Evaluation of selected aspects of the hygiene hypothesis and their effect on the incidence of allergy.

OBJECTIVES: The development of allergic conditions is largely dependent on the interactions between genetic (individual genetic predisposition) and environmental factors (exposure to risk factors). The aim of this study was an attempt to assess the influence of selected elements of the hygiene theory in the development of allergic diseases such as allergic rhinitis and asthma. MATERIAL AND METHODS: The study group consisted of 5518 women and 3868 men. The method that was used was the European Community Respiratory Health Survey II and International Study of Asthma and Allergies in Childhood questionnaire validated and adapted to Central and Eastern European conditions. The project was conducted in 8 urban areas (Gdansk, Wroclaw, Poznan, Katowice, Kraków, Lublin, Bialystok, Warsaw) and 1 rural area (Krasnystaw county). This study had 2 stages; the first stage involved grouping the 22 500 respondents based on their questionnaire responses with the use of a Personal Digital Assistant (PDA); the second stage involved 7000 subjects, who underwent additional assessments: skin prick tests (birch, grasses/cereals, Dermatophagoides pteronyssinus and Dermatophagoides farinae, molds [set I: Botrytis cinerea, Cladosporium herbarum, Alternaria tenuis, Curvularia lunata, Fusarium moniliforme, Helminthosporium], molds [set II: Aspergillus fumigatus, Mucor mucedo, Penicillium notatum, Pullularia pullulans, Rhizopus nigricans, Serpula lacrymans], cat, dog, molds Cladosporium herbarum, Alternaria tenuis) and spirometry tests. RESULTS: The age at which children attend the nursery school is critical to the development of allergic diseases; in allergic rhinitis, the risk of an IgE-dependent reaction is 2 times higher in the second than in the first year of life (p = 0.00147, p < 0.05), while in asthma, having a large number of siblings increases the risk of developing obstructive disease by almost 6 times (p = 0.00316, p < 0.05).The age at which children attend the nursery school is critical to the development of allergic diseases; in allergic rhinitis, the risk of an IgE-dependent reaction is 2 times higher in the second than in the first year of life (p = 0.00147, p < 0.05), while in asthma, having a large number of siblings increases the risk of developing obstructive disease by almost 6 times (p = 0.00316, p < 0.05). CONCLUSIONS: The hygiene theory is particularly applicable and can explain the relationship of selected habits in the development of allergic diseases. Int J Occup Med Environ Health. 2023;36(1):69-83.

Place of residence, gender, month of birth and age influence on the concentration of specific IgE antibodies in serum. The Epidemiology of Allergic Diseases in Poland (ECAP survey): part three.

Introduction: Specific immunoglobulins E (sIgE) are important parameters to estimate the severity of allergic diseases. Aim: To determine the influence of gender, age and place of residence on the concentration of specific IgE antibodies in serum. Material and methods: The concentration of sIgE antibodies against allergens of Dermatophagoides pteronyssinus, cat dander, timothy grass, Alternaria alternata were determined in serum of 4077 respondents randomly selected from 8 regions (ECAP study). The positive results of sIgE (≥ 0.35 IU/ml) were correlated with answers to ECAP questionnaires. Results: IgE antibodies are less frequently detected in respondents living in the country (p < 0.05 to p < 0.005); and they are less frequently detected in respondents living in cities of hardly industrialised regions than in respondents living in cities of industrialised regions (D. pteronyssinus p < 0.05, cat dander p < 0.01). IgE antibodies are more frequently detected in men (p < 0.005 to p < 0.001). IgE antibodies are more frequently detected in respondents born in May-July (timothy grass p < 0.005, Alternaria alternata p < 0.005) and less frequently detected in respondents born in August-October (timothy grass p < 0.005, Alternaria alternata p < 0.05). Conclusions: Characteristics of the urban environment, non-specific factors and gender affect the concentration of specific IgE antibodies in serum. Influence of seasonal allergens within the first months of life and/or in the course of the foetal period alters the production of specific IgE antibodies.

Inhalation risk to PAHs and BTEX during barbecuing: The role of fuel/food type and route of exposure.

