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Overweight Increased The Prevalence Of Asthma And Decreased That Of Allergic Rhinoconjunctivitis In Childhood And Adolescence: Nationwide Survey In Japan
AB208 Abstracts
814
Housing Characteristics and Reported Pest Infestation Differ Among Neighborhoods with High and Low Asthma Prevalence in New York City L. M. Acosta1, I. F. Goldstein2, A. G. Rundle2, Y. Sueda1, A. Dahl1, G. L. Chew1, R. B. Mellins3, L. Hoepner1, H. Andrews4, F. P. Perera1, R. L. Miller5, J. S. Jacobson2, M. S. Perzanowski1; 1Columbia University, Mailman School of Public Health, Department of Environmental Health Sciences, New York, NY, 2Columbia University, Mailman School of Public Health, Department of Epidemiology, New York, NY, 3Columbia University College of Physicians and Surgeons, Department of Pediatrics, New York, NY, 4Mailman School of Public Health, Columbia University, Data Coordinating Center, New York, NY, 5Columbia University College of Physicians and Surgeons, Department of Medicine, Division of Pulmonary, Allergy, Critical Care Medicine, New York, NY. RATIONALE: Asthma prevalence varies widely among neighborhoods in New York City. Neighborhood-level differences in housing characteristics and pests may contribute to these disparities. METHODS: In our NYC Neighborhood Asthma and Allergy case-control study, 7-8 year-old children in low or high asthma prevalence neighborhoods (LAPN and HAPN) were recruited through parentsÕ employer-based health insurance. Comprehensive questionnaires were administered in the homes. Children were classified as probable asthmatics if they had wheezed, been awakened at night by cough, or taken asthma controller medication in the past year. RESULTS: To date questionnaires have been completed on 138 children, 68 from LAPN (33 asthmatics) and 70 from HAPN (47 asthmatics). Eighty percent of the children in the HAPN but only 28% in the LAPN lived in apartment buildings; the rest lived in single-family or multi-family detached houses. The number of people living in homes per bedroom was significantly higher among children in the HAPN than in the LAPN (2.2 vs. 1.9, p50.044). When compared with those in LAPN, more respondents in HAPN reported seeing cockroaches (34.3% vs. 17.6%, p50.026) and mice (21.4% vs. 7.4%, p50.019) at least once a week. Among asthmatic children, 57.4% in HAPN compared to 27.3% in LAPN were taken to the emergency department because of wheezing in the past year (p50.008). CONCLUSIONS: Living in an apartment, increased crowding, and report of pests were all more common among children living in the HAPN as compared with those in LAPN and could be important determinants or modifiers of asthma risk in this urban community.
815
TUESDAY
Atmospheric Temperature & Pollen Counts Impact New York City Asthma ER Visits Y. Chen1, E. Forsyth1, K. Pan1, H. Chen2, A. Szema1, K. Szema3, P. Chenrachasit4; 1SUNY Stony Brook, Stony Brook, NY, 2Harvard Medical School, Boston, MA, 3Cornell University Medical College, Ithaca, NY, 4 Naresuan University, Phitsanulok, THAILAND. RATIONALE: Global warming leads to temperature changes associated with increased particulate matter air pollution, a trigger for asthma attacks. Pollen counts are temperature sensitive, increasing with elevated ambient conditions. We examined the separate and combined effects of temperature and pollen counts on asthma emergency room visits at a New York City Hospital. METHODS: Temperature data were recorded at JFK Airport (1960-present). Particulate matter (PM2.5) air pollution, the concentration of 2.5 micron-sized particles per cubic meter of air, were from the Bronx, Queens, and Manhattan (2006-9). Pollen counts were measured in Brooklyn (AAAAI databank-2008). Asthma emergency room visits were from Lincoln Hospital (Bronx; 2007-9). Relations among these data were determined based on correlation coefficients. RESULTS: 1. Temperature in 2007 correlated with 2008 (r 5 0.98) as did monthly asthma emergency room visits (r 5 0.89), indicating the relative stability of the seasonal changes in both temperature and asthma "incidents." 2. Asthma emergency room visits and temperature (2007-8) were inverse correlated (r 5 - 0.56, p <.01).
J ALLERGY CLIN IMMUNOL FEBRUARY 2010
3. Asthma emergency room visits were correlated with pollen counts (r 5 0.81, p <.03). 4. Asthma-related hospital discharge rates in the Bronx peaked in 2003, coinciding with the decrease of temperature that year. CONCLUSIONS An environmental contribution to asthma emergency room visits related to the complex interplay of temperature and pollen supports the concept that global warming has an impact on asthma.
