A national registry-based study on uptake of the first dose of MMR vaccine in 380 administrative regions in Poland, 2013-2016-2020.

INTRODUCTION AND OBJECTIVE: Regular monitoring of the measles, mumps, and rubella (MMR) vaccine uptake quickly exposes immunity gaps in the population. In Poland, the first dose of the MMR vaccine is mandatory for children between 13 and 15 months of life. This study aimed to assess the uptake of the first dose of MMR vaccine in 380 administrative counties in Poland in 2020, as well as to analyze the MMR vaccine uptake trends in 2013-2016-2020. MATERIAL AND METHODS: This study is an epidemiological retrospective national registry-based analysis. Data on mandatory childhood vaccinations in all 380 counties in Poland were collected from the epidemiological reports of the State Sanitary Inspectorate territorial representatives. MMR vaccine uptake was calculated as the percentage of children who received the first dose of MRR vaccine to all children subject to mandatory vaccination in the county. RESULTS: The uptake of the first dose of MMR vaccine decreased from 99.4% in 2013, to 95.5% in 2016 and 91.9% in 2020. In 2013, 93.2% of countys MMR vaccine uptake level reached the herd immunity level, followed by 77.1% of counties in 2016 and only 38.3% of countys in 2020. In 2020, two counties reached complete (100%) MMR vaccine uptake, and the lowest MMR vaccine uptake was 63.88%. Of the 380 counties in Poland, in 226 (61.1%) the MMR vaccine uptake level was lower than the herd immunity level, and a downward trend was observed. MMR vaccine uptake decreased with an increased number of residents in a county (r= -0.35; p<0.001). CONCLUSIONS: This study revealed that in 61% of administrative regions in Poland, the MMR vaccine uptake was below the herd immunity level. Regional differences in the MMR vaccine uptake were observed. A significant decrease in MMR vaccine uptake between 2013 - 2020 poses a risk of measles outbreaks.

The multidimensional nature of attitudes towards preventive vaccinations - a cross-sectional survey among Poles aged 15-39 years.

OBJECTIVES: Vaccination skepticism and vaccination refusal both constitute global public health concerns. Systematic monitoring of public attitudes towards vaccination is crucial for maintaining a high vaccination coverage rate. The study aimed to identify and characterize homogenous social groups distinguished by attitudes toward preventive vaccinations. MATERIAL AND METHODS: Between October and November of 2021, a nationwide representative cross-sectional survey was conducted on a representative sample of 1560 inhabitants of Poland aged 15-39 years. The study questionnaire included 60 questions on public attitudes towards vaccines, vaccination, and the COVID-19 pandemic. Factor analysis was applied to identify the main dimensions of vaccination attitudes. RESULTS: Factor analysis included 22 variables and yielded 3 factors or dimensions that accounted for 48.5% of the model's variability. Young adults were assigned into 6 homogeneous groups based on these factors: 1) general trust in vaccination, 2) vaccine safety concerns, 3) trust in fake medical news regarding COVID-19 vaccination, and denying the COVID-19 pandemic. Groups I-IV differed by sociodemographic factors and vaccination coverage rates. Nearly 60% of the respondents expressed concern regarding various aspects of vaccination. CONCLUSIONS: Most of Poland's young adults lack clearly defined attitudes towards vaccination. Attitudes towards vaccination can be divided into 6 heterogeneous groups. Int J Occup Med Environ Health. 2023;36(2):214-28.

Prevention of perennial allergic rhinitis in the conception of coordinated healthcare in Poland.

Introduction: The primary prevention is intended to prevent the development of diseases, secondary prevention aims to limit disease progression, and tertiary prevention involves reducing disease-associated symptoms. The purpose of this study was to assess the use of selected forms of secondary prevention by patients diagnosed with perennial allergic rhinitis. Moreover, this paper presents the ways in which the adopted organizational solutions could be utilized as part of coordinated healthcare to benefit patients with perennial allergies. Material and methods: The study population comprised 18,617 respondents, 4783 of whom (including patients allergic to Dermatophagoides pteronyssinus and Dermatophagoides farinae) were qualified to undergo a medical examination. The study used ECRHS and ISAAC questionnaires adapted for Europe. Results: Nearly 20% of patients diagnosed with chronic allergic rhinitis used preventive measures against house dust mites; this is in contrast with 13% in the control group (p = 1.358e-07). The secondary preventive measures most commonly used in the study group were, in descending order of frequency, mattress protectors and anti-dust-mite spray. Undertaking preventive measures was most common among study participants with higher education and residents of large cities. Conclusions: The proportion of patients diagnosed with a dust-mite allergy, who undertook preventive measures against perennial allergic rhinitis, was relatively low. Building, maintaining, and continual strengthening the doctors' relationship with chronic allergy patients may shift the nature of healthcare services more towards preventive measures, for the implementation of which the patient will be co-responsible under the coordinated healthcare system.

