Relationship between the Prevalence of Allergic Rhinitis and Allergen Sensitization in Children of Songpa Area, Seoul

Ji-Won Kwon; Ju-Hee Seo; Jinho Yu; Byoung-Ju Kim; Hyo Bin Kim; So Yeon Lee; Woo Kyung Kim; Kyung Won Kim; Hye-Mi Ji; Kyu-Earn Kim; Yee-Jin Shin; Myoung Hee Kim; Ho Kim; Soo-Jong Hong

doi:10.7581/pard.2011.21.1.47

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Kwon, Seo, Yu, Kim, Kim, Lee, Kim, Kim, Ji, Kim, Shin, Kim, Kim, and Hong: Relationship between the Prevalence of Allergic Rhinitis and Allergen Sensitization in Children of Songpa Area, Seoul

Abstract

Pediatr Allergy Respir Dis 2011;21(1):47-55.

Published online: 20 January 2011

DOI: https://doi.org/10.7581/pard.2011.21.1.47

Relationship between the Prevalence of Allergic Rhinitis and Allergen Sensitization in Children of Songpa Area, Seoul

Ji-Won Kwon^∗, Ju-Hee Seo^∗, Jinho Yu^∗, Byoung-Ju Kim^†, Hyo Bin Kim^‡, So Yeon Lee^∫, Woo Kyung Kim^∥, Kyung Won Kim^¶, Hye-Mi Ji^∗∗, Kyu-Earn Kim^††, Yee-Jin Shin^‡‡, Myoung Hee Kim^∬, Ho Kim^∬, Soo-Jong Hong^∗,

^∗Childhood Asthma Atopy Center, Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine

^†Department of Pediatrics, Haeundae Paik Hospital, Inje University College of Medicine

^‡Department of Pediatrics, Sanggye Pai Hospital, Inje University College of Medicine

^∫Department of Pediatrics, Hallym University Secred Heart Hospital

^∥Department of Pediatrics, Seoul Paik Hospital, Inje University College of Medicine

^¶Department of Pediatrics, Severance Children's Hospital, College of Medicine, Yonsei University

^∗∗Department of Pediatrics, CHA University School of Medicine

^††Department of Pediatrics, Gangnam Severance Hospital, College of Medicine, Yonsei University

^‡‡Department of Psychiatry, Gangnam Severance Hospital, College of Medicine, Yonsei University

^∬Graduate School of Public Health, Seoul National University

책임저자: 홍수종, 서울시 송파구 풍납 2동 울산대학교 의과대학 서울아산병원 소아청소년과 Tel: 02)3010-3379 Fax: 02)473-3725 E-mail: sjhong@amc.seoul.kr

Received 21 December 2010 Accepted 9 March 2011

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Methods

A modified International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire survey was administered to 1,376 elementary school children in the Songpa area of Seoul. Serum total IgE, blood eosinophils, and skin prick tests for 18 common allergens were performed.

Purpose

We investigated the relationship between allergic rhinitis (AR) and allergen sensitization in students at an elementary school in Seoul.

Results

The prevalence of AR symptoms during the last 12 months and the current AR, defined as having AR symptoms during last 12 months with a history of AR diagnosis from the doctor, were 39.0% and 24.2%, respectively. Males were more likely to have current AR than females (26.6% vs. 21.5%, P=0.04). Independent risk factors for current AR were parental allergic disease (adjusted odds ratio [aOR], 3.78, 95% CI, 2.76–5.18), history of atopic dermatitis (AD; aOR, 1.47; 95% CI, 1.05–2.04), history of asthma (aOR, 3.48; 95% CI, 2.15–5.61), and higher maternal education (aOR, 1.42; 95% CI, 1.02–1.99). The subjects with higher quartiles of serum total IgE (P value for trend <0.001), more than 4% of eosinophil fraction (aOR 1.76; 95% CI, 1.24–2.48), and allergen sensitization house dust mites [aOR, 1.54; 95% CI, 1.10–2.15], dog [aOR, 2.95; 95% CI, 1.38–6.28], cat [1.85; 95% CI, 1.02–3.34], Alternaria [aOR, 2.37; 95% CI, 1.06–5.32] and late-blooming tree pollen mixture [aOR 2.26; 95% CI, 1.12–4.57] were more likely to have current AR. Conclusion: The prevalence of AR in children has increased during the last decade. The sensitization to common allergens and increased sensitization were associated with the development of current AR. House dust mites, dog, cat, alder, and Alternaria were the important allergens for current AR.

