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Deborah Jarvis - One of the best experts on this subject based on the ideXlab platform.
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second hand smoke exposure in adulthood and lower respiratory health during 20 year follow up in the European Community respiratory health survey
Respiratory Research, 2019Co-Authors: Claudia Flexeder, Deborah Jarvis, Mario Olivieri, Janpaul Zock, Michael J Abramson, Giuseppe Verlato, Geza Benke, Torben Sigsgaard, Cecilie SvanesAbstract:Early life exposure to tobacco smoke has been extensively studied but the role of second-hand smoke (SHS) for new-onset respiratory symptoms and lung function decline in adulthood has not been widely investigated in longitudinal studies. Our aim is to investigate the associations of exposure to SHS in adults with respiratory symptoms, respiratory conditions and lung function over 20 years. We used information from 3011 adults from 26 centres in 12 countries who participated in the European Community Respiratory Health Surveys I-III and were never or former smokers at all three surveys. Associations of SHS exposure with respiratory health (asthma symptom score, asthma, chronic bronchitis, COPD) were analysed using generalised linear mixed-effects models adjusted for confounding factors (including sex, age, smoking status, socioeconomic status and allergic sensitisation). Linear mixed-effects models with additional adjustment for height were used to assess the relationships between SHS exposure and lung function levels and decline. Reported exposure to SHS decreased in all 26 study centres over time. The prevalence of SHS exposure was 38.7% at baseline (1990–1994) and 7.1% after the 20-year follow-up (2008–2011). On average 2.4% of the study participants were not exposed at the first, but were exposed at the third examination. An increase in SHS exposure over time was associated with doctor-diagnosed asthma (odds ratio (OR): 2.7; 95% confidence interval (95%-CI): 1.2–5.9), chronic bronchitis (OR: 4.8; 95%-CI: 1.6–15.0), asthma symptom score (count ratio (CR): 1.9; 95%-CI: 1.2–2.9) and dyspnoea (OR: 2.7; 95%-CI: 1.1–6.7) compared to never exposed to SHS. Associations between increase in SHS exposure and incidence of COPD (OR: 2.0; 95%-CI: 0.6–6.0) or lung function (β: − 49 ml; 95%-CI: -132, 35 for FEV1 and β: − 62 ml; 95%-CI: -165, 40 for FVC) were not apparent. Exposure to second-hand smoke may lead to respiratory symptoms, but this is not accompanied by lung function changes.
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assessment of allergen sensitization in a general population based survey European Community respiratory health survey i
Annals of Epidemiology, 2010Co-Authors: P J Bousquet, Deborah Jarvis, Joachim Heinrich, Jordi Sunyer, Richard Hooper, Christel Castelli, Jeanpierre Daures, Matthias Wjst, Peter BurneyAbstract:Purpose Exposed to a common environment, the IgE-mediated immune response differs, for instance, among sensitized subjects, some of them reacting toward one allergen (monosensitized) whereas others are sensitized to a wide array of allergens (polysensitized). However, a better phenotypic characterization is needed for epidemiologic studies. Using the data collected during the ECRHS I (European Community Respiratory Health Survey), several assessments of skin prick tests and serum-specific IgE to identify mono- and polysensitized patients were compared. Methods Subjects took part in the ECRHS-I. The CAP-System was used for serum allergen-specific IgE, and allergen-coated Phazet was used for prick tests. Four allergens ( Dermatophagoides pteronyssinus , cat, timothy grass, and Cladosporium ) were measured using IgE and nine (the same ones plus olive pollen, birch, Alternaria, Parietaria , and ragweed) were skin tested. One to two local allergens were also tested, depending on countries. Results Prevalence of sensitization in 11,355 subjects (34.0 [27.9–40.1] years, 49.9% men) ranged from 32.3% (four specific IgE, 19.3% mono- and 13.0% polysensitized) to 41.8% (four specific IgE combined to nine prick tests, 19.6% mono- and 22.2% polysensitized). Concordance between four specific IgE and four prick tests was weak (weighted κ 0.65 [0.64–0.66]). Concordance between seven and nine prick tests was high (weighted κ 0.99 [0.98–1.00]). Local allergens induced small changes in the prevalence of sensitization, and reclassified some subjects from mono- to polysensitized. Conclusions Skin tests or serum-specific IgE may be chosen to identify allergenic sensitivity, mono- and polysensitized subjects without being strictly interchangeable.
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physical activity and bronchial hyperresponsiveness European Community respiratory health survey ii
Thorax, 2007Co-Authors: Rafea Shaaban, Christer Janson, Susan Chinn, Josep M Anto, Joachim Heinrich, Benedicte Leynaert, D Soussan, Roberto De Marco, Judith Garciaaymerich, Deborah JarvisAbstract:Background: Identification of the risk factors for bronchial hyperresponsiveness (BHR) would increase the understanding of the causes of asthma. The relationship between physical activity and BHR in men and women aged 28.0-56.5 years randomly selected from 24 centres in 11 countries participating in the European Community Respiratory Health Survey II was investigated. Methods: 5158 subjects answered questionnaires about physical activity and performed BHR tests. Participants were asked about the frequency and duration of usual weekly exercise resulting in breathlessness or sweating. BHR was defined as a decrease in forced expiratory volume in 1 s of at least 20% of its post-saline value for a maximum methacholine dose of 2 mg. Results: Both frequency and duration of physical activity were inversely related to BHR. The prevalence of BHR in subjects exercising ≤ 1, 2-3 and ≥4 times a week was 14.5%, 11.6% and 10.9%, respectively (p<0.001). The corresponding odds ratios were 1.00, 0.78 (95% Cl 0.62 to 0.99) and 0.69 (95% Cl 0.50 to 0.94) after controlling for potential confounding factors. The frequency of BHR in subjects exercising <1 h, 1-3 h and ≥4 h a week was 15.9%, 10.9% and 10.7%, respectively (p<0.001). The corresponding adjusted odds ratios were 1.00, 0.70 (95% Cl 0.57 to 0.87) and 0.67 (95% Cl 0.50 to 0.90). Physical activity was associated with BHR in all studied subgroups. Conclusions: These results suggest that BHR is strongly and independently associated with decreased physical activity. Further studies are needed to determine the mechanisms underlying this association.