Level of Acceptance of Mandatory Vaccination and Legal Sanctions for Refusing Mandatory Vaccination of Children.

A preventive vaccination program is in operation in Poland. There are mandatory vaccinations for Polish residents under the age of 19 years. The law provides for financial penalties for parents who refuse to vaccinate their children. The aim of this study was to describe the attitudes of Polish residents aged 15-39 years to mandatory preventive vaccination and the level of acceptance for legal and financial sanctions for refusing mandatory vaccination of children. MATERIALS AND METHODS: A face-to-face questionnaire-based study of a representative sample of 1560 residents of Poland aged 15-39 years. Data was collected in the fourth quarter of 2021. RESULTS: In the study group, 51.5% of the respondents believed that preventive vaccination should be mandatory, and parents should have the right to decide only about additional vaccinations. Multivariate analyses (logistic regression) revealed a significant association between acceptance of mandatory vaccination and the following factors: positive COVID-19 vaccination status, self-declared religiosity, and having children. Of the 1560 respondents, 25.3% declared support for legal or financial sanctions for those refusing to vaccinate their children. In this group (n = 394), the highest percentage of respondents (59.4%) supported sanctions in the form of refusal to admit an unvaccinated child to a nursery or kindergarten. CONCLUSIONS: Despite preventive (mandatory) vaccination programs having been in operation in Poland since the 1960's, only a little over 50% of adolescent Poles and young adults accept the vaccine mandate. Only 25% of this group declare their support for sanctions for refusing mandatory vaccination of children.

The relationship between nasal polyps, bronchial asthma, allergic rhinitis, atopic dermatitis, and non-allergic rhinitis.

INTRODUCTION: Nasal polyps are frequently associated with bronchial asthma and rhinitis. The chronic nature of the symptoms, the high post-treatment recurrence rates, as well as various comorbidities, constitute key factors that significantly affect the quality of life of patients diagnosed with this condition. AIM: The purpose of the study was to estimate the prevalence of nasal polyps in the examined population and to assess the possible associative occurrence of nasal polyps (NP) with bronchial asthma (BA), allergic (AR) and non-allergic rhinitis (NAR), and atopic dermatitis (AD). MATERIAL AND METHODS: The ECRHS II and ISAAC questionnaires of the study group of 18,458 individuals, including 4,473 6-7-year-olds (24.2%), 4,675 13-14-year-olds (25.4%), and 9,310 20-44-year-olds (50.4%) were performed. RESULTS: The prevalence of nasal polyps in the examined group was 1.1%, reported by a total of 204 individuals. Nasal polyps were reported more frequently among urban residents (191 (1.1%)) than rural residents (13 (0.6%)). Our study demonstrated a correlation between the presence of nasal polyps and asthma, as well as allergic and non-allergic rhinitis The greatest risk factor for NP in the evaluated subpopulation with multiple allergic conditions was the co-existence of non-allergic rhinitis and atopic dermatitis (OR = 6.09; 95% CI: 3.4-10.93). CONCLUSIONS: Nasal polyps are relatively rare in the evaluated Polish population. Nonetheless, we believe their co-occurrence with non-allergic rhinitis, allergic rhinitis, bronchial asthma, and atopic dermatitis to be of significant importance, as it illustrates the phenomenon of multimorbidity of inflammatory conditions affecting the upper and lower respiratory tract.

The effect of infectious agents on the prevalence of allergies.

