Eczema In Adolescents Research Articles

The influence of acetaminophen on human health

In pain management, acetaminophen, a widely used analgesic and antipyretic, holds a central position. The metabolic pathways can lead to acetaminophen-induced hepatotoxicity, elucidating from glucuronidation to the cytochrome P450 system. It meticulously details the complexities of acetaminophen metabolism, culminating in the formation of the toxic metabolite, n-acetyl-p-benzoquinone imine (NAPQI). Providing a holistic understanding guiding clinical practice, it explores risk factors, clinical implications, and management strategies. Transitioning to respiratory risks, potential associations between acetaminophen use and asthma, rhinoconjunctivitis, and eczema in adolescents is investigated. The study offers nuanced insights, urging caution in acetaminophen use during adolescence. In addition, the role of drug metabolism in acetaminophen-induced hepatic necrosis is also analyzed. Despite its temporal origins, the studys identification of cytochrome P450 as a catalyst for NAPQI formation remains foundational, contributing mechanistic insights to drug-induced liver injury knowledge. Synthesizing these studies reveals a delicate balance between acetaminophen metabolism and detoxification, crucial in determining its hepatotoxic potential. This nuanced understanding informs clinical practice and beckons researchers to bridge gaps, embarking on further explorations. In essence, this synthesis becomes a compass guiding the scientific community toward a profound comprehension of acetaminophen, epitomizing the standards expected in high-quality, peer-reviewed literature.

Prevalence of Allergic Rhinitis and Eczema in Adolescents Living in Yazd City: Part of Global Asthma Network Survey.

Allergic rhinitis and eczema are two common global diseases that can lead to impaired quality of life. Determining the prevalence of these allergic disorders can be useful in planning prevention and treatment. This study aimed to investigate the prevalence and severity of allergic rhinitis and eczema in adolescents living in Yazd city. Using an electronic questionnaire based on the Global Asthma Network (GAN) core questionnaire, 5141 adolescents aged 13-14 years were cross-sectionally surveyed. The prevalence of current symptoms of rhinitis turned out to be 36.3%, proving significantly higher in boys (p=0.009). Moreover, the prevalence of allergic rhinitis and rhinoconjunctivitis in the past year leveled at 12.4% and 10.5%, respectively; however, the former was significantly higher in females (p=0.014). Additionally, severe rhinoconjunctivitis was observed in 0.2% of the participants with no gender preference (p=0.09). Confirmed hay fever by a doctor was reported in 13.2% of adolescents, significantly higher in males (p<0.001). The prevalence of current itchy rash and current eczema was found to be 5.5%, and 2.9%, respectively, with no difference in terms of gender. Severe atopic eczema and eczema confirmed by a doctor were seen in 0.4% and 5% of the participants, no gender preference was identified. Concurrent prevalence of current rhinoconjunctivitis and eczema was detected in 1% of the participants. Despite the increasing trend of allergic diseases in most parts of the world, the prevalence of rhinoconjunctivitis and eczema in adolescents has not increased in Yazd in the last two decades, and this city is located in a low to moderate prevalence area.

Filaggrin gene mutations in relation to contact allergy and hand eczema in adolescence.

Filaggrin is an important protein for structure and function of the skin barrier. Filaggrin gene (FLG) mutations are known to result in dry skin, impaired skin barrier, and increased risk for atopic dermatitis. However, it is not clear whether these mutations are associated with contact allergy or hand eczema in adolescence. The purpose of this study was to investigate whether FLG mutations are associated with contact allergy, self-reported hand eczema, or dry skin in adolescence. We used data from the 16-year follow-up in the BAMSE cohort, information obtained from a Web-based questionnaire including questions on hand eczema and dry skin, from FLG mutation analysis (R501X, R2447X, 2282del4), and patch testing (n = 1822). Logistic regression analyses showed no statistically significant associations between FLG mutations and contact allergy (any contact allergy, nickel allergy, or fragrance allergy) according to patch test, or self-reported hand eczema at 16 years, or hand eczema ever. However, FLG mutations were associated with self-reported dry skin at 16 years. FLG mutations are associated with self-reported dry skin at 16 years. However, in this study no consistent associations were found between FLG mutations and contact allergy or hand eczema at 16.

