International Journal of Epidemiology, Vol 26, 610-619, Copyright © 1997 by International Epidemiological Association
B Forsberg, J Pekkanen, J Clench-Aas, MB Martensson, N Stjernberg, A Bartonova, KL Timonen and S Skerfving
BACKGROUND: The high and increasing prevalence of childhood asthma is a
major public health issue. Various risk factors have been proposed in local
studies with different designs. METHODS: We have made a questionnaire study
of the prevalence of childhood asthma, potential risk factors and their
relations in four regions in Scandinavia (Umea and Malmo in Sweden, Kuopio
in eastern Finland and Oslo, Norway). One urban and one less urbanized area
were selected in each region, and a study group of 15962 children aged 6-12
years was recruited. RESULTS: The prevalence of symptoms suggestive of
asthma varied considerably between different areas (dry cough 8-19%, asthma
attacks 4-8%, physician-diagnosed asthma 4-9%), as did the potential risk
factors. Urban residency was generally not a risk factor. However, dry
cough was common in the most traffic polluted area. Exposure to some of the
risk factors. such as smoking indoors and moisture stains or moulds at home
during the first 2 years of life, resulted in an increased risk. However,
current exposure was associated with odds ratios less than one.
CONCLUSIONS: Our findings were probably due to a combination of early
impact and later avoidance of these risk factors. The effects of some risk
factors were found to differ significantly between regions. No overall
pattern between air pollution and asthma was seen, but air pollution
differed less than expected between the areas.
ARTICLES
Childhood asthma in four regions in Scandinavia: risk factors and avoidance effects
Department of Environmental Health, Umea University, Sweden.
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