ArticlesIncreasing prevalence of hay fever and atopy among children in Leipzig, East Germany
Introduction
Several surveys in eastern Europe carried out after the fall of the communist system showed that the prevalence of atopic diseases in children and adults was low compared with that in western countries.1, 2 We previously reported lower prevalences of asthma, hay fever, airway hyper-responsiveness, and atopic sensitisation among schoolchildren aged 9–11 years living in Leipzig, East Germany, than in children of the same age living in Munich, West Germany.3, 4
The reasons for the striking differences in the prevalence of atopic diseases between people living in eastern and western Europe are the focus of much research. Factors associated with western lifestyle, such as smaller family size,5 high socioeconomic status,6 western diet,7 and increasing allergen exposure attributable to insulated housing conditions,8 have been proposed as potential explanations for the higher prevalence of atopic disorders in west European countries. Since the German unification in October, 1990, tremendous changes in everyday life towards western conditions have occurred in the former East Germany. If the adoption of a western lifestyle is associated with factors inducing atopic sensitisation and childhood asthma, a substantial rise in the prevalence of these disorders would therefore be expected.
In 1995–96, 5–6 years after the German unification, we undertook a prevalence study in Leipzig, using the same methods as in our previous study in 1991–92.4 The aim of the second survey was to investigate time trends in the prevalence of asthma and allergies in 9–11-year-old schoolchildren. These children spent their first 3 years of life under eastern living conditions and were subsequently exposed to western lifestyle.
Section snippets
Study population
Leipzig, a city of about 535 000 inhabitants, is located in the southeastern part of Germany. In 1995–96, we undertook a cross-sectional survey based on a cluster sample of 44 schools, enrolling 2666 children. The sampling procedure was the same as in the previous survey in 1991–92, of 1854 children.4 All pupils attending classes of the fourth grade (aged 9–11 years) were studied. In both surveys, questionnaires were sent through the schools to the parents for completion. Children underwent
Results
So that the populations in the two surveys were as similar as possible in terms of ethnic background, the analysis was restricted to children of German nationality in both surveys: 1492 and 2311 children with completed questionnaires; 1303 and 1624 children with skinprick tests by the multitest device; and 1272 and 1875 children undergoing bronchial challenge.
The prevalence of asthma and related symptoms, such as recurrent attacks of shortness of breath, recurrent wheeze, and nocturnal cough,
Discussion
The results of the 1995–96 survey show that at the same time as drastic changes towards western lifestyle in Leipzig there were rises in the frequencies of hay fever and atopic sensitisation in schoolchildren. The frequencies of asthma and airway hyper-responsiveness remained virtually unchanged. This discrepancy points towards important differences in the development of atopic disorders. The children surveyed were born about 3 years before the fall of the communist system and were therefore
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