Risk Factor Patterns Recorded in Adults with Asthma, Rhinitis, and Eczema

Roxana Mincheva, MD, PhD

A recent investigation from Sweden suggested that there were overlapping risk factor patterns associated with asthma, rhinitis, and eczema in adults.

Though the increase in cases of asthma, rhinitis, and eczema had been thoroughly studies in children and adolescents, according to investigators, the risk factor pattern of atopic diseases, especially as they pertain to eczema, had been underdeveloped in adult patients.

With the number of studies on these patterns being few, investigators led by Roxana Mincheva, MD, PhD, Krefting Research Center, University of Gothenburg, compared the risk factor patterns of these 3 conditions in a randomly selected adult population.

The Methods

For their study, Mincheva and colleagues issued a questionnaire survey on atopic diseases which was mailed to 30,000 randomly selected adults in West Sweden, a region home to a population of 1.6 million people.

A total of 15,000 subjects were selected from the metropolitan area of Gothenburg, and 15,000 subjects were selected from the remainder of the country.

The response rate to the questionnaires was 62%, with a total of 18,087 participants enrolled in the study. Among these responders, 2000 were invited to clinical examinations while 1172 (59%) participated.

The questionnaire consisted of 3 parts, all of which were administered at the same time.

The first part was the Swedish OLIN study questionnaire, which covered asthma, thinitis, COPD, respiratory symptoms, and possible risk factors of disease such as smoking and a family history of airway disease.

The second part of the questionnaire featured questions regarding occupational and environmental exposures as well as health status.

The third and final part consisted of the Swedish Global Allergy and Asthma questionnaire, which addressed respiratory symptoms and diseases with added question about eczema.

Clinical examinations were also conducted and included objective measures of height and weight, as well as. A structured interview and a drawn blood sample.

The Findings

Investigators reported that the prevalence of current asthma was 11.8 %, while the prevalence of current rhinitis and current eczema were 42.8 %, and 13.5%, respectively. A total of 2.3 % had all 3 conditions
while 13.9 % had at least 2 conditions.

No mutual risk factor was identified for all 3 conditions.

The prevalence of asthma and eczema at any age, as well as current rhinitis in adult participants were all inversely associated with increasing age, as was family history of asthma and rhinitis.

Additionally, the use of rhinitis medications in the previous 12 months were more common among younger subjects, and the prevalence of allergic sensitization was 29.7% , which was decreased by age and more common among male participants.

Allergic sensitization was a strong risk factor for current asthma (OR 4.1 CI 2.7–6.3) and current rhinitis (OR 5.1CI 3.8–6.9) but not so for current eczema.

Finally, obesity was a risk factor for current asthma and current rhinitis, while farm childhood decreased the risk for current asthma and current rhinitis, and occupational exposure to gas dust or fumes and female sex was associated with an increased risk of current asthma and current eczema.

The investigators noted that no common risk factors were identified in all 3 conditions

“However, some exposures and covariates, such as obesity, farm childhood and allergic sensitization are risk factors for two of the conditions but not all 3,” the team wrote. “Future epidemiological research on the combined determinants of the diseases is needed and especially for rhinitis and eczema.”

The study, “Different risk factor patterns for adult asthma, rhinitis and eczema: results from West Sweden Asthma Study,” was published online in Clinical and Translational Allergy.