Journal of Korean Medical Science

Korean Acad Medical Sciences (대한의학회)
권호 표지
DOI QR코드

DOI QR Code

Prevalence of Allergic Diseases among Korean School-age Children: A Nationwide Cross-Sectional Questionnaire Study

  • Suh, Mi-Na (Department of Preventive Medicine, Environmental Research, Yonsei University College of Medicine) ;
  • Kim, Ho-Hyun (Institute for Environmental Research, Yonsei University College of Medicine) ;
  • Sohn, Myung-Hyun (Department of Pediatrics, Yonsei University College of Medicine) ;
  • Kim, Kyu-Earn (Department of Pediatrics, Yonsei University College of Medicine) ;
  • Kim, Chang-Soo (Department of Preventive Medicine, Environmental Research, Yonsei University College of Medicine) ;
  • Shin, Dong-Chun (Department of Preventive Medicine, Environmental Research, Yonsei University College of Medicine)
  • Published : 2011.03.30
⟨ Previous Next ⟩

Abstract

The purpose of this study was to investigate the nationwide prevalence of childhood asthma, eczema and other allergic diseases in Korean school-age children (8-11 yr old) and to assess the difference between residential areas. Among 6,279 elementary schools, 427 schools were randomly selected according to residential area (metropolitan, provincial, rural, and industrial area) by the cluster sampling method. Parents of students completed a modified Korean version of a questionnaire formulated by the International Study of Asthma and Allergies in Childhood (ISAAC). Among 50,200 subjects, 31,026 (61.8%) responded, and 30,893 (99.6%) were analyzed. The 12-month prevalence of wheeze, flexural rash, and allergic rhinitis symptoms were 4.8%, 15.3%, and 32.9%, respectively. The prevalence of diagnosis of allergic diseases in boys was higher than that in girls, with the exception of eczema. In both boys and girls, the difference of the prevalence of allergic diseases among industrial, metropolitan and provincial areas was not statistically significant, but the differences between rural area and other areas were significant. Our results support the importance of contextual effect associated with residential area as causative agents of allergic diseases among Korean school-age children.

