Environmental tobacco smoke and cardiometabolic risk in young children: results from a survey in south-west Germany.

AIMS: We explored the association between exposure to environmental tobacco smoke (ETS) and various cardiometabolic biomarkers in 10-year-old children. METHODS AND RESULTS: A population-based cross-sectional study was carried out. Data on ETS exposure and potential confounders were collected by parental questionnaire. Adiponectin, leptin, markers of inflammation, apolipoproteins (apo) AI and B, and lipoprotein-associated phospholipase A(2) (Lp-PLA(2)) were measured. Linear and logistic regression models were applied using the 90th percentile as a cut-off point except for adiponectin and apoAI (10th percentile). In linear models, ETS exposure was significantly associated with increasing plasma concentrations of leptin, C-reactive protein, fibrinogen, interleukin (IL)-6, and Lp-PLA(2). When compared with none, ETS exposure of more than 10 cigarettes per day was associated with elevated concentrations of leptin (OR 6.40; 95% CI, 2.67-15.39), C-reactive protein (OR 3.17; 95% CI, 1.31-7.68), Lp-PLA(2) (OR 2.97 95% CI, 1.32-6.68), low adiponectin (OR 2.69; 95% CI, 1.10-6.57), and low apoAI (OR 4.48; 95% CI, 2.16-10.85). Increasing dose of ETS exposure was related to an increasing number of abnormal cardiometabolic markers. CONCLUSION: Among children, ETS exposure was associated with a low-grade inflammatory response and altered markers of lipid metabolism, which may initiate atherosclerosis in early life. However, longitudinal studies are necessary to determine the potential causal relevance of these associations.

Association of apolipoproteins with symptoms of asthma and atopy among schoolchildren.

BACKGROUND: There is evidence for an association between serum cholesterol concentrations and asthma, but little is known about the underlying mechanisms. We explored the associations between serum apolipoprotein concentrations and symptoms of asthma and atopy. METHODS: In a population-based cross-sectional study among 10-year-old schoolchildren (n = 462), plasma concentrations of apolipoprotein AI (apoAI) and apolipoprotein B (apoB) were measured. Information on disease symptoms and diagnoses was collected by parental questionnaire. Multivariate logistic regression models were used to analyse the data. RESULTS: High plasma apoAI concentrations (>or=1.74 g/l) were associated with high prevalence of wheeze (OR 3.65; 95% CI 1.43-9.33), and a trend was seen with asthma (OR 3.35; 95% CI 0.94-11.93). In linear analyses, plasma apoAI concentrations were positively related to wheeze (beta-coefficient = 3.20; p = 0.045) and non-atopic wheeze (beta-coefficient = 4.47; p = 0.036), and a trend was found for asthma (beta-coefficient = 3.29; p = 0.099). Overall, plasma apoB concentrations were not associated with either symptoms of asthma or allergy. CONCLUSION: Our results support the hypothesis that high apoAI is associated with the manifestation of asthma and atopy. The underlying pathomechanism still remains to be fully elucidated, but suggests that immune mechanisms may play a central role. However, our results are based on a small study sample and larger studies are warranted to confirm these observations.

Associations of adipokines with asthma, rhinoconjunctivitis, and eczema in German schoolchildren.

There is growing evidence for an association between obesity and asthma, but little is known about the underlying mechanisms. We hypothesized that high plasma leptin and low plasma adiponectin concentrations might be related to asthma and allergies in children. Plasma leptin and adiponectin concentrations were measured in a cross-sectional study involving 462 children aged 10 years. Information on disease symptoms and diagnosis was collected by parental questioning. Multivariate linear and logistic regression models were used to assess the association between biomarkers and disease. High leptin levels were associated with increased lifetime prevalence of asthma [odds ratio (OR): 3.76; 95% confidence interval (CI): 1.42-9.92]. The relationship was particularly strong for non-atopic asthma (OR: 5.51; 95% CI: 1.99-17.51). No associations were observed between plasma leptin levels and hay fever, and rhinoconjunctivitis. Low adiponectin levels were associated with increased prevalence of both symptoms of atopic dermatitis (OR: 3.23; 95% CI: 1.28-7.76) and ever-diagnosed eczema (OR: 2.35; 95% CI: 1.13-4.89). In girls and non-atopic children, stronger associations for both leptin and adiponectin levels with asthma than in boys and atopic children were observed. These results suggest that adipokines may contribute to increased asthma and allergy risk in obese subjects. Stronger associations among girls with non-atopic asthma may indicate diverse pathological mechanisms.

