOR, 1.65; 95% CI, 1.34–2.04), rhinoconjunctivitis (aOR, 1.76; 95% CI, 1.31–2.37), and eczema (aOR, 1.55; 95% CI, 1.17–2.04). The annual average concentration for NO2 and total suspended particulate matter showed inverse associations with the prevalence of nocturnal dry cough.Conclusions: Findings suggest that air pollutants such as SO2 and CO increase the risk of recent symptoms of asthma and allergic rhinitis in schoolchildren aged between 6 and 7 years in Spain(AU)

[Air pollution and recent symptoms of asthma, allergic rhinitis, and atopic eczema in schoolchildren aged between 6 and 7 years]. / Contaminación del aire y síntomas recientes de asma, rinitis alérgica y eccema atópico en escolares de 6 y 7 años.

OBJECTIVE: The objective of the study was to analyze the relationship between air pollutants and the prevalence of recent symptoms of asthma, allergic rhinitis, and atopic eczema in schoolchildren aged between 6 and 7 years. PATIENTS AND METHODS: The prevalence of recent (previous 12 months) symptoms of allergic diseases was obtained by means of the questionnaire of the International Study of Asthma and Allergies in Childhood (ISAAC), Spain, with the participation of 7 centers (Asturias, Barcelona, Bilbao, Cartagena, La Coruña, Madrid, and Valencia) and 20 455 schoolchildren aged between 6 and 7 years, from 2002 to 2003. The pollutant detection systems of the aforementioned centers provided the mean annual concentrations of sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO), and total suspended particulate matter. RESULTS: The annual average concentration of SO2 showed a significant association with a higher prevalence of recent severe asthma (adjusted odds ratio [aOR] between level-1 and level-3 pollution, 1.32; 95% confidence interval [CI], 1.01-1.73), rhinitis (aOR, 1.56; 95% CI, 1.39-1.75), and rhinoconjunctivitis (aOR, 1.70; 95% CI, 1.45-2.00). The annual average concentration of CO was associated with a higher prevalence of rhinitis (aOR, 1.65; 95% CI, 1.34-2.04), rhinoconjunctivitis (aOR, 1.76; 95% CI, 1.31-2.37), and eczema (aOR, 1.55; 95% CI, 1.17-2.04). The annual average concentration for NO2 and total suspended particulate matter showed inverse associations with the prevalence of nocturnal dry cough. CONCLUSIONS: Findings suggest that air pollutants such as SO2 and CO increase the risk of recent symptoms of asthma and allergic rhinitis in schoolchildren aged between 6 and 7 years in Spain.

Influence of two different geo-climatic zones on the prevalence and time trends of asthma symptoms among Spanish adolescents and schoolchildren.

Few studies have focused on the long-term influence of the climate on the prevalence of asthma. The aim of this study is to establish the influence of geo-climatic conditions on the prevalence of asthma symptoms both in adolescents and schoolchildren, and to discover if this influence is associated with their time trends. Eight centres in Spain performed both ISAAC phases I (1994) and III (2002) in children 13-14 years old. Six of them also surveyed children 6-7 years old. For each age group and phase, about 3,000 children were surveyed per centre. This study examines the prevalence of current wheeze and severe current wheeze in two different geo-climatic zones, coast and plateau, considering their relative humidity and temperature range. In both age groups, the mean asthma prevalence on the coast, for phase I and III, was significantly higher than on the plateau. Living on the plateau was an independent protective factor for current wheeze and severe current wheeze for the two age groups. Within the coastal centres, the increase of the annual relative humidity was a statistical significant risk factor for current wheeze, the same trend existing for current severe wheeze. These effects were independent of the sex and of the phase of the study. The prevalence of asthma and severe asthma symptoms is more frequent on the coast of Spain as compared to the inner plateau. This finding was repeated both in 1994 and in 2002.