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geographical variation in the prevalence of positive skin tests to environmental aeroallergens in the European Community respiratory health survey i
Allergy, 2007Co-Authors: P J Bousquet, S Chinn, Christer Janson, Manolis Kogevinas, Peter Burney, Deborah JarvisAbstract:Background: Many studies have reported the prevalence of sensitization using skin prick tests. However, comparisons between studies and between regions are difficult because the number and the type of allergens tested vary widely. Using the European Community Health Respiratory Survey I data, the geographical variation of sensitization to environmental allergen as measured by skin tests was established. Methods: Adults aged 20–44 years, living in 35 centres in 15 developed countries, underwent skin tests for allergy to nine common aeroallergens: Dermatophagoides pteronyssinus, timothy grass, cat, Cladosporium herbarium, Alternaria alternata, birch, Olea europea, common ragweed and Parietaria judaica. The age– sex standardized prevalence of sensitization was determined and centres with high (95% confidence interval above and excluding study median) and low prevalence (95% confidence interval below and excluding study median) of sensitization to each allergen and to any of the nine allergens were identified. Results: There was substantial geographical variation in the prevalence of sensitization to each of the nine allergens tested and in the prevalence of sensitization to any allergen (lowest 17.1%, median 36.8% and highest 54.8%). Sensitization to D. pteronyssinus, grass pollen and cat were usually the most prevalent (median between centre 21.7%, 16.9% and 8.8%, respectively). Timothy grass sensitization was higher than that for any other pollen species. Conclusions: As expected, geographical variations of sensitization to environmental allergen were observed across centres. These findings were compatible for those observed with serum-specific IgE. Skin tests can be used to assess the geographical distribution of allergens in a multicentric epidemiological survey.
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changes in active and passive smoking in the European Community respiratory health survey
European Respiratory Journal, 2006Co-Authors: Christer Janson, Deborah Jarvis, Susan Chinn, Thorarinn Gislason, Rain Jogi, Nino Kunzli, R De Marco, Cecilie Svanes, Joachim Heinrich, J SunyerAbstract:The aim of the present investigation was to study changes and determinants for changes in active and passive smoking. The present study included 9,053 adults from 14 countries that participated in the European Community Respiratory Health Survey II. The mean follow-up period was 8.8 yrs. Change in the prevalence of active and passive smoking was expressed as absolute net change (95% confidence interval) standardised to a 10-yr period. Determinants of change were analysed and the results expressed as adjusted hazard risk ratio (HRR) or odds ratio (OR). The prevalence of active smoking declined by 5.9% (5.1-6.8) and exposure to passive smoking in nonsmokers declined by 18.4% (16.8-20.0). Subjects with a lower educational level (HRR: 0.73 (0.54-0.98) and subjects living with a smoker (HRR: 0.45 (0.34-0.59)) or with workplace smoking (HRR: 0.69 (0.50-0.95)) were less likely to quit. Low socio-economic groups were more likely to become exposed (OR: 2.21 (1.61-3.03)) and less likely to cease being exposed to passive smoking (OR: 0.48 (0.37-0.61)). In conclusion, the quitting rate was lower and the risk of exposure to passive smoking higher among subjects with lower socio-economic status. Exposure to other peoples smoking decreased quitting rates and increased the risk of starting to smoke.
Peter Burney - One of the best experts on this subject based on the ideXlab platform.
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assessment of allergen sensitization in a general population based survey European Community respiratory health survey i
Annals of Epidemiology, 2010Co-Authors: P J Bousquet, Deborah Jarvis, Joachim Heinrich, Jordi Sunyer, Richard Hooper, Christel Castelli, Jeanpierre Daures, Matthias Wjst, Peter BurneyAbstract:Purpose Exposed to a common environment, the IgE-mediated immune response differs, for instance, among sensitized subjects, some of them reacting toward one allergen (monosensitized) whereas others are sensitized to a wide array of allergens (polysensitized). However, a better phenotypic characterization is needed for epidemiologic studies. Using the data collected during the ECRHS I (European Community Respiratory Health Survey), several assessments of skin prick tests and serum-specific IgE to identify mono- and polysensitized patients were compared. Methods Subjects took part in the ECRHS-I. The CAP-System was used for serum allergen-specific IgE, and allergen-coated Phazet was used for prick tests. Four allergens ( Dermatophagoides pteronyssinus , cat, timothy grass, and Cladosporium ) were measured using IgE and nine (the same ones plus olive pollen, birch, Alternaria, Parietaria , and ragweed) were skin tested. One to two local allergens were also tested, depending on countries. Results Prevalence of sensitization in 11,355 subjects (34.0 [27.9–40.1] years, 49.9% men) ranged from 32.3% (four specific IgE, 19.3% mono- and 13.0% polysensitized) to 41.8% (four specific IgE combined to nine prick tests, 19.6% mono- and 22.2% polysensitized). Concordance between four specific IgE and four prick tests was weak (weighted κ 0.65 [0.64–0.66]). Concordance between seven and nine prick tests was high (weighted κ 0.99 [0.98–1.00]). Local allergens induced small changes in the prevalence of sensitization, and reclassified some subjects from mono- to polysensitized. Conclusions Skin tests or serum-specific IgE may be chosen to identify allergenic sensitivity, mono- and polysensitized subjects without being strictly interchangeable.