PURPOSE: The role of infectious agents in allergy development is ambivalent. On one hand, there are reports of an association between a previous infection (especially a viral respiratory tract infection) and developing hypersensitivity to inhaled allergens, which in turn may increase the risk of developing allergic reactions. On the other hand, there are reports emphasizing a protective effect of a number of infectious agents against allergy development. The aim the study was to find possible associations between a past infectious or parasitic disease and an allergic condition. MATERIAL AND METHODS: The study population was a group of 18,648 subjects. The study, which was a part of the project: 'Implementation of a System for the Prevention and Early Detection of Allergic Diseases in Poland', was conducted in 9 selected regions of Poland and used the ECRHS and ISAAC questionnaires adapted for Europe. The following statistical tools were used: Pearson's chi-squared test, Fisher's exact test, and logistic regression. RESULTS: This research was an attempt to clear association between a history of measles or viral hepatitis and the likelihood of developing asthma, especially in males (χ2 = 5.29; p<0.05). Past parasitic disease showed a clear association with a suspected allergic rhinitis in various groups of patients (differing both in terms of sex and age). CONCLUSIONS: A history of some forms of either infectious or parasitic diseases has a measurable effect on the risk of developing allergies.

Stimulation of an immune system by different types of allergens causes seasonal (late spring and summer) factors to increase probability of allergic rhinitis symptoms. The Epidemiology of Allergic Diseases in Poland (ECAP) survey: part two.

INTRODUCTION: Specific immunoglobulins E (sIgE) are important parameters to estimate severity of allergic diseases. AIM: To determine the relationship between the concentration of sIgE antibodies in serum and clinical outcome of allergic diseases. MATERIAL AND METHODS: The concentration of sIgE antibodies against allergens Dermatophagoides pteronyssinus, cat dander, Timothy grass, Alternaria alternata were determined in serum of 4077 respondents randomly selected from 9 regions (ECAP study). Positive results of sIgE (≥ 0.35 IU/ml) were correlated with answers in ECRHSII and ISAAC questionnaires. RESULTS: IgE antibodies are more frequently detected in respondents aged over 4 years when they had their first attack of asthma (cat dander p < 0.05, Timothy grass p < 0.05). IgE antibodies are less frequently detected in respondents aged over 29 years when they had the first allergic rhinitis symptoms as compared to respondents aged 0-19 years when they had the first allergic rhinitis symptoms (p < 0.05 to p < 0.001). Among respondents showing allergic rhinitis symptoms, IgE antibodies are more frequently detected in respondents showing those symptoms from May to August (p < 0.05 to p < 0.005). CONCLUSIONS: The first attack of asthma appears later mainly in patients whose immune systems are more strongly stimulated by allergens. Development of allergic rhinitis in patients aged over 29 years presumably needs weaker stimulation of their immune systems by allergens than in patients aged 0-19 years. Stimulation of an immune system by different types of allergens modifies its response in such a way that seasonal (late spring and summer) factors increase probability of allergic rhinitis symptoms.

Survey participations rates reporting ­ toward standardization in epidemiological studies

Participation rates are recognized as key indicators of the quality of the data collected during a survey. This is particularly important in epidemiological studies where the findings are extrapolated from the study sample to the general population. The response rate is very frequently selected as the key indicator of the overall quality of the data collected but the literature search shows that there are many different ways to calculate it. Only the use of the whole set of participation rates allows assessment of both the quality of the survey (the quality of the data collected) and the reliability of the fieldwork. Standardization of the methods for calculating participation rates seems to be a prerequisite for a reliable comparison of the quality of population surveys.

Correction to: Dissociating polysensitization and multimorbidity in children and adults from a Polish general population cohort.

[This corrects the article DOI: 10.1186/s13601-019-0246-y.].

Dissociating polysensitization and multimorbidity in children and adults from a Polish general population cohort.

Background: Links between multimorbidity of allergic diseases and allergen sensitization are still under debate, especially in adults. This study aimed to establish a relationship between polysensitization and allergic multimorbidity in children and adults and the allergens involved in multimorbidity. Material and method: A cross-sectional multicentre study enrolled children aged 6-7 and 13-14 years and adults aged 20-44 years from a Polish national cohort. The diagnosis of allergic diseases was made by a physician. Skin prick tests to 13 allergens and serum IgE levels to 4 allergens were tested. Results: Among the 3856 participants, single disease (asthma, allergic rhinitis or atopic dermatitis) was diagnosed in 27.7% subjects and allergic multimorbidity in 9.3%. Allergic multimorbidity occurred more commonly in children than in adults (p < 0.01). Asthma or atopic dermatitis alone were not associated with polysensitization. Rhinitis and multimorbidity were associated with polysensitization. Allergic multimorbidity occurred in 2.2% of participants with negative skin prick tests, 9.8% of those with one positive prick test (SPT ≥ 3 mm) and 20.6% of polysensitized ones (p < 0.001). There was an increasing risk of multimorbidity depending on the number of positive prick tests for both SPT ≥ 3 mm (OR 9.6-16.5) and SPT ≥ 6 mm (OR 5.9-13.7). A statistically significant relationship was found between allergic multimorbidity and sensitization to cat and mite allergens. Conclusions: Multimorbidity is associated with polysensitization especially in children compared with adults in Polish population cohort. New insights into single disease patterns were found: bronchial asthma is the strongest risk factor for the development of multimorbidity in comparison with allergic rhinitis and atopic dermatitis.

