No increase in the prevalence of asthma, allergies, and atopic sensitisation among children in Germany: 1992-2001.

BACKGROUND: From 1970 to 1990 increasing rates of asthma and allergic sensitisation were observed in several countries. The aim of this study was to investigate time trends in the prevalence of asthma and allergic sensitisation among school children in Germany between 1992 and 2001. METHODS: Parental reports of asthma, hay fever, and wheezing and measurements of specific serum IgE antibodies were investigated in six serial cross sectional surveys of 9-11 year old school children in three study areas in south west Germany. RESULTS: A total of 6762 school children of mean age 10 years (mean participation rate 77.9%) took part in the investigation in the three study areas. Over the 9 year study period no increase in the prevalence of current wheezing and asthma was observed. In addition, the prevalence of atopic sensitisation remained unchanged during the observation period. CONCLUSIONS: These data, using parental reports and objective measures of allergy, suggest that there has been no further increase in the prevalence of asthma and atopy since 1992. The epidemic may thus have reached a plateau.

[Human biomonitoring investigations of organochlorine compounds -- PCB, DDE, HCB, beta- and gamma-HCH, PCDD/PCDF, Dioxin-like PCB's and polybrominated biphenyl ethers]. / Humanbiomonitoring-Untersuchungen von Organohalogenverbindungen -- PCB, DDE; HCB, beta- und gamma-HCH, PCDD/PCDF, koplanaren PCB sowie polybromierten Biphenylethern.

Although PCB and PCB-containing materials are not processed for a long time, PCB is under discussion again and again caused by the pollution of indoor environments. To objectify the discussion, the dates of the PCB-biomonitoring, the organochlorine-compounds (DDE, HCB, beta-/gamma -HCH, PCDD/PCDF) and the polybrominated biphenyl ethers concerning the investigations within the project "Sentinel Health Departments" in Baden-Wurttemberg are represented. Additionally results from children from Kazakhstan (Aral-Sea area) and from teachers which are working in PCB polluted schools as well as from a long term investigated test person are reported. Blood concentrations of the following compounds decreased from 1996/97 to 2002/03: the sum of the concentration of PCB 138,153 and 180 decreased from 0.46 microg/L to 0.20 microg/L, DDE from 0.32 microg/L to 0.17 microg/, HCB from 0.20 microg/L to 0.08 microg/L, beta-HCH below the level of detection, I-TEQ NATO to 4.8 pg/g blood fat, TEQ WHO (without PCB) to 5.5 pg/g blood fat, PCB 126 to 18,8,pg/g blood fat and PCB 169 to 12.8 pg/g blood fat. The influence of breast feeding and the gender on the level of the pollution is conspicious. No local correlations were found in Baden-Wurttemberg, but they were found in comparison with the results of Kazakhstan (Aral-Sea area). The difficulty to produce time series while the analyzing pollutants are more and more decreasing, as well as the change of the calculation base of the summation of parameters like I-TEQ NATO to TEQ WHO are discussed.

[Exposition and sensitisation to indoor allergens, house dust mite allergen and cat allergens]. / Exposition und Sensibilisierung gegenüber Milben- und Katzenallergenen bei Kindern in Baden-Württemberg.

The study examined the exposure to biological indoor air agents and their possible role for allergies and respiratory tract illnesses of children. It was conducted as a case control study (atopic vs non-atopic children) at the four surveillance public health departments in Baden-Württemberg in the winter season 1999/2000 and included 379 children of the fourth class. The concentrations of the house dust mite antigens Der F1, Der p1, and Der Gr2 as well as cat allergen Fel d1 were determined in the children's bedrooms on the ground and in the mattress. Specific IgE-antibodies against allergens from house dust, mites and cat were determined in the serum of the children. For mite allergens the following medians ( micro g/g) were estimated in floor dust: Der p1 = 0.6, Der f1 = 2.3, Gr2 = 0.1; in mattresses: Der p1 = 1.2, Der f1 = 3.4, Gr2 = 0.3. The median of Fel d1 in floor dust was 0.2 microg/g, in mattresses 0.1 microg/g. Sensitisation to dust mite allergen was found to be more prevalent than sensitisation to cat. The distribution of sensitisation among the cases and controls is different. Among the cases, more subjects were sensitised to dust mites (32.9 %) and cat (13.1 %). Among the controls, 17.1 % were sensitised to dust mites and 4.1 % to cat. The results showed no direct association between the prevalence of allergies or respiratory tract illnesses and the indoor concentrations of the allergens. Possible reasons for these findings are discussed.

[10 years of observation by public health offices in Baden-Württemberg--assessment of human biomonitoring for mercury due to dental amalgam fillings and other sources]. / 10 Jahre Beobachtungsgesundheitsämter in Baden-Württemberg--Beurteilung der Human-Biomonitoring-Untersuchungen bezüglich der Quecksilber-Belastung durch Amalgamfüllungen und andere Quellen.