Use of cleaning agents at home and respiratory and allergic symptoms in adolescents

Abstract Background It has been suggested that adults who use cleaning agents in their homes have a higher risk of asthma and allergic symptoms. The associations of asthma and allergic symptoms with household use of cleaning agents in adolescents have not been investigated yet. Objectives To examine the associations of household cleaning agents use with the prevalence of asthma, rhinitis and eczema in adolescents. Methods In this cross-sectional analysis, we included participants of the PIAMA birth cohort study with data on household use of 10 types of cleaning agents and information on asthma, rhinitis and/or eczema from parent-completed questionnaires at age 14 (N = 2333). For the cleaning agents, we developed a composite score ranging from 0 (no exposure) to 30 points (household use on 4–7 days per week for all 10 types of cleaning agents). Logistic regression was used to analyse associations between household cleaning agents use (composite score and specific cleaning agents) and outcomes, adjusting for potential confounders. Results Seven, 13 and 11% of the participants had asthma, rhinitis and eczema, respectively, at age 14. The composite score for household use of cleaning agents was not associated with asthma, rhinitis and eczema. For instance, adjusted odds ratios (95% confidence interval) for the prevalence of asthma, rhinitis and eczema comparing those with the highest use of cleaning agents (≥10 points) to those with never/seldom use (0–4 points) were 0.95 (0.56, 1.63), 1.23 (0.82, 1.82) and 0.95 (0.56, 1.63), respectively. For individual cleaning agents, we only found the use of ammonia to be significantly associated with a lower risk of rhinitis [0.60, (0.44, 0.82)]. Conclusions There was no indication of an increased prevalence of asthma, rhinitis or eczema among adolescents living in households within the highest category of cleaning agents use.

Use of cleaning agents at home and respiratory and allergic symptoms in adolescents: The PIAMA birth cohort study

BackgroundIt has been suggested that adults who use cleaning agents in their homes have a higher risk of asthma and allergic symptoms. The associations of asthma and allergic symptoms with household use of cleaning agents in adolescents have not been investigated yet. ObjectivesTo examine the associations of household cleaning agents use with the prevalence of asthma, rhinitis and eczema in adolescents. MethodsIn this cross-sectional analysis, we included participants of the PIAMA birth cohort study with data on household use of 10 types of cleaning agents and information on asthma, rhinitis and/or eczema from parent-completed questionnaires at age 14 (N = 2333). For the cleaning agents, we developed a composite score ranging from 0 (no exposure) to 30 points (household use on 4–7 days per week for all 10 types of cleaning agents). Logistic regression was used to analyse associations between household cleaning agents use (composite score and specific cleaning agents) and outcomes, adjusting for potential confounders. ResultsSeven, 13 and 11% of the participants had asthma, rhinitis and eczema, respectively, at age 14. The composite score for household use of cleaning agents was not associated with asthma, rhinitis and eczema. For instance, adjusted odds ratios (95% confidence interval) for the prevalence of asthma, rhinitis and eczema comparing those with the highest use of cleaning agents (≥10 points) to those with never/seldom use (0–4 points) were 0.95 (0.56, 1.63), 1.23 (0.82, 1.82) and 0.95 (0.56, 1.63), respectively. For individual cleaning agents, we only found the use of ammonia to be significantly associated with a lower risk of rhinitis [0.60, (0.44, 0.82)]. ConclusionsThere was no indication of an increased prevalence of asthma, rhinitis or eczema among adolescents living in households within the highest category of cleaning agents use.