Keywords

References

  1. The International Study of Asthma and Allergies in Childhood (ISAAC) Steering Committee. Worldwide variation in prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and atopic eczema: ISAAC. Lancet 1998; 351: 1225-32. https://doi.org/10.1016/S0140-6736(97)07302-9
  2. Ellwood P, Asher MI, Beasley R, Clayton TO, Stewart AW; ISAAC Steering Committee. The international study of asthma and allergies in childhood (ISAAC): phase three rationale and methods. Int J Tuberc Lung Dis 2005; 9: 10-6.
  3. Beasley R, Crane J, Lai CK, Pearce N. Prevalence and etiology of asthma. J Allergy Clin Immunol 2000; 105: S466-72. https://doi.org/10.1016/S0091-6749(00)90044-7
  4. Fineman SM. The burden of allergic rhinitis: beyond dollars and cents. Ann Allergy Asthma Immunol 2002; 88 (4 Suppl 1): 2-7. https://doi.org/10.1016/S1081-1206(10)62022-4
  5. Sennhauser FH, Braun-Fahrlander C, Wildhaber JH. The burden of asthma in children: a European perspective. Paediatr Respir Rev 2005; 6: 2-7. https://doi.org/10.1016/j.prrv.2004.11.001
  6. Yoon SJ, Bae SC, Lee SI, Chang H, Jo HS, Sung JH, Park JH, Lee JY, Shin Y. Measuring the burden of disease in Korea. J Korean Med Sci 2007; 22: 518-23. https://doi.org/10.3346/jkms.2007.22.3.518
  7. Brauer M, Hoek G, Van Vliet P, Meliefste K, Fischer PH, Wijga A, Koopman LP, Neijens HJ, Gerritsen J, Kerkhof M, Heinrich J, Bellander T. Brunekreef B. Air pollution from traffic and the development of respiratory infections and asthmatic and allergic symptoms in children. Am J Respir Crit Care Med 2002; 166: 1092-8. https://doi.org/10.1164/rccm.200108-007OC
  8. Ryan PH, Lemasters GK, Biswas P, Levin L, Hu S, Lindsey M, Bernstein DI, Lockey J, Villareal M, Khurana Hershey GK, Grinshpun SA. A comparison of proximity and land use regression traffic exposure models and wheezing in infants. Environ Health Perspect 2007; 115: 278-84.
  9. Nordling E, Berglind N, Melen E, Emenius G, Hallberg J, Nyberg F, Pershagen G, Svartengren M, Wickman M, Bellander T. Traffic-related air pollution and childhood respiratory symptoms, function and allergies. Epidemiology 2008; 19: 401-8. https://doi.org/10.1097/EDE.0b013e31816a1ce3
  10. Liao PF, Sun HL, Lu KH, Lue KH. Prevalence of childhood allergic diseases in central Taiwan over the past 15 years. Pediatr Neonatol 2009; 50: 18-25. https://doi.org/10.1016/S1875-9572(09)60025-5
  11. von Mutius E. Asthma and allergies in rural areas of Europe. Proc Am Thorac Soc 2007; 4: 212-6. https://doi.org/10.1513/pats.200701-028AW
  12. Sozanska B, Macneill SJ, Kajderowicz-Kowalik M, Danielewicz H, Wheatley M, Newman Taylor AJ, Boznanski A, Cullinan P. Atopy and asthma in rural Poland: a paradigm for the emergence of childhood respiratory allergies in Europe. Allergy 2007; 62: 394-400. https://doi.org/10.1111/j.1398-9995.2007.01346.x
  13. Wong GW, Chow CM. Childhood asthma epidemiology: insights from comparative studies of rural and urban populations. Pediatr Pulmonol 2008; 43: 107-16. https://doi.org/10.1002/ppul.20755
  14. Lee SI, Shin MH, Lee HB, Lee JS, Son BK, Koh YY, Kim KE, Ahn YO. Prevalences of symptoms of asthma and other allergic diseases in Korean children: a nationwide questionnaire survey. J Korean Med Sci 2001; 16: 155-64.