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prevalence and distribution of sensitization to foods in the European Community respiratory health survey a europrevall analysis
Allergy, 2010Co-Authors: Peter Burney, S Chinn, C Summers, Richard Hooper, R Van Ree, Jonas LidholmAbstract:To cite this article: Burney P, Summers C, Chinn S, Hooper R, van Ree R, Lidholm J. Prevalence and distribution of sensitization to foods in the European Community Respiratory Health Survey: a EuroPrevall analysis. Allergy 2010; 65: 1182–1188. Abstract Background: Reports of adverse reactions to foods are increasing, but there is limited information on the comparative prevalence of sensitization to food allergens using standardized methods. Methods: Sera from the ‘random sample’ of young adults seen during the second phase of the European Community Respiratory Health Survey were analysed for IgE against 24 foods using ImmunoCAP. Sera were tested on five food mixes, and subsequently on individual foods in each positive mix. Results: Sera from 4522 individuals living in 13 countries were tested for at least one food allergen mix. Prevalence of sensitization to any of the 24 food allergens ranged from 24.6% in Portland (USA) to 7.7% in Reykjavik (Iceland). With few exceptions, the relative prevalence of sensitization to different foods was similar in all countries. Sensitization rates to egg, fish and milk were each less than 1%, and the most common sensitizations are not represented in current commercial mixes. The prevalence of sensitization to foods was not related to that of sensitization to aeroallergens but was related to the geometric mean total IgE for the country. Conclusions: Sensitization to foods is common but highly variable. The relative prevalence of sensitization to different foods is more consistent than would be expected by chance, suggesting that quantity of consumption of specific foods does not determine prevalence. The aetiology of food sensitization is only partly similar to that for aeroallergens but is related to local levels of total IgE. This may provide an important clue to the origins of food sensitization.
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geographical variation in the prevalence of positive skin tests to environmental aeroallergens in the European Community respiratory health survey i
Allergy, 2007Co-Authors: P J Bousquet, S Chinn, Christer Janson, Manolis Kogevinas, Peter Burney, Deborah JarvisAbstract:Background: Many studies have reported the prevalence of sensitization using skin prick tests. However, comparisons between studies and between regions are difficult because the number and the type of allergens tested vary widely. Using the European Community Health Respiratory Survey I data, the geographical variation of sensitization to environmental allergen as measured by skin tests was established. Methods: Adults aged 20–44 years, living in 35 centres in 15 developed countries, underwent skin tests for allergy to nine common aeroallergens: Dermatophagoides pteronyssinus, timothy grass, cat, Cladosporium herbarium, Alternaria alternata, birch, Olea europea, common ragweed and Parietaria judaica. The age– sex standardized prevalence of sensitization was determined and centres with high (95% confidence interval above and excluding study median) and low prevalence (95% confidence interval below and excluding study median) of sensitization to each allergen and to any of the nine allergens were identified. Results: There was substantial geographical variation in the prevalence of sensitization to each of the nine allergens tested and in the prevalence of sensitization to any allergen (lowest 17.1%, median 36.8% and highest 54.8%). Sensitization to D. pteronyssinus, grass pollen and cat were usually the most prevalent (median between centre 21.7%, 16.9% and 8.8%, respectively). Timothy grass sensitization was higher than that for any other pollen species. Conclusions: As expected, geographical variations of sensitization to environmental allergen were observed across centres. These findings were compatible for those observed with serum-specific IgE. Skin tests can be used to assess the geographical distribution of allergens in a multicentric epidemiological survey.
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geographic variations in the effect of atopy on asthma in the European Community respiratory health study
The Journal of Allergy and Clinical Immunology, 2004Co-Authors: Jordi Sunyer, Christer Janson, Peter Burney, Deborah Jarvis, Christina Luczynska, Susan Chinn, Benedicte Leynaert, Juha Pekkanen, Raquel Garciaesteban, Josep M AntoAbstract:Background Atopy has long been related to asthma. The prevalences of both atopy and asthma have shown substantial variation. Objective We sought to assess geographic variations in the fraction of asthma attributable to IgE sensitization to specific allergens in the European Community Respiratory Health Survey. Methods A cross-sectional study was undertaken during the years 1991 and 1992 on 13,558 individuals in 36 centers in 16 countries. Asthma was defined in several ways, variously incorporating reported symptoms, bronchial responsiveness to methacholine, and physician diagnosis. Specific IgE against house dust mite ( Dermatophagoides pteronyssinus ), cat, timothy grass, Cladosporium herbarum , and a local allergen (birch, Parietaria judaica , or ragweed) were measured. Results The overall attributable fraction (AF) of asthma symptoms caused by atopy was 30% but varied widely between centers, ranging from 4% to 61%. The overall AF increased to 43% when asthma was based on wheezing and bronchial responsiveness, to 45% with a physician diagnosis of asthma, and to 48% when the patient reported more than 12 attacks in the last year. Between centers, the AF for atopy was significantly correlated with the prevalence of atopy among the asthmatic patients ( r =0.91) and with the sensitization to house dust mite ( r =0.64), as well as with the prevalence of asthma among atopic individuals ( r =0.43) and the prevalence of asthma among nonatopic individuals ( r =−0.51). Conclusion The effect of atopy on the prevalence of asthma varies widely between centers, probably because of variations in factors related to the expression of asthma and to the prevalence of sensitization, particularly to house dust mite.