Changes over time in the prevalence of asthma, rhinitis and atopic eczema in adolescents from Taubaté, São Paulo, Brazil (2005–2012): Relationship with living near a heavily travelled highway

BackgroundThe prevalence of allergic diseases is increasing. We evaluated temporal trends in the prevalence of asthma, rhinitis and eczema in adolescents (13–14 years) living in Taubaté, SP, Brazil (2005–2012) and assessed the relationship between these prevalences and the residential proximity to Presidente Dutra Highway (PDH, a heavily travelled highway). MethodsThis cross-sectional study of adolescents (N=1039) from public and private schools was evaluated using the standard questionnaire of the International Study of Asthma and Allergies in Childhood (ISAAC) plus a question about their place of residence in relation to PDH. The data obtained were compared to the 2005 data using a chi-square test or Fisher's exact test. An analysis by groups consisting of two phases (two-step cluster) was used to evaluate the effect of living near PDH. ResultsThere was a lifetime increase in the prevalence of active asthma (15.3% vs. 20.4%, p=0.005) and physician-diagnosed asthma (6.8% vs. 9.2%, p=0.06) and a decrease in the symptoms of active rhinitis (36.6% vs. 18.5%) between 2005 and 2012. A high frequency of asthma and rhinitis (18.1% vs. 23.2%, respectively) was observed among adolescents living close or very close to PDH; furthermore, 85.6% of the adolescents without symptoms of asthma or rhinitis lived far from PDH. ConclusionAn increase in the prevalence of asthma and a decrease in the prevalence of rhinitis were observed during the studied period. Living near PDH was associated with higher rates of asthma, rhinitis, and eczema.

Onset and severity of atopic dermatitis, atopy and hand eczema in adolescents

Onset and severity of atopic dermatitis, atopy and hand eczema in adolescents

Hand eczema and atopic dermatitis in adolescents: a prospective cohort study from the BAMSE project.

There is a well-known association between atopic dermatitis (AD) and hand eczema but less is known about how age at onset, persistence and severity of AD influence the risk of developing hand eczema. To examine the role of AD in the occurrence of hand eczema in adolescence. In addition, associations between asthma and rhinoconjunctivitis, sensitization to common airborne and food allergens, and hand eczema were studied. From the population-based birth cohort BAMSE, 2927 adolescents who had been followed up repeatedly concerning allergy-related disease were included. Questionnaires identified adolescents with hand eczema at 16 years, and their blood was analysed for specific IgE. A total of 152 (5·2%) adolescents had hand eczema at the age of 16 years. Many of these adolescents had a history of AD (n = 111; 73·0%) and asthma and/or rhinitis (n = 83; 54·6%), respectively. Children with AD (aged 0-16 years) had more than threefold increased odds ratios (OR) for having hand eczema; those with persistent or severe AD had a crude OR of 6·1 [95% confidence interval (CI) 4·0-9·1] and 5·3 (95% CI 2·9-9·6), respectively. We confirm a strong association between AD during childhood and hand eczema in adolescence. Children with persistent or more severe AD are at greater risk of developing hand eczema. Asthma and/or rhinoconjunctivitis, positive specific IgE or age at onset of AD are not associated with hand eczema in adolescence.

Atopic and nonatopic eczema in adolescence: is there adifference?

There is limited information on clinical manifestations of atopic eczema (AE) and non-AE in teenagers. To describe the characteristics of adolescent eczema in the general population and to identify potential differences between AE and non-AE in teenagers. Overall, 3108 teenagers were included from the population-based BAMSE cohort and 2529 of these teenagers provided blood samples for analysis of specific IgE. At age 16years, the teenagers answered questionnaires regarding the symptoms of eczema, asthma and rhinitis for the previous year. The prevalence of eczema in adolescence was 9·6% (n=297). More girls than boys had eczema (12·5% vs. 6·5%; P<0·001). The age at onset was usually within the first 2years of life (48·8%), but onset in adolescence was also common (25·6%). Eczema was mild in 72·7% of cases, moderate in 16·8% and severe in 10·4%. Body folds were most frequently affected (73·4%). More than half of the teenagers with eczema had AE (59%). The teenagers with AE had more severe and more chronic eczema. Onset in infancy was most common in AE and onset in adolescence was most common in non-AE. There were no major differences in location or seasonal variance between AE and non-AE in adolescence. AE is more common than non-AE among teenagers. More than one in four teenagers with eczema has moderate-to-severe disease. Onset in adolescence is common, especially for non-AE. AE in adolescence has an earlier onset and is more chronic and more severe than non-AE.