The manuscript presents an innovative and holistic approach to quantifying PAHs and BTEX emissions from the grilling process and indicates a novel driven-toxicity-based solution to recognize health effects related to BBQ emissions. The exposure scenario includes the type of grilling device, food type, and individual attitudes, but also a keen understanding of the broad health implications related to the gaseous/particulate PAHs emission, or age-related effects. The calculated incremental lifetime cancer risk (ILCR) associated with the exposure to PAH congeners and BTEX indicates an unacceptable level in the case of charcoal and briquette grilling with the highest values for professional cooks. The sum of 15 PAH concentrations in grilled foods was highest for meat grilling over charcoal briquettes - 382,020.39 ng/m3 and lowest for meat grilling on a gas grill - 1442.16 ng/m3. The emissions of BTEX from lump charcoal grilling were 130 times higher compared to the gaseous grill. In all considered scenarios lump-charcoal and charcoal briquettes grilling derive the ILCR above the 10-4, indicating negative effects of traditional grills on human health. The paper completes knowledge of wide-ranging health implications associated with BBQs, a topic that is almost completely unaddressed among the scientific community and policymakers.

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.

Building age, type of indoor heating and the occurrence of allergic rhinitis and asthma.

INTRODUCTION: Structural materials and interior appliances are frequently mentioned as elements of modern buildings which may have an impact on the natural history of allergic diseases. AIM: We hypothesized that the building age, the type of the heating system and the use of various indoor appliances can influence the occurrence of allergic rhinitis (AR) and asthma. MATERIAL AND METHODS: The study group comprised 18,617 individuals. The tool used in the study was the European Community Respiratory Health Survey (ECRHS) and the 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 called "Implementation of a System for the Prevention and Early Detection of Allergic Diseases in Poland". RESULTS: Questionnaire results indicated that people living in homes built in the years 1971-1990 had higher rates of allergic rhinitis (OR = 1.15025), which was correlated with clinical findings of increased occurrence of seasonal allergic rhinitis (OR = 1.60543). The leading factor contributing to the intensification of AR symptoms was the central heating (OR = 1.45358). As opposed to AR, people living in buildings with central heating less often declared asthma (OR = 0.8407). A clinical examination confirmed that central heating reduced the symptoms of moderate asthma (OR = 0.3524). CONCLUSIONS: Increasing building age and certain indoor heating methods are important risk factors for the occurrence of allergic rhinitis and asthma.

Organizational model for the management of patients with chronic allergic conditions.

INTRODUCTION: Allergic conditions present a serious problem for the Polish population. The most common form of allergy is allergic rhinitis. Due to its chronic nature and a complex pathophysiological mechanism the allergic rhinitis could be associated with others comorbidities. That is why it is a poses a considerable bio-psychosocial problem both for the affected individual patient and for the healthcare system. AIM: To identify organizational factors and analyse their effect on patients with chronic allergic conditions. MATERIAL AND METHODS: The study group comprised 9,370 respondents (including 1,967 patients with allergic rhinitis (AR), 372 patients with self-reported bronchial asthma (BA1), and 351 patients with physician-diagnosed bronchial asthma (BA2)) aged from 20 to 44 years, some of whom were additionally examined (skin pick tests) in an outpatient setting. The findings obtained in the outpatient subgroup (n = 4,783) were analysed in more detail. The study was based on translated and validated ECRHS and ISAAC questionnaires. RESULTS: Over a half of the evaluated patients with AR visited a specialist due to their symptoms. Some respondents neither visited their doctor regularly nor had regular check-ups, which undoubtedly affected their quality of life. CONCLUSIONS: The authors propose an organizational model incorporating the position of a healthcare educator (HE) as a coordinator in the process of managing chronic allergic conditions in adult patients within the Polish healthcare system. Adult patient education by the HE would include introducing the principles of secondary and tertiary prevention in order to improve the quality of life in patients with chronic allergic conditions.

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.].

Self-Assembled Supramolecular Ribbon-Like Structures Complexed to Single Walled Carbon Nanotubes as Possible Anticancer Drug Delivery Systems.

Designing an effective targeted anticancer drug delivery method is still a big challenge, since chemotherapeutics often cause a variety of undesirable side effects affecting normal tissues. This work presents the research on a novel system consisting of single walled carbon nanotubes (SWNT), dispersed with Congo Red (CR), a compound that forms self-assembled ribbon-like structures (SRLS) and anticancer drug doxorubicin (DOX). SWNT provide a large surface for binding of planar aromatic compounds, including drugs, while CR supramolecular ribbon-like assemblies can be intercalated by drugs, like anthracycline rings containing DOX. The mechanism of interactions in SWNT-CR-DOX triple system was proposed based on electrophoretic, spectral, Dynamic Light Scattering and scanning electron microscopy analyzes. The profile of drug release from the investigated system was evaluated using dialysis and Differential Scanning Calorimetry. The results indicate that ribbon-like supramolecular structures of CR bind to SWNT surface forming SWNT-CR complexes which finally bind DOX. The high amount of nanotube-bound CR greatly increases the capacity of the carrier for the drug. The high capacity for drug binding and possible control of its release (through pH changes) in the analyzed system may result in prolonged and localized drug action. The proposed SWNT-CR-DOX triple system meets the basic criteria that justifies its further research as a potential drug carrier.