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increase in diagnosed asthma but not in symptoms in the European Community respiratory health survey
Thorax, 2004Co-Authors: Susan Chinn, Peter Burney, Deborah Jarvis, Christina Luczynska, Josep M Anto, R De Marco, Ursula Ackermannliebrich, Isa Cerveri, T Gislason, Joachim HeinrichAbstract:Background: Information on the epidemiology of asthma in relation to age is limited and hampered by reporting error. To determine the change in the prevalence of asthma with age in young adults we analysed longitudinal data from the European Community Respiratory Health Survey. Methods: A self-administered questionnaire was completed by 11 168 randomly selected subjects in 14 countries in 1991–3 when they were aged 20–44 years and 5–11 years later from 1998 to 2003. Generalised estimating equations were used to estimate net change in wheeze, nocturnal tightness in chest, shortness of breath, coughing, asthma attacks in the last 12 months, current medication, “diagnosed” asthma, and nasal allergies. Results: Expressed as change in status per 10 years of follow up, subjects reporting asthma attacks in the previous 12 months increased by 0.8% of the population (95% CI 0.2 to 1.4) and asthma medication by 2.1% (95% CI 1.6 to 2.6), while no statistically significant net change was found in reported symptoms. Reported nasal allergies increased, especially in the youngest age group. Conclusions: As this cohort of young adults has aged, there has been an increase in the proportion treated for asthma but not in the proportion of those reporting symptoms suggestive of asthma. Either increased use of effective treatments has led to decreased morbidity among asthmatic subjects or those with mild disease have become more likely to label themselves as asthmatic.
Christina Luczynska - One of the best experts on this subject based on the ideXlab platform.
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geographic variations in the effect of atopy on asthma in the European Community respiratory health study
The Journal of Allergy and Clinical Immunology, 2004Co-Authors: Jordi Sunyer, Christer Janson, Peter Burney, Deborah Jarvis, Christina Luczynska, Susan Chinn, Benedicte Leynaert, Juha Pekkanen, Raquel Garciaesteban, Josep M AntoAbstract:Background Atopy has long been related to asthma. The prevalences of both atopy and asthma have shown substantial variation. Objective We sought to assess geographic variations in the fraction of asthma attributable to IgE sensitization to specific allergens in the European Community Respiratory Health Survey. Methods A cross-sectional study was undertaken during the years 1991 and 1992 on 13,558 individuals in 36 centers in 16 countries. Asthma was defined in several ways, variously incorporating reported symptoms, bronchial responsiveness to methacholine, and physician diagnosis. Specific IgE against house dust mite ( Dermatophagoides pteronyssinus ), cat, timothy grass, Cladosporium herbarum , and a local allergen (birch, Parietaria judaica , or ragweed) were measured. Results The overall attributable fraction (AF) of asthma symptoms caused by atopy was 30% but varied widely between centers, ranging from 4% to 61%. The overall AF increased to 43% when asthma was based on wheezing and bronchial responsiveness, to 45% with a physician diagnosis of asthma, and to 48% when the patient reported more than 12 attacks in the last year. Between centers, the AF for atopy was significantly correlated with the prevalence of atopy among the asthmatic patients ( r =0.91) and with the sensitization to house dust mite ( r =0.64), as well as with the prevalence of asthma among atopic individuals ( r =0.43) and the prevalence of asthma among nonatopic individuals ( r =−0.51). Conclusion The effect of atopy on the prevalence of asthma varies widely between centers, probably because of variations in factors related to the expression of asthma and to the prevalence of sensitization, particularly to house dust mite.
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increase in diagnosed asthma but not in symptoms in the European Community respiratory health survey
Thorax, 2004Co-Authors: Susan Chinn, Peter Burney, Deborah Jarvis, Christina Luczynska, Josep M Anto, R De Marco, Ursula Ackermannliebrich, Isa Cerveri, T Gislason, Joachim HeinrichAbstract:Background: Information on the epidemiology of asthma in relation to age is limited and hampered by reporting error. To determine the change in the prevalence of asthma with age in young adults we analysed longitudinal data from the European Community Respiratory Health Survey. Methods: A self-administered questionnaire was completed by 11 168 randomly selected subjects in 14 countries in 1991–3 when they were aged 20–44 years and 5–11 years later from 1998 to 2003. Generalised estimating equations were used to estimate net change in wheeze, nocturnal tightness in chest, shortness of breath, coughing, asthma attacks in the last 12 months, current medication, “diagnosed” asthma, and nasal allergies. Results: Expressed as change in status per 10 years of follow up, subjects reporting asthma attacks in the previous 12 months increased by 0.8% of the population (95% CI 0.2 to 1.4) and asthma medication by 2.1% (95% CI 1.6 to 2.6), while no statistically significant net change was found in reported symptoms. Reported nasal allergies increased, especially in the youngest age group. Conclusions: As this cohort of young adults has aged, there has been an increase in the proportion treated for asthma but not in the proportion of those reporting symptoms suggestive of asthma. Either increased use of effective treatments has led to decreased morbidity among asthmatic subjects or those with mild disease have become more likely to label themselves as asthmatic.