816
Overweight Increased The Prevalence Of Asthma And Decreased That Of Allergic Rhinoconjunctivitis In Childhood And Adolescence: Nationwide Survey In Japan K. Yoshida1,2, T. Itazawa2,3, Y. Adachi2,3, H. Odajima2,4, Y. Ohya1,2, A. Akasawa2,5; 1Division of Allergy, National Center for Child Health and Development, Tokyo, JAPAN, 2Japanese Asthma Survey Group, Tokyo, JAPAN, 3Department of Pediatrics, University of Toyama, Toyama, JAPAN, 4Department of Pediatrics, Fukuoka National Hospital, Fukuoka, JAPAN, 5Division of General Pediatrics, National Center for Child Health and Development, Tokyo, JAPAN. RATIONALE: We conducted the nationwide survey on the prevalence of allergic diseases during childhood and adolescence in Japan. We focused on the association between overweight and the prevalence of allergic diseases. METHODS: Cross sectional survey of elementary school students (6 to 8 year old), junior high school students (13 to 15 year old) and senior high school students (16 to 18 year old) was carried out using ISAAC written questionnaire in Japan. The study was based on a data from 40,623 children in elementary school, 48,466 adolescents in junior high school, and 53,958 adolescents in senior high school who provided information on height and weight and responded to ISAAC written questionnaire. They between 10th and 90th percentiles of BMI for age and gender were considered to be normal weight and those above 90th percentile were considered to be overweight. RESULTS: The adjusted odds ratios (ORs) for overweight with the prevalence of current wheeze were 1.25 (95% confidence interval (CI), 1.161.36) for elementary school children, 1.31 (95% CI, 1.20-1.43) for junior high school students and 1.27 (95% CI 1.17-1.38) for senior high school students. The adjusted ORs for overweight with the prevalence of current allergic rhinoconjunctivitis were 0.87 (95% CI, 0.81-0.95), 0.92 (95% CI, 0.86-0.98) and 1.02 (95% CI 0.96-1.08), respectively. CONCLUSIONS: There is a positive association between overweight and the prevalence of current wheeze in children and adolescents, whereas overweight is inversely associated with that of current rhinoconjunctivitis, typical IgE-mediated allergy in children and junior high school adolescents.
814
Housing Characteristics and Reported Pest Infestation Differ Among Neighborhoods with High and Low Asthma Prevalence in New York City L. M. Acosta1, I. F. Goldstein2, A. G. Rundle2, Y. Sueda1, A. Dahl1, G. L. Chew1, R. B. Mellins3, L. Hoepner1, H. Andrews4, F. P. Perera1, R. L. Miller5, J. S. Jacobson2, M. S. Perzanowski1; 1Columbia University, Mailman School of Public Health, Department of Environmental Health Sciences, New York, NY, 2Columbia University, Mailman School of Public Health, Department of Epidemiology, New York, NY, 3Columbia University College of Physicians and Surgeons, Department of Pediatrics, New York, NY, 4Mailman School of Public Health, Columbia University, Data Coordinating Center, New York, NY, 5Columbia University College of Physicians and Surgeons, Department of Medicine, Division of Pulmonary, Allergy, Critical Care Medicine, New York, NY. RATIONALE: Asthma prevalence varies widely among neighborhoods in New York City. Neighborhood-level differences in housing characteristics and pests may contribute to these disparities. METHODS: In our NYC Neighborhood Asthma and Allergy case-control study, 7-8 year-old children in low or high asthma prevalence neighborhoods (LAPN and HAPN) were recruited through parentsÕ employer-based health insurance. Comprehensive questionnaires were administered in the homes. Children were classified as probable asthmatics if they had wheezed, been awakened at night by cough, or taken asthma controller medication in the past year. RESULTS: To date questionnaires have been completed on 138 children, 68 from LAPN (33 asthmatics) and 70 from HAPN (47 asthmatics). Eighty percent of the children in the HAPN but only 28% in the LAPN lived in apartment buildings; the rest lived in single-family or multi-family detached houses. The number of people living in homes per bedroom was significantly higher among children in the HAPN than in the LAPN (2.2 vs. 1.9, p50.044). When compared with those in LAPN, more respondents in HAPN reported seeing cockroaches (34.3% vs. 17.6%, p50.026) and mice (21.4% vs. 7.4%, p50.019) at least once a week. Among asthmatic children, 57.4% in HAPN compared to 27.3% in LAPN were taken to the emergency department because of wheezing in the past year (p50.008). CONCLUSIONS: Living in an apartment, increased crowding, and report of pests were all more common among children living in the HAPN as compared with those in LAPN and could be important determinants or modifiers of asthma risk in this urban community.