Effect of indoor air quality on the natural history of asthma in an urban population in Poland.

Background: Indoor air pollution may have an impact on asthma. Objective: To evaluate the influence of indoor air pollution on the natural history of asthma. Methods: Data collection by using the European Community Respiratory Health Survey and International Study of Asthma and Allergies in Childhood standardized questionnaire (N = 18,617) and medical examinations (N = 4783) in selected Polish regions was used. Statistical analysis was performed by using the χ² test. A value of p < 0.05 was considered statistically significant. Results: Questionnaire results demonstrated that people who used the central heating system were less likely to declare the occurrence of asthma (odds ratio [OR] 0.84) and were corroborated with clinical findings of moderate asthma (OR 0.35). Symptomatic asthma occurred more frequently in people who used a solid-fuel heating device (OR 1.36) and electric heaters (OR 1.54). The use of cooking appliances with municipal natural gas (OR 1.77) and gas storage tanks (OR 2.03) was correlated with more frequent declarations of asthma. Symptomatic asthma was more common among people who smoked for at least 1 year (OR 2.26) and those who smoked over the course of the preceding month (OR 1.60). Passive exposure to tobacco smoke provided for a 1.5-fold increase in the incidence of symptomatic asthma (OR 1.53), regardless of the time of exposure. Conclusion: Both active and passive tobacco smoke exposure as well as the use of certain types of heating and cooking appliances have a significant impact on the incidence of asthma and the intensification of its symptoms in rooms with limited air exchange. Highlights of the study included the following: (1) central heating had an amelioratory effect on asthma, (2) heating technologies used at home had a significant impact on the incidence of asthma, and (3) devices used for cooking (municipal and cylinder gas stoves) played an important role in the intensification of asthma symptoms.

The effect of selected risk factors, including the mode of delivery, on the development of allergic rhinitis and bronchial asthma.

INTRODUCTION: Cesarean section affects the process of colonization by bacteria transferred from the mother's skin and hospital bacteria, which in turn contributes to development of allergic conditions. AIM: To assess selected risk factors, including the mode of delivery, parity, and the role of genetic factors for the development of allergic rhinitis and bronchial asthma. MATERIAL AND METHODS: The study was conducted in 18,617 respondents aged 6-7, 13-14, and 20-44 years who completed the ECRHS II and ISSAC questionnaires. Thirty percent of the study population underwent complementary assessments in the form of skin-prick tests, serum IgE levels, lung function tests, and peak nasal inspiratory flow (PNIF). The study is a part of the Epidemiology of Allergic Disorders in Poland (ECAP) study conducted in 8 areas in Poland (Warsaw, Lublin, Bialystok, Gdansk, Poznan, Wroclaw, Katowice, Krakow, and two rural areas - Zamosc and Krasnystaw counties). RESULTS: Respondents diagnosed with allergic rhinitis were at a significantly higher risk of inheriting the allergic condition if their mother (OR = 2.17; 95% CI: 1.98-2.39, p = 2.00 × 10-16) or father (OR = 2.20; 95% CI: 1.96-2.47; p = 2.00 × 10-16) suffers from this allergy. Conversely, in the group diagnosed with bronchial asthma, the highest risk of an inherited allergy was observed in situations where maternal (OR = 2.00; 95% CI: 1.57-2.55; p = 1.69 × 10-5) or paternal (OR = 1.94; 95% CI: 1.42-2.66; p = 3.61 × 10-5) grandparent was affected. Moreover, the risk of developing allergic rhinitis depended on the mode of delivery: i.e. it was higher for a Cesarean section (OR = 1.20; 95% CI: 1.01-1.43; p = 0.04) than vaginal delivery (OR = 0.88; 95% CI: 0.78-0.99; p = 0.03). The higher the number of siblings, the lower the risk of allergic rhinitis. CONCLUSIONS: Allergy risk factors, especially those predisposing to allergic rhinitis, include not only genetic factors but also the mode of delivery: vaginal delivery or Cesarean section.