Keywords: Allergic rhinitis, Prevalence, Risk factor, Atopy, Childhood

References

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Fig. 1.

The odds ratios (95% CI) for current allergic rhinitis by the fraction of blood eosinophil. ^∗aOR: Adjusted by age, sex, BMI, ETS, parental allergic diseases and degree of maternal education ^∗aOR for trend=1.29 (1.11–1.50), P =0.001

Fig. 2.

The odds ratios (95% CI) for current allergic rhinitis by the level of serum total IgE. ^∗aOR: Adjusted by age, sex, BMI, ETS, parental allergic diseases and degree of maternal education ^∗aOR for trend=1.39 (1.20–1.62), P<0.001

Fig. 3.

The Odds Ratios (95% CI) for Current Allergic Rhinitis by the Number of Sensitization ^∗aOR: Adjusted by age, sex, BMI, ETS, parental allergic diseases and degree of maternal education ^∗aOR for trend=1.38 (1.15–1.65), P <0.001

Table 1.

Characteristics of Subjects

Number	1,376
Age, Year mean±SD	9.43±1.76
Sex, M/F	740/636
BMI, mean±SD	18.57±3.17
Parental history of allergic diseases	371/1,037 (35.8%)
Parental history of AR	331/1,008 (32.8%)
Economic state, monthly income
Low, ≤2,999 USD)	362 (31.0%)
Middle, 3,000–4,990 USD	685 (58.7%)
High, ≥5,000 USD	120 (10.2%)
Environmental tobacco smoking	454/1,232 (36.9%)
Atopy^∗	495/1,159 (42.7%)
Allergen sensitization No.
0	664 (57.3%)
1	331 (28.6%)
2	83 (7.2%)
3	42 (3.6%)
≥4	39 (3.4%)

Abbreviations:BMI, body mass index; AR, allergic rhinitis

^∗ defined as at least 1 positive skin prick test (allergen wheal diameter is greater than 3 mm and histamine wheal diameter)

Table 2.

Prevalence of Allergic Rhinitis in Primary School Children of Seoul

	Number	Prevalence (95% CI)
AR symptoms, ever	474/1,116	42.5% (39.6–45.4)
AR symptoms, last 12 months	453/1,163	39.0% (36.2–41.8)
AR symptoms with itchy watery eyes, last 12 months	164/1,255	13.1% (11.2–15.0)
AR diagnosis, ever	446/1,159	38.5% (35.7–41.3)
Current AR^∗	292/1,208	24.2% (21.7–26.7)
Treatment of AR, last 12 months	339/1,151	29.5% (26.9–32.1)

Abbreviation:AR, allergic rhinitis

^∗ Current AR; diagnosis ever plus symptoms within last 12 months

Table 3.

Risk Factors for Current Allergic Rhinitis

	Current AR		Univariate Analysis		Adjusted Analysis^∗
	Numbers	%	OR (95% CI)	P Value	aOR (95% CI)	P Value
Personal characteristics
Sex, male	169/636	26.6	1.32	0.043	1.16	0.350
			(1.01–1.72)		(0.84–1.58)
BMI ≥ 85percentile	59/251	23.5	0.96	0.868	0.99	0.967
			(0.69–1.33)		(0.68–1.44)
Past history of AD diagnosis	122/378	32.3	1.84	<0.001	1.47	0.021
			(1.40–2.42)		(1.05–2.04)
Past history of asthma diagnosis	49/108	45.4	3.05	<0.001	3.48	<0.001
Genetic factors			(2.03–4.58)		(2.15–5.61)
Parental allergic diseases	145/361	40.2	3.85	<0.001	3.78	<0.001
			(2.85–5.21)		(2.76–5.18)
Socioeconomic factors
Maternal education ≥ graduate	207/747	27.7	1.63	0.001	1.42	0.036
			(1.22–2.17)		(1.02–1.99)
Biologic markers
Eosinophil fraction ≥ 4%	108/341	31.7	1.71	<0.001	1.76	0.001
			(1.28–2.28)		(1.24–2.48)
Total IgE ≥ 100 kU/L	126/372	33.9	2.00	<0.001	1.80	0.001
			(1.51–2.67)		(1.29–2.52)
Sensitization to common allergens	140/465	30.1	1.68	<0.001	1.47	0.020
			(1.27–2.22)		(1.06–2.04)