  15. Hong SJ, Lee MS, Sohn MH, Shim JY, Han YS, Park KS, Ahn YM, Son BK, Lee HB; Korean ISAAC Study Group. Self-reported prevalence and risk factors of asthma among Korean adolescents: 5-year follow-up study, 1995-2000. Clin Exp Allergy 2004; 34: 1556-62. https://doi.org/10.1111/j.1365-2222.2004.02084.x
  16. Bae JM, Shin KS. Estimating the prevalence of atopic dermatitis in school students of Jejudo, Korea. J Prev Med Public Health 2009; 42: 171-6. https://doi.org/10.3961/jpmph.2009.42.3.171
  17. Lee JG, Moon HJ, Kim KS, Yoon JH, Kim SS, Park IY. Epidemiological study for allergic disease of school aged children and adolescence in rural area of Korea. Korean J Otolaryngol - Head Neck Surg 1998; 41: 1156-63.
  18. Yeon NS, Sun YH, Kyung KW. Prevalence of allergic disease in kindergarten age children in Korea. Pediatr Allergy Respir Dis 2005; 15: 439-45.
  19. Asher MI, Montefort S, Bjorksten B, Lai CK, Strachan DP, Weiland SK, Williams H; ISAAC Phase Three Study Group. Worldwide time trends in the prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and eczema in childhood: ISAAC phases one and three repeat multicountry cross-sectional surveys. Lancet 2006; 368: 733-43. https://doi.org/10.1016/S0140-6736(06)69283-0
  20. Anderson HR, Pottier AC, Strachan DP. Asthma from birth to age 23: incidence and relation to prior and concurrent atopic disease. Thorax 1992; 47: 537-42. https://doi.org/10.1136/thx.47.7.537
  21. Pekkanen J, Remes ST, Husman T, Lindberg M, Kajosaari M, Koivikko A, Soininen L. Prevalence of asthma symptoms in video and written questionnaires among children in four regions of Finland. Eur Respir J 1997; 10: 1787-94. https://doi.org/10.1183/09031936.97.10081787
  22. Chang HY, Mitzner W. Sex differences in mouse models of asthma. Can J Physiol Pharmacol 2007; 85: 1226-35. https://doi.org/10.1139/Y07-116
  23. Osman M, Tagiyeva N, Wassall HJ, Ninan TK, Devenny AM, McNeill G, Helms PJ, Russell G. Changing trends in sex specific prevalence rates for childhood asthma, eczema, and hay fever. Pediatr Pulmonol 2007; 42: 60-5. https://doi.org/10.1002/ppul.20545
  24. Musharrafieh U, Al-Sahab B, Zaitoun F, El-Hajj MA, Ramadan F, Tamim H. Prevalence of asthma, allergic rhinitis and eczema among Lebanese adolescents. J Asthma 2009; 46: 382-7. https://doi.org/10.1080/02770900902777775
  25. Fagan JK, Scheff PA, Hryhorczuk D, Ramakrishnan V, Ross M, Persky V. Prevalence of asthma and other allergic diseases in an adolescent population: association with gender and race. Ann Allergy Asthma Immunol 2001; 86: 177-84. https://doi.org/10.1016/S1081-1206(10)62688-9
  26. Jansen DF, Timens W, Kraan J, Rijcken B, Postma DS. (A)symptomatic bronchial hyper-responsiveness and asthma. Respir Med 1997; 91: 121-34. https://doi.org/10.1016/S0954-6111(97)90048-2
  27. Weinberg EG. Urbanization and childhood asthma: an African perspective. J Allergy Clin Immunol 2000; 105: 224-31. https://doi.org/10.1016/S0091-6749(00)90069-1
  28. Liao MF, Liao MN, Lin SN, Chen JY, Huang JL. Prevalence of allergic diseases of schoolchildren in central Taiwan. From ISAAC surveys 5 years apart. J Asthma 2009; 46: 541-5. https://doi.org/10.1080/02770900902795546
  29. Majkowska-Wojciechowska B, Pelka J, Korzon L, Kozlowska A, Kaczala M, Jarzebska M, Gwardys T, Kowalski ML. Prevalence of allergy, patterns of allergic sensitization and allergy risk factors in rural and urban children. Allergy 2007; 62: 1044-50. https://doi.org/10.1111/j.1398-9995.2007.01457.x