Extent of protective or allergy-inducing effects in cats and dogs.

OBJECTIVE: The study aimed to assess the effect of fur-bearing pets, including cats and dogs, on the health of individuals with allergic conditions. MATERIAL AND METHODS: The study group comprised 18,617 individuals (16,562 from urban and 2,055 from rural areas). The tool used in the study was the European Community Respiratory Health Survey (ECRHS) and International Study of Asthma and Allergies in Childhood (ISAAC) study questionnaire, adapted to European conditions (Middle and Eastern Europe) and used as part of the study Implementation of a System for the Prevention and Early Detection of Allergic Diseases in Poland. RESULTS: The factors determining the keeping of fur-bearing pets in a household included a larger living space and the number of cigarettes smoked, which were observed especially in urban settings. The keeping of fur-bearing animals in rural areas acts preventively against allergic conditions, while in urban areas, these animals were a factor clearly aggravating symptoms of bronchial asthma - the risk of cough (OR 1.921; CI 10-3.36; P=0.02) and wheezing (OR 2.60; CI 1.22-5.54; P=0.01). CONCLUSIONS: Fur-bearing animals kept in rural settings exhibit preventive effects on the development of allergies; whereas in urban areas they exacerbate allergic symptoms, especially the symptoms of bronchial asthma.

Probiotics: Myths or facts about their role in allergy prevention.

BACKGROUND: The hygiene hypothesis proposed by Strachan in the 1980s clearly emphasized the role of microorganisms in atopy prevention. OBJECTIVES: The study objective was to assess the preventive role of probiotics in patients with allergic rhinitis, bronchial asthma, atopic dermatitis, and/or food allergy. MATERIAL AND METHODS: The methods used in the study were the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaires for 6-7- and 13-14-year-olds and the European Community Respiratory Health Survey II (ECRHS II) questionnaire targeted for the 20-44 age group. The study was conducted as part of the cross-sectional Epidemiology of Allergic Diseases in Poland study conducted in 9 Polish regions (8 urban: Warszawa, Lublin, Bialystok, Gdansk, Poznan, Wroclaw, Katowice, Kraków, and the rural regions of Zamojski and Krasnostawski counties). The study material was a group of patients diagnosed with food allergy (n = 407), atopic dermatitis (n = 311), allergic rhinitis (n = 1.353), bronchial asthma (n = 505), and healthy volunteers (n = 2,403). RESULTS: Genetic factors play an important role in the allergy development. A family history positive for chronic skin disorders increased the risk of atopic dermatitis and food allergies (OR = 1.456, CI = 1.14-1.85, p = 0.002; and OR = 1.378, CI = 1.05-1.81, p = 0.02, respectively). The consumption of products containing live bacterial cultures showed no preventive effects in any of the evaluated disorders in early childhood. Conversely, over the age of 14 years, probiotic formulations exhibit health-promoting effects and may lower the risk of allergic diseases. CONCLUSIONS: The use of probiotics in the Polish population showed no protective effect in the first years of life. The changes in dietary habits introduced during late adolescence demonstrated significantly greater preventive effects of live bacterial cultures against the development of allergic diseases.

Haplotype dependent association of rs7927894 (11q13.5) with atopic dermatitis and chronic allergic rhinitis: A study in ECAP cohort.

The T allele of rs7927894 (at 11q13.5) was associated with atopic dermatitis and other allergic diseases. Our purpose was to replicate the association with allergic phenotypes and explore the role of rs7927894 in predisposing to persistent allergic rhinitis and atopic asthma. We also wanted to explore if other SNPs at 11q13.5 contributed to effect of rs7927894. We studied patients with atopic dermatitis (N = 270), atopic asthma (N = 486), persistent allergic rhinitis (N = 589) and controls matched for age, sex and region (N = 540, N = 372 and N = 1178, respectively). We found that rs7927894 T was associated with atopic dermatitis (OR = 1.39, CI: 1.12-1.73, P = 0.003) and independently with persistent allergic rhinitis (OR = 1.24, CI:1.07-1.43, P = 0.0043, Pcorrected = 0.013) but not atopic asthma. Analysis of additional tagging SNPs (rs7930763, rs2513517, rs7125552) showed that effect of rs7927894 T was limited to haplotypes encoding G at rs7125552. In conclusion, rs7927894 T is associated not only with atopic dermatitis but also persistent allergic rhinitis. Since these effects are haplotype dependent rs7927894 alone does not account for the association between 11q13.5 and atopic dermatitis/persistent allergic rhinitis.