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housing characteristics reported mold exposure and asthma in the European Community respiratory health survey
The Journal of Allergy and Clinical Immunology, 2002Co-Authors: Janpaul Zock, Christina Luczynska, Deborah Jarvis, Jordi Sunyer, Peter BurneyAbstract:Abstract Background: The effects of home dampness and mold exposure on adult asthma are not clear. Objective: We aimed to investigate the associations between housing characteristics related to dampness, mold exposure, and house dust mite levels and adult asthma in 38 study centers from the European Community Respiratory Health Survey. Methods: Data about the present home, heating and ventilation systems, double glazing, floor covers, recent water damage, and mold exposure were obtained by means of an interviewer-led questionnaire. The associations between these factors and asthma, as defined on the basis of symptoms in the last year, and of bronchial responsiveness, as determined with methacholine challenge, were evaluated. Odds ratios (ORs) were obtained by using random-effects meta-analyses adjusted within study centers for sex, age group, and smoking status. Results: Fitted carpets and rugs in the bedroom were related to fewer asthma symptoms and bronchial responsiveness (OR range, 0.69-0.91). This effect was consistent across centers and more pronounced among house dust mite-sensitized individuals. Reported mold exposure in the last year was associated with asthma symptoms and bronchial responsiveness (OR range, 1.14-1.44). This effect was homogeneous among centers and stronger in subjects sensitized to Cladosporium species. In centers with a higher prevalence of asthma, the prevalence of reported indoor mold exposure was also high. This association was observed for reported mold exposure by asthmatic subjects (Spearman r s = 0.46), as well as reported mold exposure by nonasthmatic subjects ( r s = 0.54). Reported mold exposure was highest in older houses with recent water damage. Conclusion: We conclude that indoor mold growth has an adverse effect on adult asthma.
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the European Community respiratory health survey what are the main results so far
European Respiratory Journal, 2001Co-Authors: Christer Janson, Peter Burney, Deborah Jarvis, Susan Chinn, Josep M Anto, R De Marco, Joachim Heinrich, Nino Kuenzli, B Leynaert, Christina LuczynskaAbstract:The European Community Respiratory Heath Survey (ECRHS) was the first study to assess the geographical variation in asthma and allergy in adults using the same instruments and definitions. The database of the ECRHS includes information from ∼140,000 individuals from 22 countries. The aim of this review is to summarize the results of the ECRHS to date. The ECRHS has shown that there are large geographical differences in the prevalence of asthma, atopy and bronchial responsiveness, with high prevalence rates in English speaking countries and low prevalence rates in the Mediterranean region and Eastern Europe. Analyses of risk factors have highlighted the importance of occupational exposure for asthma in adulthood. The association between sensitization to individual allergens and bronchial responsiveness was strongest for indoor allergens (mite and cat). Analysis of treatment practices has confirmed that the treatment of asthma varies widely between countries and that asthma is often undertreated. In conclusion, the European Community Respiratory Health Survey has shown that the prevalence of asthma varies widely. The fact that the geographical pattern is consistent with the distribution of atopy and bronchial responsiveness supports the conclusion that the geographical variations in the prevalence of asthma are true and most likely due to environmental factors.
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variation in bronchial responsiveness in the European Community respiratory health survey ecrhs
European Respiratory Journal, 1997Co-Authors: S Chinn, Deborah Jarvis, P Burney, Christina LuczynskaAbstract:Attempts to compare bronchial responsiveness between populations have been hampered by between-study differences in the pharmacological agent of provocation, the method of administration and the summary statistic employed. The European Community Respiratory Health Survey used methacholine challenge delivered by Mefar dosimeter according to a standardized protocol used in 35 centres in 16 countries. Data were obtained from 13,161 men and women, aged 20-44 yrs at the start of the study. The dose of methacholine producing a 20% fall in forced expiratory volume in one second (FEV1) (PD20) and the regression coefficient of percentage decline in FEV1 with log dose, were calculated ("slope", after transformation), with and without calibration of nebulizers by weight and adjustment for nonresponse bias. Standardization for baseline lung function and variation in smoking prevalence was applied to slope. Results were robust to whichever summary measure was used, and to the various adjustments. Responsiveness was low in Iceland and Switzerland, and in most centres in Sweden, Italy and Spain, and high in New Zealand, Australia, the USA, Britain, France, Denmark and Germany. Bronchial responsiveness varies considerably in Europe, and high levels are not confined to the English-speaking world.
Susan Chinn - One of the best experts on this subject based on the ideXlab platform.