Amyloids, Congo red and the apple-green effect.

This paper attempts to find evidence of the previously proposed opinion that amyloids complex with Congo red molecules which preserve their supramolecular organization. As evidence of the overpowering tendency of Congo red molecules to self-assemble, we present an increasing acidity of molecules that follows increasing concentration of the dye, and a highly notable nonlinear increase in absorbance in the UV band (300-400 nm). This effect is analyzed in a model where the amyloid fibril is simulated by polyvinyl alcohol, providing a scaffold to stabilize a long Congo red micelle. Enormous absorbance in the UV band, coupled with the increasing association capabilities of individual Congo red molecules may cause the absorbance to extend even into the visible band. In addition, the UV and visual absorbance bands shift significantly, depending on conditions, and may either approach or recede from each other, leading to spectral changes which may be observed under polarized light. This commonly observed spectral variability appears to be associated with the strong capacity for electron delocalization in supramolecular Congo red complexed with amyloids.

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 association between paracetamol use and the risk of asthma, rhinitis and eczema in the Polish population.

INTRODUCTION: A growing number of epidemiological studies suggest that paracetamol, which is commonly used in children, may be a risk factor for asthma, allergic rhinitis, and atopic eczema. OBJECTIVE: The aim of this study was to determine and characterize the correlation between paracetamol use and asthma, allergic rhinitis, and atopic eczema symptoms in the Polish population. MATERIAL AND METHODS: The study is part of the ECAP project involving the use of the ISAAC and ECRHS questionnaires. Completed questionnaires of 18,617 subjects, including 10,011 (53.8%) females, were analyzed. Children aged 6-7 (n=4,510), adolescents aged 13-14 (n=4,721), and adults aged 20-44 (n=9,386) constituted 24.2%, 25.4%, and 50.4% of respondents, respectively. Study subjects lived in 8 major urban centres and one rural area. The frequency of paracetamol use during the previous 12 months and symptoms of asthma, allergic rhinitis, and atopic eczema during that period were analyzed. RESULTS: The use of paracetamol was associated with a significant dose-dependent increase in the risk of asthma symptoms in all evaluated age groups. This was demonstrated via odds ratios (OR) for developing asthma symptoms, including wheezing or whistling in the chest in 6-7-year-olds and exercise-induced shortness of breath in 13-14-year-olds and adults, depending on the frequency of paracetamol use in the previous 12 months, compared to no paracetamol intake during that period. CONCLUSIONS: The use of paracetamol in the last 12 months was associated with a significant dose-dependent increase in the risk of rhinitis and skin allergy symptoms, as demonstrated by the odds ratio. Therefore, frequent paracetamol use may be a risk factor for symptoms of asthma, rhinitis, and skin allergy in the Polish population.

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.

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.

Wplyw wybranych czynników srodowiskowych na maksymalny przeplyw nosowy wdechowy - czesc projektu ECAP (Epidemiologia Chorób Alergicznych w Polsce).

Celem niniejszej pracy byla próba okreslenia wplywu wybranych czynników/parametrów na wynik maksymalnego przeplywu nosowego wdechowego (PNIF, ang. peak nasal inspiratory flow) w badanej populacji polskiej projektu Epidemiologia Chorób Alergicznych w Polsce (ECAP). Material/metody: Badana populacje stanowila grupa dzieci w wieku 6-7 lat (n=1123), mlodziezy w wieku 13-14 lat (n=1136) oraz doroslych (n=1876) zamieszkalych w siedmiu duzych polskich miastach. W badaniu posluzono sie pomiarem maksymalnego przeplywu nosowego wdechowego (PNIF). Do oceny wplywu wybranych czynników na wartosci PNIF wykorzystano przetlumaczone i walidowane kwestionariusze opracowane na potrzeby swiatowych badan ECRHS II (European Community Respiratory Health Survey II) i ISAAC (International Study of Asthma and Allergies in Childhood). Wyniki: Okreslone warunki wewnatrz gospodarstwa domowego, m.in. ogrzewanie weglem, drewnem lub piecem gazowym, istotnie zwiekszaja przekrwienie blony sluzowej nosa. W grupie biernych palaczy PNIF byl nizszy niz w grupie czynnych palaczy. Wskaznik PNIF malal wraz ze wzrostem liczby domowników palacych papierosy. Wnioski: Wybrane czynniki srodowiska.