Biomonitoring of persistent organochlorine pesticides, PCDD/PCDFs and dioxin-like PCBs in blood of children from South West Germany (Baden-Wuerttemberg) from 1993 to 2003.

In the context of a monitoring program, persistent organic pollutants (POPs) were quantified in the blood of 10 year old children at four different demographic regions in Baden-Wuerttemberg, a highly industrialised federal state in South West Germany. DDE, HCB, PCB 138, PCB 153 and PCB 180 were measured in 1996/1997, 1998/1999, 2000/2001 and 2002/2003 in individual samples of about 400 children per year. PCDD/PCDFs and some relevant coplanar PCBs were determined in pooled samples from children in seven cycles from 1993 to 2003. Blood concentrations of the investigated compounds decreased in that time period by a factor of 2-4 with the exception of most PCDFs. The concentrations of POPs in the blood of the children were distinctly lower than the concentrations reported for adults. Breast feeding was associated with about 30% higher median concentrations of DDE, HCB, PCBs and a 30% increase for mean PCDD/PCDF concentrations. Concerning demographic differences, significant lower concentrations of HCB, PCBs and PCDD/PCDFs could be seen in children from Mannheim compared to the region of Aulendorf. About 10-20% higher concentrations were found in boys compared to girls for HCB, indicator PCBs and PCDD/PCDFs. The pattern of non-ortho and mono-ortho PCBs in the blood of children was similar to the pattern reported for mother's milk, and PCB 126 and PCB 156 contributed about 70% to the toxicity of dioxin-like PCBs and about one-third to total TEQ including PCDD/PCDFs.

Major outbreak of hepatitis A associated with orange juice among tourists, Egypt, 2004.

In 2004, a major outbreak of hepatitis A among tourists returning from Egypt involved 351 case-patients from 9 European countries who were infected with a single strain (genotype 1 b). The case-control study identified orange juice as the most likely infection vehicle. Vaccination against hepatitis A virus is strongly recommended before travel to disease-endemic areas.

Fetal morbidity and mortality after acute human parvovirus B19 infection in pregnancy: prospective evaluation of 1018 cases.

OBJECTIVE: To determine more precisely the incidence of fetal complications following maternal parvovirus B19 infection at various gestational ages. METHODS: An observational prospective study of 1018 pregnant women whose acute B19 infection was serologically confirmed in our laboratory. RESULTS: The observed rate of fetal death throughout pregnancy was 6.3% (64/1018) (95% confidence interval [CI]: 4.9, 8.0). The fetal death rate for those infected within the first 20 weeks of gestation (WG) was 64/579 (11.0%). Fetal death was only observed when maternal B19 infection occurred before the completed 20 WG. The observed stillbirth proportion was 0.6% (6/960). Three of six stillbirth cases presented with fetal hydrops. The overall risk of hydrops fetalis was 3.9% (40/1018) (95% CI: 2.8, 5.3). Three of 17 cases with non-severe hydrops and 13 of 23 cases with severe hydrops received intrauterine transfusion(s). The proportion of fetuses with severe hydrops that survived following fetal transfusions was 11/13 (84.6%). All of the non-transfused fetuses with severe hydrops died. CONCLUSION: Our data demonstrate a relevant B19-associated risk of fetal death, which is largely confined to maternal B19 infection in the first 20 WG. Timely intrauterine transfusion of fetuses with severe hydrops fetalis reduces the risk of fetal death. Parvovirus B19-associated stillbirth without hydropic presentation is not a common finding.