Cited by

  1. Association Between Body Mass Index and Asthma Symptoms Among Korean Children: A Nation-Wide Study vol.26, pp.12, 2011, https://doi.org/10.3346/jkms.2011.26.12.1541
  2. Genetic Association between Eotaxin Genes and Asthma and Its Relationship to Birth Season in Korean Children vol.9, pp.1, 2011, https://doi.org/10.5808/gi.2011.9.1.012
  3. Use of Intravenous Immunoglobulin in the Treatment of Childhood Atopic Dermatitis vol.3, pp.2, 2011, https://doi.org/10.4168/aair.2011.3.2.65
  4. The prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and eczema in Korean children: Nationwide cross-sectional survey using complex sampling design vol.54, pp.7, 2011, https://doi.org/10.5124/jkma.2011.54.7.769
  5. Current status of managing food allergies in schools in Seoul, Korea vol.16, pp.4, 2011, https://doi.org/10.1177/1367493512448128
  6. The Prevalence of Atopic Dermatitis, Asthma, and Allergic Rhinitis and the Comorbidity of Allergic Diseases in Children vol.27, pp.None, 2011, https://doi.org/10.5620/eht.2012.27.e2012006
  7. Association between Household Income and Asthma Symptoms among Elementary School Children in Seoul vol.27, pp.None, 2011, https://doi.org/10.5620/eht.2012.27.e2012020
  8. Analysis of Polycheck Allergy Results of the Recent Two Years: Comparison with Skin Prick Test and ImmunoCAP vol.2, pp.3, 2012, https://doi.org/10.3343/lmo.2012.2.3.139
  9. The Effect of Active Smoking and Second-hand Smoke on Wheezing and Asthma among Korean Adolescents vol.32, pp.4, 2011, https://doi.org/10.15709/hswr.2012.32.4.605
  10. Sensitization rates to inhalant allergens in children and adolescents of Incheon and Asan area and the relationship between polysensitization and prevalence of allergic diseases vol.1, pp.1, 2011, https://doi.org/10.4168/aard.2013.1.1.41
  11. The effect of Korean red ginseng on allergic inflammation in a murine model of allergic rhinitis vol.37, pp.2, 2011, https://doi.org/10.5142/jgr.2013.37.167
  12. Gene-environment interaction between Toll-like receptor 4 and mold exposure in the development of atopic dermatitis in preschool children vol.1, pp.2, 2011, https://doi.org/10.4168/aard.2013.1.2.129
  13. Analysis of the association between air pollution and allergic diseases exposure from nearby sources of ambient air pollution within elementary school zones in four Korean cities vol.20, pp.7, 2011, https://doi.org/10.1007/s11356-012-1358-2
  14. Respiratory Effects of the Hebei Spirit Oil Spill on Children in Taean, Korea vol.5, pp.6, 2011, https://doi.org/10.4168/aair.2013.5.6.365
  15. Classification and Epidemiology of Allergic Rhinitis vol.85, pp.5, 2011, https://doi.org/10.3904/kjm.2013.85.5.445
  16. A Nationwide Survey of Inhalant Allergens Sensitization and Levels of Indoor Major Allergens in Korea vol.6, pp.3, 2011, https://doi.org/10.4168/aair.2014.6.3.222
  17. Changes in Allergen Sensitization Over The Last 30 Years in Korea Respiratory Allergic Patients: A Single-Center vol.6, pp.5, 2011, https://doi.org/10.4168/aair.2014.6.5.434
  18. Exposure assessment and health risk of poly-brominated diphenyl ether (PBDE) flame retardants in the indoor environment of elementary school students in Korea vol.470, pp.None, 2014, https://doi.org/10.1016/j.scitotenv.2013.09.013
  19. 아토피 환자의 치료선택 경향에 대한 설문연구 vol.27, pp.1, 2011, https://doi.org/10.6114/jkood.2014.27.1.037
  20. Changes of aeroallergen sensitization in children with asthma or allergic rhinitis from a tertiary referral hospital in Seoul over 10 years vol.2, pp.2, 2011, https://doi.org/10.4168/aard.2014.2.2.97
  21. Association Between Antibiotic Exposure, Bronchiolitis, and TLR4 (rs1927911) Polymorphisms in Childhood Asthma vol.7, pp.2, 2011, https://doi.org/10.4168/aair.2015.7.2.167
  22. The relationship between asthma and bronchiolitis is modified by TLR4, CD14, and IL‐13 polymorphisms vol.50, pp.1, 2011, https://doi.org/10.1002/ppul.22978
  23. Prevalence and allergens of allergic rhinitis in children and adolescents in Gwangju vol.3, pp.1, 2011, https://doi.org/10.4168/aard.2015.3.1.54