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physical activity and bronchial hyperresponsiveness European Community respiratory health survey ii
Thorax, 2007Co-Authors: Rafea Shaaban, Christer Janson, Susan Chinn, Josep M Anto, Joachim Heinrich, Benedicte Leynaert, D Soussan, Roberto De Marco, Judith Garciaaymerich, Deborah JarvisAbstract:Background: Identification of the risk factors for bronchial hyperresponsiveness (BHR) would increase the understanding of the causes of asthma. The relationship between physical activity and BHR in men and women aged 28.0-56.5 years randomly selected from 24 centres in 11 countries participating in the European Community Respiratory Health Survey II was investigated. Methods: 5158 subjects answered questionnaires about physical activity and performed BHR tests. Participants were asked about the frequency and duration of usual weekly exercise resulting in breathlessness or sweating. BHR was defined as a decrease in forced expiratory volume in 1 s of at least 20% of its post-saline value for a maximum methacholine dose of 2 mg. Results: Both frequency and duration of physical activity were inversely related to BHR. The prevalence of BHR in subjects exercising ≤ 1, 2-3 and ≥4 times a week was 14.5%, 11.6% and 10.9%, respectively (p<0.001). The corresponding odds ratios were 1.00, 0.78 (95% Cl 0.62 to 0.99) and 0.69 (95% Cl 0.50 to 0.94) after controlling for potential confounding factors. The frequency of BHR in subjects exercising <1 h, 1-3 h and ≥4 h a week was 15.9%, 10.9% and 10.7%, respectively (p<0.001). The corresponding adjusted odds ratios were 1.00, 0.70 (95% Cl 0.57 to 0.87) and 0.67 (95% Cl 0.50 to 0.90). Physical activity was associated with BHR in all studied subgroups. Conclusions: These results suggest that BHR is strongly and independently associated with decreased physical activity. Further studies are needed to determine the mechanisms underlying this association.
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changes in active and passive smoking in the European Community respiratory health survey
European Respiratory Journal, 2006Co-Authors: Christer Janson, Deborah Jarvis, Susan Chinn, Thorarinn Gislason, Rain Jogi, Nino Kunzli, R De Marco, Cecilie Svanes, Joachim Heinrich, J SunyerAbstract:The aim of the present investigation was to study changes and determinants for changes in active and passive smoking. The present study included 9,053 adults from 14 countries that participated in the European Community Respiratory Health Survey II. The mean follow-up period was 8.8 yrs. Change in the prevalence of active and passive smoking was expressed as absolute net change (95% confidence interval) standardised to a 10-yr period. Determinants of change were analysed and the results expressed as adjusted hazard risk ratio (HRR) or odds ratio (OR). The prevalence of active smoking declined by 5.9% (5.1-6.8) and exposure to passive smoking in nonsmokers declined by 18.4% (16.8-20.0). Subjects with a lower educational level (HRR: 0.73 (0.54-0.98) and subjects living with a smoker (HRR: 0.45 (0.34-0.59)) or with workplace smoking (HRR: 0.69 (0.50-0.95)) were less likely to quit. Low socio-economic groups were more likely to become exposed (OR: 2.21 (1.61-3.03)) and less likely to cease being exposed to passive smoking (OR: 0.48 (0.37-0.61)). In conclusion, the quitting rate was lower and the risk of exposure to passive smoking higher among subjects with lower socio-economic status. Exposure to other peoples smoking decreased quitting rates and increased the risk of starting to smoke.
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geographic variations in the effect of atopy on asthma in the European Community respiratory health study
The Journal of Allergy and Clinical Immunology, 2004Co-Authors: Jordi Sunyer, Christer Janson, Peter Burney, Deborah Jarvis, Christina Luczynska, Susan Chinn, Benedicte Leynaert, Juha Pekkanen, Raquel Garciaesteban, Josep M AntoAbstract:Background Atopy has long been related to asthma. The prevalences of both atopy and asthma have shown substantial variation. Objective We sought to assess geographic variations in the fraction of asthma attributable to IgE sensitization to specific allergens in the European Community Respiratory Health Survey. Methods A cross-sectional study was undertaken during the years 1991 and 1992 on 13,558 individuals in 36 centers in 16 countries. Asthma was defined in several ways, variously incorporating reported symptoms, bronchial responsiveness to methacholine, and physician diagnosis. Specific IgE against house dust mite ( Dermatophagoides pteronyssinus ), cat, timothy grass, Cladosporium herbarum , and a local allergen (birch, Parietaria judaica , or ragweed) were measured. Results The overall attributable fraction (AF) of asthma symptoms caused by atopy was 30% but varied widely between centers, ranging from 4% to 61%. The overall AF increased to 43% when asthma was based on wheezing and bronchial responsiveness, to 45% with a physician diagnosis of asthma, and to 48% when the patient reported more than 12 attacks in the last year. Between centers, the AF for atopy was significantly correlated with the prevalence of atopy among the asthmatic patients ( r =0.91) and with the sensitization to house dust mite ( r =0.64), as well as with the prevalence of asthma among atopic individuals ( r =0.43) and the prevalence of asthma among nonatopic individuals ( r =−0.51). Conclusion The effect of atopy on the prevalence of asthma varies widely between centers, probably because of variations in factors related to the expression of asthma and to the prevalence of sensitization, particularly to house dust mite.
