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Comparison of individual-level and population-level risk factors for rhinoconjunctivitis, asthma, and eczema in the International Study of Asthma and Allergies in Childhood (ISAAC) Phase Three

Title: Comparison of individual-level and population-level risk factors for rhinoconjunctivitis, asthma, and eczema in the International Study of Asthma and Allergies in Childhood (ISAAC) Phase Three
Authors: Rutter, CE; Silverwood, RJ; Asher, MI; Ellwood, P; Pearce, N; Garcia-Marcos, L; Strachan, DP; ISAAC Phase Three Study Group
Publisher Information: Elsevier
Publication Year: 2020
Collection: St George's University of London: Repository
Description: Background Symptoms of asthma, allergic rhinoconjunctivitis, and atopic eczema in children cluster at both the individual and population levels. Objectives To assess individual-level and school-level risk factors for symptoms of rhinoconjunctivitis and compare them to corresponding associations with symptoms of asthma and eczema in Phase Three of the International Study of Asthma and Allergies in Childhood. Methods We studied 116,863 children aged 6–7 years from 2163 schools in 59 centres and 22 countries and 224,436 adolescents aged 13–14 years from 2037 schools in 97 centres in 41 countries. Multilevel logistic regression models were fitted with random intercepts for school, centre, and country, adjusting for sex and maternal education at the child level. Associations between symptoms and a range of lifestyle and environmental risk factors were assessed for both the child's exposure and mean exposure at the school. Models were fitted for rhinoconjunctivitis, asthma, and eczema singly (unimorbidity) and for combinations of these conditions (multimorbidity). Results Generally, associations between symptoms and exposures at the school level were similar in direction and magnitude to those at the child level. Associations with multimorbidity were stronger than for unimorbidity, particularly in individuals with symptoms of all three diseases, but risk factor associations found in conventional single disease analyses persisted among children with only one condition, after excluding multimorbid groups. Comparisons of individuals with only one disease showed that many risk factor associations were consistent across the three conditions. More strongly associated with asthma were low birthweight, cat exposure in infancy, and current maternal smoking. Current paracetamol use was more strongly associated with asthma and rhinoconjunctivitis than eczema. Breastfeeding was more strongly associated with eczema than asthma or rhinoconjunctivitis. The direction and magnitude of most risk factor associations were similar in ...
Document Type: article in journal/newspaper
File Description: application/pdf
Language: English
ISSN: 1939-4551
Relation: https://openaccess.sgul.ac.uk/id/eprint/111919/6/WAOJ%20paper%20as%20published%20online.pdf; https://openaccess.sgul.ac.uk/id/eprint/111919/1/ISAAC3%20Rhinitis%20Synthesis%20Paper%20final.pdf; Rutter, CE; Silverwood, RJ; Asher, MI; Ellwood, P; Pearce, N; Garcia-Marcos, L; Strachan, DP; ISAAC Phase Three Study Group (2020) Comparison of individual-level and population-level risk factors for rhinoconjunctivitis, asthma, and eczema in the International Study of Asthma and Allergies in Childhood (ISAAC) Phase Three. World Allergy Organization Journal, 13 (6). p. 100123. ISSN 1939-4551 https://doi.org/10.1016/j.waojou.2020.100123 SGUL Authors: Strachan, David Peter
Availability: https://openaccess.sgul.ac.uk/id/eprint/111919/; https://openaccess.sgul.ac.uk/id/eprint/111919/6/WAOJ%20paper%20as%20published%20online.pdf; https://openaccess.sgul.ac.uk/id/eprint/111919/1/ISAAC3%20Rhinitis%20Synthesis%20Paper%20final.pdf
Rights: cc_by_4
Accession Number: edsbas.A8EFC6C
Database: BASE