Since 1992, in Baden-Württemberg, ten-year old children have been surveyed in the project "Sentinel Health Departments" to study their exposure to environmental pollutants and possible health effects. In the four study areas 1200 children have been investigated every year initially, since 1996 every second year. The data for mercury in body fluids are reported here. The decrease in the body burden of mercury as a result of the declining usage of dental amalgam fillings, was been verified. In 1992/93, of all the children who had been surveyed, the 95 percentile for the body burden of mercury was 3.1 microg/l and in 2000/01 1.35 microg/l. Also to be discussed is the reason why mercury-based cosmetic ointments seriously exceed the HBM-II-intervention-value. Because of using these ointments, concentrations of mercury in urine up to 1400 microg/l were found. A study within the project "Sentinel Health Departments" compared the concentrations of mercury in the urine of adults with those in blood and salvia. The results support the opinion that mercury in urine is appropriate for estimating the mercury uptake from dental amalgam fillings. It can be assumed that these results reflect the situation in the entire Federal Republic of Germany. The ten years' experience confirms that the concept of the "Sentinel Health Departments" is excellently suited to obtain data relevant for environmental health of children. Environmental health protection and the essential gathering of data for future health observation in Baden-Württemberg.

First data on background levels of non-ortho and mono-ortho PCBs in blood of residents from southern Germany.

Blood-fat concentrations of polychlorinated biphenyls (PCB) congeners: no. 105, 118, 156 (mono-ortho-substituted) and no. 77, 126, 169 (non-ortho-substituted) and PCB congeners no. 28, 52, 101, 138, 153 and 180 were measured. The investigations were carried out in pooled samples from children and in individual samples from adults. Additionally polychloro-p-dibenzodioxins and -furans (PCDD/PCDF) were investigated.

[Sentinel public health offices--a new approach to determining public health relevant data by the public health service]. / Beobachtungsgesundheitsämter--ein neuer Ansatz zur Erhebung gesundheitsrelevanter Daten durch den OGD.

The discipline of environment-related health protection lacks continuously recorded data. Therefore, a three-year pilot project "Sentinel Public Health Offices" was initiated by the Ministry of Labour, Health and Social Welfare of Baden-Württemberg in 1992. Selected public health offices were instructed to conduct a series of three cross-sectional surveys of biological and effect monitoring among children attending the fourth grade of primary schools. The surveys were coordinated by the Provincial Public Health Office. During the pilot project the system of " Sentinel Public Health Offices" has proved successful not only in the continuous recording of data relevant to health. Its continuation as a permanent institution is contemplated.

[Duplicate study on the dietary intake of some metals/metalloids by children in Germany. I. Arsenic and mercury]. / Duplikatstudie zur Aufnahme von einigen Metallen/Metalloiden bei Kindern in Deutschland. Teil I: Arsen und Quecksilber.

The dietary intake of arsenic and mercury by 47 children (aged 5-8 years) living in West-Germany (Duisburg) is reported. Duplicate portions of all food and beverages were obtained on 2 days. Arsenic and mercury were measured by atomic absorption spectrometry under careful quality control. Results of are shown in the following table. [table: see text] Fish was consumed at 3 of 94 sampling days only. The arsenic and mercury intake on days with fish consumption was much higher compared with the other days (median, range): arsenic 8821; 4431-11954; mercury 123.7; 80, 0-167.5 ng/kg b.w. and day. The dietary arsenic and mercury intake was much lower than the FAO/WHO PTWI. For mercury the median intake amounted to 1.7% on days without and to 16.6% on days with fish consumption, for arsenic on days without fish consumption to 5.2% PTWI (only for inorganic arsenic compounds established) and on days with fish consumption (in fish mainly organic arsenic occur) 411% of PTWI. Based on the PTWI our data indicate no health risks for German 5-8-year-old children due to arsenic and mercury dietary intake.

[Duplicate study on the dietary intake of some metals/metalloids by children in Germany. part II. Aluminum, cadmium and lead]. / Duplikatstudie zur alimentären Aufnahme von einigen Metallen/Metalloiden bei Kindern in Deutschland. Teil II: Aluminium, Cadmium und Blei.

The dietary intake of aluminium, cadmium and lead by 47 children (aged 5-8 years) living in West-Germany (Duisburg) is reported. Duplicate portions of all food and beverages were obtained on 2 days. Aluminium, cadmium and lead were measured by atomic absorption spectrometry under careful quality control. Results are shown in the following table. [table: see text] The dietary intake of aluminium was low. The median amounted to 2.9% and the maximum value to 11.2% of the FAO/WHO PTWI. The correspondent data for cadmium were 30.2 and 98.7% and for lead 22.2% and 72.1% respectively.

[The correlation between the excretion of thioethers and their mutagenic activity in urine in workers of different occupational groups]. / Untersuchungen über die Korrelation zwischen Ausscheidung von Thioethern und mutagener Aktivität im Urin bei Arbeitnehmern von verschiedenen Berufsgruppen.

Electrophilic substances can be inactivated by binding to glutathione or other SH-bearing molecules leading to urinary excretion of mercapturic acids or other thioether products. The mutagenic activity in urine as detected by mutagenicity assay (Ames-Test) is caused by genotoxic agents or their electrophilic metabolites. Therefore, it has been suggested that an effective protection by the glutathione system may diminish the urinary excretion of mutagens after exposure to genotoxicants. We determined the thioether concentration and mutagenic activity in urine samples of exposed workers (20 workers of a repair shop exposed to car exhaust, 35 workers of several dry cleaning shops exposed to halogenated hydrocarbons and 26 workers of a metal processing factory exposed to polycyclic aromatic hydrocarbons). We performed microfluctuation assay using Salmonella typhimurium TA98 and applied a method for the determination of urinary thioethers based on liquid chromatographic quantification of N-acetylcysteine. Our results show a linear correlation between the two exposure parameters which is independent on exposure conditions described above.