Persons with allergy symptoms use alternative medicine more often.

INTRODUCTION: The aim of the study is to indicate the relation between the use of alternative medicine and the occurrence of allergic diseases in the Polish population of adults in the age of 20-44 years. Moreover the additional aim of the study is to define the relation between the sex, age and place of living and the use of alternative medicine. MATERIAL AND METHODS: The data from the project Epidemiology of Allergic Diseases in Poland (ECAP) has been used for analysis. This project was a continuation of the European Community Respiratory Health Survey II. The questions on alternative medicine were asked to the group of 4671 respondents in the age of 20-44 years. Additionally outpatient tests were performed in order to confirm the diagnosis of allergic diseases. RESULTS: The total of 22.2% of respondents that participated in the study have ever used alternative medicine (n = 4621). A statistically significant relation between the use of alternative medicine and declaration of allergic diseases and asthma symptoms has been demonstrated (p < 0.001). No statistically significant relation between the use of alternative medicine by persons diagnosed by a doctor with any form of asthma or seasonal allergic rhinitis (p > 0.05) has been demonstrated. CONCLUSIONS: The occurrence of allergic diseases and asthma influences the frequency of alternative medicine use. However the frequency of alternative medicine use does not depend on allergic disease or asthma being confirmed by a doctor.

Allergies in urban versus countryside settings in Poland as part of the Epidemiology of the Allergic Diseases in Poland (ECAP) study - challenge the early differential diagnosis.

INTRODUCTION: The incidence of allergies depends on a number of factors, including adopting an urban "western" lifestyle, genetic predispositions, and different regions of residence. AIM: To compare the prevalence of allergic conditions (seasonal allergic rhinitis (SAR) and perennial allergic rhinitis (PAR), bronchial asthma (BA), atopic dermatitis (AD)) in a group of countryside versus urban residents in Poland. MATERIAL AND METHODS: The prevalence of allergic conditions in urban versus countryside settings was assessed using the translated and approved questionnaire developed for international ECRHS II and ISAAC studies. Respondents were selected via random multistage sampling, with proportionate stratified sampling, and the Polish Resident Identification Number (PESEL) as the basis. A total of 18,617 respondents took part in the study. Subsequently, approximately 25% of the subjects underwent outpatient assessments: skin-prick, lung function, peak nasal inspiratory flow (PNIF) tests, as well as history-taking. RESULTS: Allergic rhinitis (AR) proved to be the most common condition in the entire study population. Children residing in the countryside were twice more likely to be diagnosed with BA (8.33% vs. 4%; p < 0.05). Conversely, in the adult subgroup, BA was more commonly observed in urban areas. Whereas reported symptom rates were much higher in AR and AD patients, symptomatic BA was proportionately lower with respect to the official diagnoses (underdiagnosed BA phenomenon). Atopic dermatitis was considerably more common in the metropolitan population. One factor that significantly correlated with allergic diseases was a positive family history. CONCLUSIONS: Inhabitants of metropolitan areas are to a greater extent predisposed to allergic conditions. One factor significantly contributing to allergies is genetic predisposition. Given the scale of the problem, there is an urgent need to implement measures for early prevention and diagnosis of allergies to minimize distant health effects.

Atopic dermatitis is a serious health problem in Poland. Epidemiology studies based on the ECAP study.