Assessing the relationship between contact sensitization and eczema in adolescents and adults on the example of nickel and neomycin: preliminary results of a meta‐analysis of epidemiological data

Background Throughout literature, positive patch tests to nickel were found in 8.0–51.5% patients with eczema and in 5.9– 27.8% general population, the respective figures for neomycin being 0.0–40.0% and 0.0–2.9%, respectively. As these ranges for eczema patients and general population overlap, it is not clear how strong is the association between the disease and contact sensitization to respective haptens. The aim of the study was to analyze the putative relationship between contact sensitization to nickel or neomycin and eczema with the means of meta-analysis of available data for adolescents and adults. Method A systematic review of published data on the prevalence of sensitization to nickel and neomycin in adolescent and adult eczema patients and the general population. Patch test data from studies of respective populations that were comparable with regard to geographical location, year of study, demographics of the study group and patch test protocols were extracted and pooled to calculate estimated odds ratios (eOD) and estimated attributable risk ratios (eAR). Results

Prevalence of asthma and allergic diseases in adolescents: nine‐year follow‐up study (2003‐2012)

ObjectiveTo determine the prevalence of symptoms of asthma, rhinitis, and atopic eczema in adolescents (AD; 13‐14 years) living in seven Brazilian cities, by applying the standardized written questionnaire (WQ) of the International Study of Asthma and Allergies in Childhood (ISAAC), and to evaluate the time trend nine years after the last assessment of ISAAC phase 3 (ISP3). MethodsThe ISAAC‐WQ was answered by 20,099 AD from the Northern, Northeastern, Southeastern, and Southern Brazilian regions. Values obtained were compared to those observed in ISP3 using nonparametric (chi‐squared or Fisher) tests, and the ratio of annual increment/decrement was established for each of the centers, according to the symptom assessed. ResultsConsidering the national data and comparing to values of ISP3, there was a decrease in the mean prevalence of active asthma (18.5% vs. 17.5%) and an increase in the frequency of severe asthma (4.5% vs. 4.7%) and physician‐diagnosed asthma (14.3% vs. 17.6%). An increase in prevalence of rhinitis, rhinoconjunctivitis, and atopic eczema was also observed. ConclusionsThe prevalence of asthma, rhinitis, and atopic eczema in Brazil was variable; higher prevalence values, especially of asthma and eczema, were observed in regions located closer to the Equator.

Prevalence and incidence of hand eczema in adolescence: report from BAMSE – a population‐based birth cohort

BAMSE is a Swedish population-based birth cohort. To estimate prevalence proportions and the incidence rate of hand eczema in Swedish adolescents, and to compare information given by adolescents and parents. Further aims were to study sex distribution, age at onset and extension of hand eczema. At 16 years of age, 2927 adolescents were included in this study; both adolescent and parental questionnaires were used, as well as clinical examination. The 1-year prevalence of hand eczema was 5·2% (n = 152) and 4·0% (n = 116) (P < 0·03), and lifetime prevalence was 9·7% (n = 284) and 7·0% (n = 206) (P < 0·01), respectively, when adolescents and parents reported. The incidence rate was 573/100 000 person-years according to the adolescent report. The level of agreement between adolescents and parents was fair for 1-year and lifetime prevalence (κ = 0·56 and κ = 0·49, respectively). According to the Hand Eczema Extent Score, 27·0% (n = 36) had moderate-to-severe hand eczema. At the age of 16 years, the 1-year prevalence of hand eczema was substantial, with an incidence rate of the same magnitude as in adults. Female predominance was seen in adolescence. It is preferable that the occurrence of hand eczema is reported by adolescents themselves, as they are the ones most aware of their symptoms.