  24. Indoor total volatile organic compounds exposure at 6？months followed by atopic dermatitis at 3 years in children vol.26, pp.4, 2011, https://doi.org/10.1111/pai.12393
  25. A 9-year Trend in the Prevalence of Allergic Disease Based on National Health Insurance Data vol.48, pp.6, 2011, https://doi.org/10.3961/jpmph.15.011
  26. Socioeconomic and sociodemographic factors related to allergic diseases in Korean adolescents based on the Seventh Korea Youth Risk Behavior Web-based Survey: a cross-sectional study vol.16, pp.None, 2011, https://doi.org/10.1186/s12887-016-0549-2
  27. 청소년 알레르기 질환 유병률과 관련 요인 -2013년 청소년 건강행태 온라인조사 활용 vol.27, pp.1, 2011, https://doi.org/10.7465/jkdi.2016.27.1.155
  28. Near-Road Exposure and Impact of Air Pollution on Allergic Diseases in Elementary School Children: A Cross-Sectional Study vol.57, pp.3, 2011, https://doi.org/10.3349/ymj.2016.57.3.698
  29. The Prevalence of Allergic Rhinitis, Eczema and Asthma in Students of Guidance Schools in Mazandaran Province, Iran vol.4, pp.4, 2011, https://doi.org/10.3889/oamjms.2016.112
  30. Epidemiology of Chronic Urticaria in Korea Using the Korean Health Insurance Database, 2010-2014 vol.9, pp.5, 2011, https://doi.org/10.4168/aair.2017.9.5.438
  31. School Absenteeism Associated with Asthma and Allergic Diseases in Korean School-Aged Children vol.31, pp.3, 2011, https://doi.org/10.1089/ped.2017.0835
  32. Dog and Cat Allergies: Current State of Diagnostic Approaches and Challenges vol.10, pp.2, 2018, https://doi.org/10.4168/aair.2018.10.2.97
  33. Studies and proposals of childhood asthma in Korea vol.6, pp.suppl1, 2011, https://doi.org/10.4168/aard.2018.6.s1.s52
  34. Anti-inflammatory effect of wogonin on allergic responses in ovalbumin-induced allergic rhinitis in the mouse vol.9, pp.None, 2011, https://doi.org/10.1177/2152656718764145
  35. Comparison of Multiple Allergen Simultaneous Test and ImmunoCAP for the Diagnosis of Allergic Rhinitis vol.61, pp.1, 2018, https://doi.org/10.3342/kjorl-hns.2017.00381
  36. Time trends of the prevalence of allergic diseases in Korea: A systematic literature review vol.8, pp.1, 2011, https://doi.org/10.5415/apallergy.2018.8.e8
  37. 만성질환에 관한 잠재계층분석과 예측요인 -2014 국민건강영양조사를 중심으로- vol.19, pp.6, 2018, https://doi.org/10.5762/kais.2018.19.6.324
  38. Health-related quality of life by allergy symptoms in elementary school students vol.16, pp.None, 2011, https://doi.org/10.1186/s12955-018-0922-y
  39. Infantile Anaphylaxis in Korea: a Multicenter Retrospective Case Study vol.34, pp.13, 2011, https://doi.org/10.3346/jkms.2019.34.e106
  40. Recent changing pattern of aeroallergen sensitization in children with allergic diseases: A single center study vol.7, pp.4, 2019, https://doi.org/10.4168/aard.2019.7.4.186
  41. Optimization of Allergen Panels for Diagnosis of Allergic Rhinitis vol.62, pp.11, 2011, https://doi.org/10.3342/kjorl-hns.2019.00451
  42. A cross sectional survey on health-related quality of life among parents of children with allergic symptoms using the EQ-5D-5L vol.56, pp.11, 2011, https://doi.org/10.1080/02770903.2019.1571086
  43. Trends of Sensitization to Inhalant Allergens in Korean Children Over the Last 10 Years vol.61, pp.9, 2020, https://doi.org/10.3349/ymj.2020.61.9.797
  44. Potential Co-Factors of an Intraoral Contact Allergy—A Cross-Sectional Study vol.8, pp.3, 2011, https://doi.org/10.3390/dj8030083
  45. Impact of Environmental Factors on the Prevalence Changes of Allergic Diseases in Elementary School Students in Ulsan, Korea: A Longitudinal Study vol.17, pp.23, 2011, https://doi.org/10.3390/ijerph17238831
  46. Current Asthma Prevalence Using Methacholine Challenge Test in Korean Children from 2010 to 2014 vol.36, pp.19, 2011, https://doi.org/10.3346/jkms.2021.36.e130
  47. Changes in allergen sensitization in children with allergic diseases in the 1980 to 2019 vol.9, pp.4, 2021, https://doi.org/10.4168/aard.2021.9.4.208