ORIGINAL ARTICLE

Early respiratory and skin symptoms in relation to ethnic background: the importance of socioeconomic status; the PIAMA study

L P Koopman¹, A Wijga², H A Smit², J C de Jongste¹, M Kerkhof³, J Gerritsen³, A P H Vos⁴, R T van Strien⁴, B Brunekreef⁴, H J Neijens¹

¹ Erasmus University Medical Center/Sophia Children's Hospital Rotterdam, Department of Pediatrics
² National Institute of Public Health and the Environment, Department of Chronic Disease Epidemiology
³ Groningen University/Beatrix Children's Hospital Groningen, Department of Epidemiology/Pediatric Pulmonology
⁴ University of Utrecht, Institute for Risk Assessment Sciences, Department of Environmental and Occupational Health

Correspondence to:
Correspondence to:
Prof. H J Neijens, Sophia Children's Hospital, Department of Pediatrics, PO Box 2060, 3000 CB, Rotterdam, Netherlands;
Neijens{at}alkg.azr.nl

Aims: To evaluate ethnic differences in the prevalence of respiratory and skin symptoms in the first two years of life.

Methods: A total of 4146 children participated in the Prevention and Incidence of Asthma and Mite Allergy (PIAMA) study. Parents completed questionnaires on respiratory and skin symptoms, ethnic background, and other potential confounders during pregnancy, and at 3 months, 1 year, and 2 years of age.

Results: In the first year, "non-Dutch" children (compared with "Dutch" children) had a higher prevalence of runny nose with itchy/watery eyes (11.0% versus 5.0%). In the second year, a higher prevalence of wheeze at least once (26.7% versus 18.5%), night cough without a cold (24.6% versus 15.5%), runny nose without a cold (34.1% versus 21.3%), and runny nose with itchy/watery eyes (13.7% versus 4.6%) was found. Adjustment for various confounders, especially adjustment for socioeconomic factors, reduced most associations between ethnicity and respiratory symptoms. Only runny nose with itchy/watery eyes in the second year of life was independently associated with non-Dutch ethnicity (adjusted odds ratio 2.89, 95% CI 1.3–6.4).

Conclusions: Non-Dutch children more often had respiratory symptoms in the first two years of life than Dutch children. This could largely be explained by differences in socioeconomic status. Follow up of the cohort will determine whether this higher prevalence of respiratory symptoms in children with non-Dutch ethnicity represents an increased risk of developing allergic disease rather than non-specific or infection related respiratory symptoms.

Keywords: eczema; ethnic; socioeconomic status; wheezing

Abbreviations: aOR, adjusted odds ratio; CI, confidence interval; cOR, crude odds ratio; OR, odds ratio; SES, socioeconomic status

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