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International Journal of Epidemiology 2000;29:125-130
© International Epidemiological Association 2000

Sensitization to individual allergens as risk factors for lower FEV1 in young adults

Jordi Sunyer, Joan Soriano, Josep M Antó, Felip Burgos, Antonio Pereira, Félix Payo, Jesús Martínez-Moratalla and Jacinto Ramos on behalf of the Spanish groups of European Community Respiratory Health Surveya

Respiratory and Environmental Health Research Unit, IMIM, Barcelona, Spain.
Pneumology, Clinic Hospital, Barcelona; Pneumology, Hospital General de Huelva, Spain.
Instituto Nacional de Silicosis, Oviedo, Spain.
Pneumology, Hospital General de Albacete, Spain.
Epidemiology, Dirección de Salud de Vizcaya, Bilbao, Spain.
a Centres and investigators: JM Antó (Principal Investigator), Albacete:J Martínez-Moratalla, E Almar, M Arévalo, A Mateos, M Vizcaya; Barcelona: J Sunyer, F Burgos, J Castellsagué, M Kogevinas, J Roca, JB Soriano,A Tobías; Galdakao: N Muniozguren, M Errazola, A Capelastegui, J Ramos; Huelva: JA Maldonado, JL Sánchez, A Pereira, J Gravalos; Oviedo: J Azofra, I Huerta, L Palenciano, F Payo, A Vega.

Reprint requests to: Dr Jordi Sunyer, Unitat de Recerca Respiratòria i Ambiental, Institut Municipal d'Investigació Mèdica (IMIM), Doctor Aiguader 80, E-08003 Barcelona, Spain. E-mail: jsunyer{at}imim.es

Background Atopy may impair ventilatory function, but results are controversial. We assess the association between individual reactivity to allergens and the level of baseline maximal one-second forced expiratory volume (FEV1), by smoking and respiratory symptoms.

Methods The 1472 participants (response 44.5%) of the five Spanish areas of the European Community Respiratory Health Survey (ECRHS) who performed respiratory function tests, skin prick tests and/or specific IgE against common aeroallergens (e.g. mites, pets, mould, pollens) are included. Bronchial hyperreactivity (BHR) was measured with a methacholine challenge.

Results After adjusting for BHR and smoking, in addition to the other allergens, skin reactivity to Alternaria (–208 ml; 95% CI : –451, 35) and IgE antibodies against cat (–124 ml; 95% CI : –269, 21) and Timothy grass (–115 ml, 95% CI : –190, –40) were associated with a decrease in FEV1 in females. Among males, skin reactivity to olive showed the strongest association (–111 ml; 95% CI : –261, 38). The associations were stronger in females. Smoking modifies the association for Alternaria and cat (P for interaction < 0.05). While cat is associated with a decrease in FEV1 in current smokers (–190 ml), Alternaria (–336 ml) was associated among never smokers. The exclusion of subjects with asthma symptoms, or adjustment for respiratory symptoms, led to similar results.

Conclusions We conclude that immunoresponse to individual allergens (particularly outdoor) is associated with the level of FEV1, and this association occurred independently of asthma, and in smokers and non-smokers, which may be of interest in natural history of chronic obstructive pulmonary disease (COPD).

Keywords Asthma, atopy, COPD, cross-sectional, FEV1, smoking

Accepted 30 July 1999


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