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increase in diagnosed asthma but not in symptoms in the European Community respiratory health survey
Thorax, 2004Co-Authors: Susan Chinn, Peter Burney, Deborah Jarvis, Christina Luczynska, Josep M Anto, R De Marco, Ursula Ackermannliebrich, Isa Cerveri, T Gislason, Joachim HeinrichAbstract:Background: Information on the epidemiology of asthma in relation to age is limited and hampered by reporting error. To determine the change in the prevalence of asthma with age in young adults we analysed longitudinal data from the European Community Respiratory Health Survey. Methods: A self-administered questionnaire was completed by 11 168 randomly selected subjects in 14 countries in 1991–3 when they were aged 20–44 years and 5–11 years later from 1998 to 2003. Generalised estimating equations were used to estimate net change in wheeze, nocturnal tightness in chest, shortness of breath, coughing, asthma attacks in the last 12 months, current medication, “diagnosed” asthma, and nasal allergies. Results: Expressed as change in status per 10 years of follow up, subjects reporting asthma attacks in the previous 12 months increased by 0.8% of the population (95% CI 0.2 to 1.4) and asthma medication by 2.1% (95% CI 1.6 to 2.6), while no statistically significant net change was found in reported symptoms. Reported nasal allergies increased, especially in the youngest age group. Conclusions: As this cohort of young adults has aged, there has been an increase in the proportion treated for asthma but not in the proportion of those reporting symptoms suggestive of asthma. Either increased use of effective treatments has led to decreased morbidity among asthmatic subjects or those with mild disease have become more likely to label themselves as asthmatic.
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parental smoking in childhood and adult obstructive lung disease results from the European Community respiratory health survey
Thorax, 2004Co-Authors: Cecilie Svanes, Deborah Jarvis, Susan Chinn, E Omenaas, Amund Gulsvik, Peter BurneyAbstract:Background: Early exposure to parental smoking appears to influence the development of the airways and predispose to respiratory symptoms. A study was undertaken to determine whether the consequences of parental smoking could be traced in adulthood. Methods: Information from interviewer-led questionnaires was available for 18 922 subjects aged 20–44 years from random population samples in 37 areas participating in the European Community Respiratory Health Survey. Lung function data were available for 15 901 subjects. Results: In men, father’s smoking in childhood was associated with more respiratory symptoms (OR wheeze 1.13 (95% CI 1.00 to 1.28); never smokers: OR wheeze 1.21 (95% CI 0.96 to 1.50)) and there was a dose-dependent association between number of parents smoking and wheeze (one: OR 1.08 (95% CI 0.94 to 1.24); both: OR 1.24 (95% CI 1.05 to 1.47); p trend = 0.010). A reduced ratio of forced expiratory volume in 1 second (FEV 1 ) to forced vital capacity (FVC) was related to father’s smoking (−0.3% (95% CI −0.6 to 0)) and number of parents smoking (p trend wheeze 1.15 (95% CI 1.01 to 1.31), never smokers: OR wheeze 1.21 (95% CI 0.98–1.51); FEV 1 −24 ml (95% CI −45 to −3); FEV 1 /FVC ratio −0.6% (95% CI −0.9 to −0.3)). These effects were possibly accounted for by maternal smoking in pregnancy (OR wheeze 1.39 (95% CI 1.17 to 1.65); FEV 1 −23 ml (95% CI −52 to 7); FEV 1 /FVC ratio −0.9% (95% CI −1.3 to −0.4)) as there was no association with paternal smoking among women (interaction by sex, p Conclusion: Both intrauterine and environmental exposure to parental tobacco smoking was related to more respiratory symptoms and poorer lung function in adulthood in this multicultural study. The age window of particular vulnerability appeared to differ by sex, postnatal exposure being important only in men and a role for prenatal exposure being more evident in women.
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assessment of allergen sensitization in a general population based survey European Community respiratory health survey i
Annals of Epidemiology, 2010Co-Authors: P J Bousquet, Deborah Jarvis, Joachim Heinrich, Jordi Sunyer, Richard Hooper, Christel Castelli, Jeanpierre Daures, Matthias Wjst, Peter BurneyAbstract:Purpose Exposed to a common environment, the IgE-mediated immune response differs, for instance, among sensitized subjects, some of them reacting toward one allergen (monosensitized) whereas others are sensitized to a wide array of allergens (polysensitized). However, a better phenotypic characterization is needed for epidemiologic studies. Using the data collected during the ECRHS I (European Community Respiratory Health Survey), several assessments of skin prick tests and serum-specific IgE to identify mono- and polysensitized patients were compared. Methods Subjects took part in the ECRHS-I. The CAP-System was used for serum allergen-specific IgE, and allergen-coated Phazet was used for prick tests. Four allergens ( Dermatophagoides pteronyssinus , cat, timothy grass, and Cladosporium ) were measured using IgE and nine (the same ones plus olive pollen, birch, Alternaria, Parietaria , and ragweed) were skin tested. One to two local allergens were also tested, depending on countries. Results Prevalence of sensitization in 11,355 subjects (34.0 [27.9–40.1] years, 49.9% men) ranged from 32.3% (four specific IgE, 19.3% mono- and 13.0% polysensitized) to 41.8% (four specific IgE combined to nine prick tests, 19.6% mono- and 22.2% polysensitized). Concordance between four specific IgE and four prick tests was weak (weighted κ 0.65 [0.64–0.66]). Concordance between seven and nine prick tests was high (weighted κ 0.99 [0.98–1.00]). Local allergens induced small changes in the prevalence of sensitization, and reclassified some subjects from mono- to polysensitized. Conclusions Skin tests or serum-specific IgE may be chosen to identify allergenic sensitivity, mono- and polysensitized subjects without being strictly interchangeable.