815
TUESDAY
Atmospheric Temperature & Pollen Counts Impact New York City Asthma ER Visits Y. Chen1, E. Forsyth1, K. Pan1, H. Chen2, A. Szema1, K. Szema3, P. Chenrachasit4; 1SUNY Stony Brook, Stony Brook, NY, 2Harvard Medical School, Boston, MA, 3Cornell University Medical College, Ithaca, NY, 4 Naresuan University, Phitsanulok, THAILAND. RATIONALE: Global warming leads to temperature changes associated with increased particulate matter air pollution, a trigger for asthma attacks. Pollen counts are temperature sensitive, increasing with elevated ambient conditions. We examined the separate and combined effects of temperature and pollen counts on asthma emergency room visits at a New York City Hospital. METHODS: Temperature data were recorded at JFK Airport (1960-present). Particulate matter (PM2.5) air pollution, the concentration of 2.5 micron-sized particles per cubic meter of air, were from the Bronx, Queens, and Manhattan (2006-9). Pollen counts were measured in Brooklyn (AAAAI databank-2008). Asthma emergency room visits were from Lincoln Hospital (Bronx; 2007-9). Relations among these data were determined based on correlation coefficients. RESULTS: 1. Temperature in 2007 correlated with 2008 (r 5 0.98) as did monthly asthma emergency room visits (r 5 0.89), indicating the relative stability of the seasonal changes in both temperature and asthma "incidents." 2. Asthma emergency room visits and temperature (2007-8) were inverse correlated (r 5 - 0.56, p <.01).
J ALLERGY CLIN IMMUNOL FEBRUARY 2010
3. Asthma emergency room visits were correlated with pollen counts (r 5 0.81, p <.03). 4. Asthma-related hospital discharge rates in the Bronx peaked in 2003, coinciding with the decrease of temperature that year. CONCLUSIONS An environmental contribution to asthma emergency room visits related to the complex interplay of temperature and pollen supports the concept that global warming has an impact on asthma.
816
Overweight Increased The Prevalence Of Asthma And Decreased That Of Allergic Rhinoconjunctivitis In Childhood And Adolescence: Nationwide Survey In Japan K. Yoshida1,2, T. Itazawa2,3, Y. Adachi2,3, H. Odajima2,4, Y. Ohya1,2, A. Akasawa2,5; 1Division of Allergy, National Center for Child Health and Development, Tokyo, JAPAN, 2Japanese Asthma Survey Group, Tokyo, JAPAN, 3Department of Pediatrics, University of Toyama, Toyama, JAPAN, 4Department of Pediatrics, Fukuoka National Hospital, Fukuoka, JAPAN, 5Division of General Pediatrics, National Center for Child Health and Development, Tokyo, JAPAN. RATIONALE: We conducted the nationwide survey on the prevalence of allergic diseases during childhood and adolescence in Japan. We focused on the association between overweight and the prevalence of allergic diseases. METHODS: Cross sectional survey of elementary school students (6 to 8 year old), junior high school students (13 to 15 year old) and senior high school students (16 to 18 year old) was carried out using ISAAC written questionnaire in Japan. The study was based on a data from 40,623 children in elementary school, 48,466 adolescents in junior high school, and 53,958 adolescents in senior high school who provided information on height and weight and responded to ISAAC written questionnaire. They between 10th and 90th percentiles of BMI for age and gender were considered to be normal weight and those above 90th percentile were considered to be overweight. RESULTS: The adjusted odds ratios (ORs) for overweight with the prevalence of current wheeze were 1.25 (95% confidence interval (CI), 1.161.36) for elementary school children, 1.31 (95% CI, 1.20-1.43) for junior high school students and 1.27 (95% CI 1.17-1.38) for senior high school students. The adjusted ORs for overweight with the prevalence of current allergic rhinoconjunctivitis were 0.87 (95% CI, 0.81-0.95), 0.92 (95% CI, 0.86-0.98) and 1.02 (95% CI 0.96-1.08), respectively. CONCLUSIONS: There is a positive association between overweight and the prevalence of current wheeze in children and adolescents, whereas overweight is inversely associated with that of current rhinoconjunctivitis, typical IgE-mediated allergy in children and junior high school adolescents.