Abstract
BackgroundAcute respiratory tract infections (ARTI) are an important public health problem. Improved identification of risk factors might enable targeted intervention. Therefore we carried out a case-control study with the aim of identifying environmental risk factors for ARTI consultations in the Dutch general population.MethodsA subset of patients visiting their GP in the period of 2000–2003 with an ARTI (cases) and age-matched controls (visiting for other complaints) were included in a case-control study. They were asked to complete a questionnaire about potential risk factors. Conditional logistic regression was used to calculate odds ratio's (OR) and 95% confidence intervals (CI) to estimate the independent effect of potential risk factors.ResultsA total of 493 matched pairs of case and control subjects were enrolled. Exposure to persons with respiratory complaints, both inside and outside the household, was found to be an independent risk factor for visiting a GP with an ARTI (respectively ORadj = 1.9 and ORadj = 3.7). Participants exposed to dampness or mould at home (ORadj=0.5) were significantly less likely to visit their GP. In accordance with the general risk of consultations for ARTI, participants with a laboratory-confirmed ARTI who were exposed to persons with respiratory complaints outside the household were also significantly more likely to visit their GP (ORadj=2.5).ConclusionThis study confirmed that heterogeneity in the general population as well as in pathogens causing ARTI makes it complicated to detect associations between potential risk factors and respiratory infections. Whereas it may be difficult to intervene on the risk posed by exposure to persons with respiratory complaints, transmission of ARTI in the general population might be reduced by improved hygienic conditions.
Highlights
Acute respiratory tract infections (ARTI) are an important public health problem
In line with the general risks of consultations for ARTI, participants with a laboratory-confirmed ARTI who were exposed to persons with respiratory complaints outside the household were significantly more likely to visit their general practitioners (GPs) (ORadj = 2.5)
We demonstrated that in the general population smoking, dampness or mould at home and having family members attending day-care were not associated with a higher risk for ARTI, which is in contrast with studies carried out in children or patients with specific respiratory diseases
Summary
Acute respiratory tract infections (ARTI) are an important public health problem. Improved identification of risk factors might enable targeted intervention. We carried out a case-control study with the aim of identifying environmental risk factors for ARTI consultations in the Dutch general population. Acute respiratory tract infections (ARTI) are an important public health problem. Worldwide they are responsible for considerable morbidity and mortality, and lead to an increase in absence from work and school and an increased number of consultations with clinicians [1,2,3,4,5,6]. The development of an effective universal treatment for ARTI is hampered by this great number of different pathogens causing ARTI as well as a diagnostic deficit of around 30% [7]. The development of preventive initiatives to reduce morbidity and mortality, like vaccines or antiviral agents, is hindered by the mixed pathogenesis [1,11]
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