Prevalence of asthma and allergic diseases in adolescents: nine-year follow-up study (2003-2012)

ObjectiveTo determine the prevalence of symptoms of asthma, rhinitis, and atopic eczema in adolescents (AD; 13-14 years) living in seven Brazilian cities, by applying the standardized written questionnaire (WQ) of the International Study of Asthma and Allergies in Childhood (ISAAC), and to evaluate the time trend nine years after the last assessment of ISAAC phase 3 (ISP3). MethodsThe ISAAC-WQ was answered by 20,099 AD from the Northern, Northeastern, Southeastern, and Southern Brazilian regions. Values obtained were compared to those observed in ISP3 using nonparametric (chi-squared or Fisher) tests, and the ratio of annual increment/decrement was established for each of the centers, according to the symptom assessed. ResultsConsidering the national data and comparing to values of ISP3, there was a decrease in the mean prevalence of active asthma (18.5% vs. 17.5%) and an increase in the frequency of severe asthma (4.5% vs. 4.7%) and physician-diagnosed asthma (14.3% vs. 17.6%). An increase in prevalence of rhinitis, rhinoconjunctivitis, and atopic eczema was also observed. ConclusionsThe prevalence of asthma, rhinitis, and atopic eczema in Brazil was variable; higher prevalence values, especially of asthma and eczema, were observed in regions located closer to the Equator.

Dose-Response Association between Smoking and Atopic Eczema: Results from a Large Cross- Sectional Study in Adolescents

Background: Tobacco smoking and exposure to environmental tobacco smoke (ETS) are known risk factors for asthma, but their association with atopic eczema is unclear. Objective: To investigate the association of smoking and exposure to ETS with prevalence of atopic eczema in a national sample of 13- to 14-year-olds in Israel. Methods: Cross-sectional study within the framework of the International Study on Asthma and Allergies in Childhood. Results: Complete data were available for 10,298 schoolchildren. Atopic eczema as well as asthma and allergic rhinitis were significantly more prevalent in smokers than nonsmokers. Multiple regression analysis revealed a dose-response association between smoking and atopic eczema compared to not smoking: occasional smokers, odds ratio (OR) = 1.6 (95% confidence interval (CI) = 1.2-2.3); daily smokers, OR = 2.2 (95% CI = 1.4-3.6). Exposure to ETS at home was significantly associated with asthma (OR = 1.25; 95% CI = 1.1-1.5) but not atopic eczema. Conclusions: The dose-response association between active smoking and atopic eczema in adolescents is a novel observation which deserves further consideration.

The association between BMI, vigorous physical activity and television viewing and the risk of symptoms of asthma, rhinoconjunctivitis and eczema in children and adolescents: ISAAC Phase Three

Several studies have observed an association between obesity and asthma, but whether or not there is an association with rhinoconjunctivitis or eczema is unclear. To examine the relationship between body mass index categories (underweight, overweight and obesity), vigorous physical activity and television viewing and the risk of symptoms of asthma, rhinoconjunctivitis and eczema. As part of International Study of Asthma and Allergies in Childhood (ISAAC) Phase Three, parents or guardians of children aged 6-7 years completed written questionnaires about symptoms of asthma, rhinoconjunctivitis and eczema, and several potential risk factors, such as vigorous physical activity and television viewing, and other information such as the child's height and weight. Adolescents aged 13-14 years self-completed the questionnaires on these symptoms and potential risk factors and reported their own height and weight. For 28% of children and 24% of adolescents, the height and weight was objectively measured. A total of 76 164 children aged 6-7 years (from 29 centres and 17 countries) and 201 370 adolescents aged 13-14 years (from 73 centres and 35 countries) provided data meeting the inclusion criteria. There were associations between overweight and obesity, but not underweight, and symptoms of asthma and eczema but not rhinoconjunctivitis. Vigorous physical activity was positively associated with symptoms of asthma, rhinoconjunctivitis and eczema in adolescents, but not children. Viewing television for five or more hours/day was associated with an increased risk of symptoms of asthma, rhinoconjunctivitis and eczema in adolescents and symptoms of asthma in children. This study has confirmed the association between overweight and obesity and symptoms of asthma. It has extended these observations to include significant associations with symptoms of eczema, but not rhinoconjunctivitis. There are complex relationships between obesity, vigorous physical activity and sedentary behaviour and the symptoms of asthma, rhinoconjunctivitis and eczema in children.