Dispersion of single-wall carbon nanotubes with supramolecular Congo red - properties of the complexes and mechanism of the interaction.

A method of dispersion of single-wall carbon nanotubes (SWNTs) in aqueous media using Congo red (CR) is proposed. Nanotubes covered with CR constitute the high capacity system that provides the possibility of binding and targeted delivery of different drugs, which can intercalate into the supramolecular, ribbon-like CR structure. The study revealed the presence of strong interactions between CR and the surface of SWNTs. The aim of the study was to explain the mechanism of this interaction. The interaction of CR and carbon nanotubes was studied using spectral analysis of the SWNT-CR complex, dynamic light scattering (DLS), differential scanning calorimetry (DSC) and microscopic methods: atomic force microscopy (AFM), transmission (TEM), scanning (SEM) and optical microscopy. The results indicate that the binding of supramolecular CR structures to the surface of the nanotubes is based on the "face to face stacking". CR molecules attached directly to the surface of the nanotubes can bind further, parallel-oriented molecules and form supramolecular and protruding structures. This explains the high CR binding capacity of carbon nanotubes. The presented system - containing SWNTs covered with CR - offers a wide range of biomedical applications.

Silver ions as em marker of congo red ligation sites in amyloids and amyloid-like aggregates.

Congo red (CR) is a known selective amyloid ligand. The focus of our work is identification (by EM imaging) of dye binding sites and their distribution in amyloids and amyloid-like aggregates formed in vitro. In order to produce the required contrast, CR has been indirectly combined with metal via including Titan yellow (TY) by intercalation which exhibits a relatively strong affinity for silver ions. The resulting combined ligand retains its ability to bind to proteins (which it owes to CR) and can easily be detected in EM studies thanks to TY. We have found, however, that in protein aggregates where unfolding is stabilized by aggregation and therefore is irreversible, TY alone may serve as both, the ligand and the metal carrier. The formation of ordered structures in amyloids was studied using IgG light chains with amyloidogenic properties, converted into amyloids by shaking. The resulting EM images were subjected to interpretation on the basis of the authors' earlier research on the CR/light chain complexation process. Our results indicate that dimeric light chains, which are the subject of our study, produce amyloids or amyloid-like complexes with chain-like properties and strong helicalization tendencies. Cursory analysis suggests that the edge polypeptide loops belonging to unstable light chains form intermolecular bridges which promote creation of loose gel deposits, or are otherwise engaged in the swapping processes leading to higher structural ordering.

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.

Nasal patency in Poles in the light of research as part of the project on Epidemiology of Allergic Diseases in Poland.

OBJECTIVE: The aim of this study was to estimate the reference values for nasal inspiratory flow in the study population in Poland as part of the project on Epidemiology of Allergic Diseases in Poland (ECAP). MATERIALS AND METHOD: The study subjects were a group of 4,137 people: 1,136 children aged 6-7 years (561 girls and 575 boys), 1,123 adolescents aged 13-14 years (546 girls, 577 boys) and 1,878 adults (1,145 women, 733 men), residing in seven large Polish cities. The method used in the study was the measurement of the peak nasal inspiratory flow (PNIF) using a special mask for rhinomanometry tests, with a measurement scale of 20-350 L/min. Measurements were conducted twice: once before and once after nasal mucosa vasoconstriction with a 0.1% xylometazoline (Xylometazolinum) solution. RESULTS: Nasal patency rates increased with age in healthy subjects (children aged 6-7 years: 75.95 L/min; teenagers aged 13-14 years: 91.44 L/min and adults: 97.13 L/min (P<0.05). Similarly significant correlations were observed in the study group based on the region of residence (P<0.05). A moderate correlation was observed between PNIF and height as well as weight (with correlation coefficients r=0.51, P<0.05; and r=0.49, P<0.05, respectively). Interestingly, the observed difference in nasal vasoconstriction varied considerably between study subgroups with respect to the pre-determined criteria of age, gender, place of residence, and clinical diagnosis (allergic rhinitis vs. healthy controls), with the mean rates of 25-28%. CONCLUSIONS: Any attempt to determine reference values for a given study population should include a number of variables, such as age, height, body weight, which can noticeably affect study results.

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.