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Increased prevalence of sensitization against aeroallergens in adults in West compared with East Germany
T Nicolai1, B Bellach, E V Mutius
1Universitätskinderklinik München, Dr v. Haunersches Kinderspital, Germany.
Background:
An increased prevalence of allergic diseases and atopic sensitization as assessed by skin-prick testing in children in West compared with East Germany has been reported.
Objectives:
This study was designed to evaluate whether such a difference is also present in adults, and if this can be shown when using a serological test for allergic sensitization.
Methods:
Two large samples representative for all adults between 25 and 69 years of age were drawn in West (1991, n = 5313) and East Germany (1992, n = 2617). A serological test screening for IgE-antibodies to common aeroallergens (SX1) was performed. A questionnaire was used to assess the presence of clinical respiratory allergy, known possible risk factors for allergies and confounding variables.
Results:
Allergic sensitization decreased with age. Significantly more subjects < 45 years of age had a positive allergy test in West as compared to East Germany. The prevalence of clinical allergy was also higher in West Germany. This difference was significant in younger adults and was independent of other risk factors identified. These additional risk factors encompassed younger age, higher educational level, male sex, and living in a community with more than 100,000 inhabitants.
Conclusion:
Sensitization to common aeroallergens as determined by a multiple allergen RAST test in adults below 45 years of age living in West Germany is increased compared to East Germany. This increase cannot be explained by genetic differences and is similar to the West to East decreasing gradient in allergies reported from studies in children employing skin-prick tests.