The challenges of replicating the methodology between Phases I and III of the ISAAC programme

The International Study of Asthma and Allergies in Childhood (ISAAC) used standardised methods to examine symptom prevalence of asthma, rhinitis and eczema in adolescents and children between Phases I and III. Centres followed essential rules to ensure comparability of methodology, examined by a centralised data centre. Centre reports (CRs) were compared for both phases and age groups. Methodological differences were categorised under major deviations (centres excluded), minor deviations (deviations identified in published tables) and very minor deviations (deviations not identified). There were 112 CRs for adolescents and 70 for children. Six centres for adolescents and four for children had major deviations and were excluded. Minor deviations (35 for adolescents and 20 for children) were identified in the publications. Very minor deviations (92 for adolescents and 51 for children) were not identified. The odds ratios for having any differences in methodology between phases with a change in Principal Investigator were 0.80 (95%CI 0.36-1.81) for adolescents and 0.91 (95%CI 0.32-2.62) for children. The majority of the centres replicated the ISAAC methodology to a high standard. Careful documentation of methodology using standardised tools with careful checks allows the full potential of studies such as ISAAC to be realised.

Acetaminophen Use and Risk of Asthma, Rhinoconjunctivitis, and Eczema in Adolescents

Rationale: There is epidemiological evidence that the use of acetaminophen may increase the risk of developing asthma.Objectives: To investigate the risk of asthma and other allergic disorders associated with the current use of acetaminophen in 13- to 14-year-old children in different populations worldwide.Methods: As part of the International Study of Asthma and Allergies in Childhood (ISAAC) Phase Three, 13- to 14-year-old children completed written and video questionnaires obtaining data on current symptoms of asthma, rhinoconjunctivitis, and eczema, and a written environmental questionnaire obtaining data on putative risk factors, including acetaminophen use in the past 12 months.Measurements and Main Results: The primary outcome measure was the odds ratio (OR) of current asthma symptoms associated with acetaminophen use calculated by logistic regression. A total of 322,959 adolescent children from 113 centers in 50 countries participated. In the multivariate analyses the recent use of acetaminophen was associated with an exposure-dependent increased risk of current asthma symptoms (OR, 1.43 [95% confidence interval, 1.33–1.53] and 2.51 [95% confidence interval, 2.33–2.70] for medium and high versus no use, respectively). Acetaminophen use was also associated with an exposure-dependent increased risk of current symptoms of rhinoconjunctivitis and eczema.Conclusions: Acetaminophen use may represent an important risk factor for the development and/or maintenance of asthma, rhinoconjunctivitis, and eczema in adolescent children.

The Effect of Wheat Allergy on the Course of Atopic Eczema in Patients over 14 Years of Age

Few studies concerning the importance of wheat allergy affecting the course ofatopic eczema in adolescents and adult patients exist. The evaluation if wheat allergy can deteriorate the course of atopic eczema. Follow-up of patients with confirmed food allergy to wheat. Altogether 179 persons suffering from atopic eczema were included in the study: 51 men and 128 women entered the study with an average age of 26.2 (s.d. 9.5 years) Dermatological and allergological examinations were performed, including skin prick tests, atopy patch tests, and specific serum IgE for wheat, open exposure test and double-blind, placebo-controlled food challenge test with wheat flour. Wheat allergy affecting the coures of atopic eczema was confirmed in eight patients (4.5%) out of 179 patients enrolled in this study by double-blind, placebo controlled food challenge test. The course of atopic eczema showed a positive trend in patients with confirmed food allergy at 3, 6, 9, 12 month follow-up (statistical evaluation with paired t-test) after the elimination of wheat flour. Wheat allergy may play an important role in the worsening of atopic eczema (acting as a triggering exacerbating factor) only in a minority of adolescents and adult patients (4.5% in our study). The diagnostic methods (skin prick test, specific IgE, atopy patch test, history) cannot be used as separated tests for the determination of food allergy to wheat in patients with atopic eczema.Open exposure tests and double-blind, placebo-controlled food challenge should be used for the confirmation of wheat allergy affecting the course of atopic eczema.