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physical activity and bronchial hyperresponsiveness European Community respiratory health survey ii
Thorax, 2007Co-Authors: Rafea Shaaban, Christer Janson, Susan Chinn, Josep M Anto, Joachim Heinrich, Benedicte Leynaert, D Soussan, Roberto De Marco, Judith Garciaaymerich, Deborah JarvisAbstract:Background: Identification of the risk factors for bronchial hyperresponsiveness (BHR) would increase the understanding of the causes of asthma. The relationship between physical activity and BHR in men and women aged 28.0-56.5 years randomly selected from 24 centres in 11 countries participating in the European Community Respiratory Health Survey II was investigated. Methods: 5158 subjects answered questionnaires about physical activity and performed BHR tests. Participants were asked about the frequency and duration of usual weekly exercise resulting in breathlessness or sweating. BHR was defined as a decrease in forced expiratory volume in 1 s of at least 20% of its post-saline value for a maximum methacholine dose of 2 mg. Results: Both frequency and duration of physical activity were inversely related to BHR. The prevalence of BHR in subjects exercising ≤ 1, 2-3 and ≥4 times a week was 14.5%, 11.6% and 10.9%, respectively (p<0.001). The corresponding odds ratios were 1.00, 0.78 (95% Cl 0.62 to 0.99) and 0.69 (95% Cl 0.50 to 0.94) after controlling for potential confounding factors. The frequency of BHR in subjects exercising <1 h, 1-3 h and ≥4 h a week was 15.9%, 10.9% and 10.7%, respectively (p<0.001). The corresponding adjusted odds ratios were 1.00, 0.70 (95% Cl 0.57 to 0.87) and 0.67 (95% Cl 0.50 to 0.90). Physical activity was associated with BHR in all studied subgroups. Conclusions: These results suggest that BHR is strongly and independently associated with decreased physical activity. Further studies are needed to determine the mechanisms underlying this association.
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source apportionment of ambient pm2 5 at five spanish centres of the European Community respiratory health survey ecrhs ii
Atmospheric Environment, 2007Co-Authors: Mar Viana, Joachim Heinrich, Xavier Querol, Thomas Gotschi, Andres Alastuey, Jordi Sunyer, Bertil Forsberg, Dan Norback, Felix Payo, Jose Antonio MaldonadoAbstract:Fine particulate matter (PM2.5) was sampled at 5 Spanish locations during the European Community Respiratory Health Survey II (ECRHS II). In an attempt to identify and quantify PM2.5 sources, sourc ...
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changes in active and passive smoking in the European Community respiratory health survey
European Respiratory Journal, 2006Co-Authors: Christer Janson, Deborah Jarvis, Susan Chinn, Thorarinn Gislason, Rain Jogi, Nino Kunzli, R De Marco, Cecilie Svanes, Joachim Heinrich, J SunyerAbstract:The aim of the present investigation was to study changes and determinants for changes in active and passive smoking. The present study included 9,053 adults from 14 countries that participated in the European Community Respiratory Health Survey II. The mean follow-up period was 8.8 yrs. Change in the prevalence of active and passive smoking was expressed as absolute net change (95% confidence interval) standardised to a 10-yr period. Determinants of change were analysed and the results expressed as adjusted hazard risk ratio (HRR) or odds ratio (OR). The prevalence of active smoking declined by 5.9% (5.1-6.8) and exposure to passive smoking in nonsmokers declined by 18.4% (16.8-20.0). Subjects with a lower educational level (HRR: 0.73 (0.54-0.98) and subjects living with a smoker (HRR: 0.45 (0.34-0.59)) or with workplace smoking (HRR: 0.69 (0.50-0.95)) were less likely to quit. Low socio-economic groups were more likely to become exposed (OR: 2.21 (1.61-3.03)) and less likely to cease being exposed to passive smoking (OR: 0.48 (0.37-0.61)). In conclusion, the quitting rate was lower and the risk of exposure to passive smoking higher among subjects with lower socio-economic status. Exposure to other peoples smoking decreased quitting rates and increased the risk of starting to smoke.
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increase in diagnosed asthma but not in symptoms in the European Community respiratory health survey
Thorax, 2004Co-Authors: Susan Chinn, Peter Burney, Deborah Jarvis, Christina Luczynska, Josep M Anto, R De Marco, Ursula Ackermannliebrich, Isa Cerveri, T Gislason, Joachim HeinrichAbstract:Background: Information on the epidemiology of asthma in relation to age is limited and hampered by reporting error. To determine the change in the prevalence of asthma with age in young adults we analysed longitudinal data from the European Community Respiratory Health Survey. Methods: A self-administered questionnaire was completed by 11 168 randomly selected subjects in 14 countries in 1991–3 when they were aged 20–44 years and 5–11 years later from 1998 to 2003. Generalised estimating equations were used to estimate net change in wheeze, nocturnal tightness in chest, shortness of breath, coughing, asthma attacks in the last 12 months, current medication, “diagnosed” asthma, and nasal allergies. Results: Expressed as change in status per 10 years of follow up, subjects reporting asthma attacks in the previous 12 months increased by 0.8% of the population (95% CI 0.2 to 1.4) and asthma medication by 2.1% (95% CI 1.6 to 2.6), while no statistically significant net change was found in reported symptoms. Reported nasal allergies increased, especially in the youngest age group. Conclusions: As this cohort of young adults has aged, there has been an increase in the proportion treated for asthma but not in the proportion of those reporting symptoms suggestive of asthma. Either increased use of effective treatments has led to decreased morbidity among asthmatic subjects or those with mild disease have become more likely to label themselves as asthmatic.