Abbreviations:AR, allergic rhinitis; BMI, body mass index; AD, atopic dermatitis

^∗ aOR; adjusted odds ratio: Adjusted by age, sex, BMI, environmental tobacco smoking (ETS), parental allergic disease and degree of maternal education

Table 4.

Proportion of Specific Allergen Sensitization by Current Allergic Rhinitis (Total 1,159 conducted to allergic skin prick test)

Allergen Sensitization (Covariates)	Current AR		Univariate Analysis		Adjusted Analysis^∗
Allergen Sensitization (Covariates)	No (n=816)	Yes (n=266)	OR (95% CI)	Pvalue	OR (95% CI)	Pvalue
Any allergen	321 (39.3%)	140 (52.6%)	1.71 (1.29–2.26)	<0.001	1.47 (1.06–2.04)	0.020
Indoor allergens	293 (35.9%)	131 (49.2%)	1.73 (1.30–2.29)	<0.001	1.49 (1.07–2.08)	0.017
HDM (Der p or Der f)	275 (33.7%)	127 (47.7%)	1.79 (1.35–2.38)	<0.001	1.54 (1.10–2.15)	0.010
Der p	244 (29.9%)	113 (42.5%)	1.73 (1.30–2.30)	<0.001	1.47 (1.05–2.05)	0.025
Der f	233 (28.6%)	102 (38.3%)	1.55 (1.16–2.08)	0.003	1.39 (0.98–1.96)	0.059
Cockroach	12 (1.5%)	7 (2.6%)	1.81 (0.70–4.64)	0.211	2.30 (0.84–6.29)	0.104
Dog	20 (2.5%)	17 (6.4%)	2.71 (1.40–5.26)	0.002	2.95 (1.38–6.28)	0.005
Cat	49 (6.0%)	28 (10.5%)	1.84 (1.13–2.99)	0.013	1.85 (1.02–3.34)	0.042
Pollen	51 (6.3%)	34 (12.8%)	2.19 (1.39–3.47)	0.001	2.22 (1.28–3.85)	0.004
Grass	7 (0.9%)	5 (1.9%)	2.21 (0.69–7.03)	0.167	2.29 (0.60–8.71)	0.221
Tree1, early-blooming	23 (2.8%)	12 (4.5%)	1.62 (0.79–3.32)	0.175	1.91 (0.83–4.38)	0.125
Tree2, late-blooming	28 (3.4%)	20 (7.5%)	2.28 (1.26–4.13)	0.005	2.26 (1.12–4.57)	0.022
Alder	18 (2.2%)	10 (3.8%)	1.73 (0.78–3.80)	0.166	2.71 (1.09–6.71)	0.031
Oak	29 (3.6%)	12 (4.5%)	1.28 (0.64–2.55)	0.478	1.84 (0.84–4.06)	0.126
Mugwort	10 (1.2%)	7 (2.6%)	2.17 (0.82–5.78)	0.109	1.83 (0.58–5.75)	0.296
Ragweed	3 (0.4%)	2 (0.8%)	2.05 (0.34–12.35)	0.602	1.69 (0.17–16.60)	0.652
Mold	26 (3.2%)	18 (6.8%)	2.20 (1.18–4.09)	0.010	2.28 (1.08–4.79)	0.030
Alternaria	22 (2.7%)	16 (6.0%)	2.31 (1.19–4.46)	0.011	2.37 (1.06–5.32)	0.035
Aspergillus	4 (0.5%)	4 (1.5%)	3.09 (0.77–12.47)	0.107	2.37 (0.46–12.12)	0.300

Abbreviation:HMD, house dust mite

^∗ aOR: Adjusted by age, sex, BMI, ETS, parental allergic diseases and degree of maternal education

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