INTRODUCTION: Global epidemiological studies have revealed considerable geographical differences in prevalence of atopic dermatitis (AD). AIM: To present the epidemiology of AD, risk factors and co-occurrence of allergic diseases in the Polish population. MATERIAL AND METHODS: The present paper is a part of the Epidemiology of Allergic Disorders in Poland study. We studied 22 703 participants by ECRHS/ISAAC questionnaire; 18 617 (53.8% female, 24.2% 6-7 y.o., 25.4% 13-14 y.o., 50.4% 20-44 y.o.) completed questionnaires were accepted. Four thousand seven hundred and eighty-three participants (25.7%) have undergone a medical examination. RESULTS: Atopic dermatitis was diagnosed in 3.91% (6-7 y.o. 5.34%, 13-14 y.o. 4.3%, adults 3.02%), more often in females (OR = 1.52; 95% CI: 0.56-0.77), in the cities (OR = 2.23; 95% CI: 1.61-3.09), in mothers (OR = 2.07; 95% CI: 1.72-2.48) and fathers (OR = 2.00; 95% CI: 1.61-2.49) with atopy, higher education (OR = 1.61; 95% CI: 1.11-2.32) and economic status (OR = 1.35; 95% CI: 1.04-1.74). The highest prevalence was found in Katowice (4.89%) and lowest in rural areas (1.9%). Coexisting AD and allergic rhinitis (AR) was found in 26.17%, AR and asthma in 9.09% and AD, AR and asthma in 14.6%. Atopic dermatitis was diagnosed by allergologists in 6.5% (6-7 y.o. 8.7%, 13-14 y.o. 9.0%, adults 3.6%). Most diagnoses were made in Poznan (16.76%) and smallest in rural area (3.67%). 78.8% of subjects were diagnosed with AD for the first time although they had earlier experienced its symptoms. CONCLUSIONS: Atopic dermatitis prevalence in Poland is below the mean rate for Europe, but the risk factor profile is similar to other countries. Atopic dermatitis is more frequent in well-educated females with atopic parents and high socioeconomic status and who live in a city.

The effects of disease awareness on lifestyle changes and the use of preventive measures in asthma patients.

Reduction in asthma incidences and mortality, as well as improved quality of life, can be achieved via a wide use of prevention methods. A number of randomized cohort studies demonstrated the effectiveness of such management and the need for multiple treatments. Here, we evaluate whether asthma awareness influences the lifestyle and the use of prevention, as well as the effects of age, sex, economic status, and education on the use of prophylaxis. A total of 18,617 (53.8% female; 24.2% 6-7 years old, 25.4% 13-14 years old, and 50.4% 20-44 years old) were selected by a stratified cluster sampling method in eight cities and one rural area, each over 150,000 citizens. The sample was selected based on the methods and questionnaires of International Study of Asthma and Allergies in Childhood and European Community Respiratory Health Survey. Patients aware of asthma significantly less often (p < 0.05) reported owning asthma-inducing items and significantly more often reported behaviors minimizing the number of allergens (p < 0.05). Patients aware of asthma took all actions reducing their exposure to in-house allergens significantly more often than the healthy (p < 0.05) and individuals with symptoms only (p < 0.05). Allergy prevention was used more often in children (p < 0.0005), responders aware of diseases (p < 0.05), higher levels of education (p < 0.05), and higher household income (p < 0.05). The most common type of prophylaxis used is prophylactic actions, which are undertaken by patients diagnosed with asthma and who are aware of their disease. Adults do not use preventive measures as often as children or adolescents do. Higher rates of prevention-oriented behavior were observed in groups characterized by higher levels of education and higher household income.

Epidemiology of atopic dermatitis in Poland according to the Epidemiology of Allergic Disorders in Poland (ECAP) study.

Epidemiological studies (International Study of Asthma and Allergies in Childhood [ISAAC], The European Community Respiratory Health Survey [ECRHS]) revealed considerable geographical differences in prevalence of atopic dermatitis (AD). The aim of our study is to present the epidemiology and the risk factors of AD in a Polish population. A total of 18,617 subjects were selected. The sample included respondents in eight cities and one rural area each over 150,000 citizens. The study had two parts: (i) questionnaire survey conducted among all respondents (response rate, 64.4%); and (ii) allergological examination performed among 25.7% with skin prick test (SPT) with 15 aeroallergens. AD was identified in 3.91% of subjects, more often in females, living in the cities, with a mother and/or father with atopy and with a higher education and higher economic status. Comorbidities of AD were atopic rhinitis (AR) in 26.17% and AR and asthma in 14.6%. AD was diagnosed by allergologists in 311 subjects (6.5%). Positive SPT occurred in 66.9% persons with AD (house dust mite, 33.1%; grasses/crop plants, 30.6%). Of the patients, 9.5% with perennial versus 9.3% seasonal and 9.6% with polyvalent versus 9.0% monovalent sensitization had AD. AD prevalence in Poland is below the mean rate for Europe, but risk factor profile is similar to other countries. AD is more frequent in female, well-educated individuals, of high socioeconomic status, with atopic parents and who live in a city. Seasonal and monovalent atopy play a more essential role in subjects with AD compared with AR and asthma.