The changing prevalence of asthma, allergic rhinitis and atopic eczema in African adolescents from 1995 to 2002

The prevalence of asthma and allergic disease in children has been increasing in developed countries, but there is little information on these trends in Africa. The aim of this study was to assess time trends in the symptoms of asthma, allergic rhinitis, and atopic eczema among South African adolescents. The study was carried out by comparing cross-sectional data from two International Study of Asthma and Allergies in Childhood (ISAAC phase I and phase III) questionnaire based surveys conducted 7 yr apart of self-reported symptoms in 13- to 14-yr-old adolescents. In both surveys, schools in the same geographical area in Cape Town, South Africa, were randomly selected. A school-based sample of 5178 (in 1995) and 5037 (in 2002) pupils participated. The 12-month prevalence of wheezing (16% vs. 20.3%), exercise-induced wheeze (21.5% vs. 32.5%), nocturnal cough (23.6% vs. 36.6%), sleep disturbance due to wheeze (9.6% vs. 16%), or severe wheeze (5.1% vs. 7.8%) increased significantly, as measured by the written questionnaire. A rise in asthma symptoms was confirmed by the video questionnaire responses, in which the 12-month prevalence of wheezing (6.5% vs.11.2%), exercise-induced wheeze (11.5% vs. 13.9%), nocturnal wheeze (3.9% vs. 5.3%), nocturnal cough (11.6% vs. 19.2%), or severe wheeze (5% vs. 7%) also increased significantly. There was a small increase in the percentage of children diagnosed with asthma from 1995 to 2002 (13.1% vs. 14.4%), this was not significant. The 12-month prevalence of symptoms of allergic rhinitis (30.4% vs. 38.5%), rhinoconjunctivitis (17.6% vs. 24.3%) and eczema (11.8% vs. 19.4%) also increased significantly. An increase in the prevalence of allergic symptoms occurred in girls and boys. Limitation of daily activity from nasal symptoms (22.3% vs. 37.8%) and sleep disturbance because of eczema (8.4% vs. 15.7%) increasingly affected quality of life on the quality of life. Symptoms of asthma, allergic rhinitis and atopic eczema in adolescents have increased over the past 7 yr in this geographical area. Allergic diseases are common in this group of adolescents and increasingly impair their quality of life.

Increasing Prevalence of Atopic Eczema in Taiwanese Adolescents From 1995 to 2001

ISEE-18 Objective: The prevalence of atopic eczema in adolescents has recently been reported as increasing in many countries, a phenomenon yet to be fully explained. This study compared the prevalence of atopic eczema among Taiwanese adolescents with individual-level risk factors and community-level data of temperature, relative humidity, and air pollutants to determine whether changes in these factors could explain the observed change in prevalence. Material and Methods: We conducted 2 nationwide, cross-sectional surveys of atopic illness and symptoms among 12- to 15-year-old Taiwanese schoolchildren in 1995 to 1996 and 2001. The effects of personal and environmental factors were assessed and temporal changes of outdoor monitoring data were also compared with prevalence difference of atopic eczema. Results: A total of 42,919 adolescents from the 1995 to1996 survey and 10,215 adolescents from the 2001 survey attended schools located within 1 km of 22 monitoring stations. The 12-month prevalence of atopic eczema increased significantly during this period [adjusted prevalence ratio (PR) = 1.43, 95% confidence interval (CI) 1.21–1.70 in boys; PR = 1.77, 95% CI 1.49–2.10 in girls]. After adjustment for potential risk factors, the prevalence differences were statistically unchanged. Although parental education level contributed the most, changes in personal and environmental factors might not explain the observed prevalence increases of atopic eczema. Temporal change in relative humidity was significantly associated with prevalence increase among boys but its contribution was also small. Conclusions: Correlates of the investigated risk factors that have changed over time still underlie the prevalence increases of atopic eczema in Taiwanese adolescents. The exact reasons for the rising trends remain to be elucidated.