The association of smoking with sensitization to common environmental allergens: Results from the European Community Respiratory Health Survey☆,☆☆,★,★★
Section snippets
METHODS
The methods used in the ECRHS have been described in detail elsewhere.15, 16 Briefly, participating centers selected areas for study that were predefined by existing administrative boundaries, had populations of at least 150,000 people, and had up to date sampling frames of 20 to 44 year old subjects where possible. In the first stage of the study, at least 1500 people of each sex were sent questionnaires enquiring about respiratory symptoms and attacks of asthma in the previous 12 months and
RESULTS
Subjects from 34 centers in 14 different countries were included in the analysis.
Total and specific IgE levels were available from 13,002 (76.1%) of the 17,096 subjects who took part in the second stage of the survey. There was variation in the response to blood testing between centers (43.3% in Portland, USA, to 98.2% in Erfurt, Germany). In the sample there were 5526 lifetime nonsmokers, 2766 exsmokers (2433 with full and consistent information on pack-years of smoking), and 4710 current
DISCUSSION
This study has shown that smoking was associated differently with sensitization to 3 common environmental allergens while being consistently associated in a dose-dependent fashion with high total IgE levels. Because of the cross-sectional design of the study and the potential for healthy-smoker bias, analyses have been conducted including and excluding those with current respiratory symptoms. These analyses confirm that current smoking is an important risk factor for sensitization to house dust
Acknowledgements
We thank Dr Jonathan Sterne for his support and advice. We also thank the late Colette Baya and Dr Manuel Hallen for their help during the study and Professor K. Vuylsteek and the members of the COMAC for their support.
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*The names and location of participants in the European Community Respiratory Health Survey can be found in the appendix.
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Supported by the European Commission and the following grants for local studies: Australia: Allen and Hanbury’s, Australia; Belgium: Belgian Science Policy Office, National Fund for Scientific Research; France: Ministère de la Santé, Glaxo France, Insitut Pneumologique d’Aquitaine, Contrat de Plan Etat-Région Languedoc-Rousillon, CNMATS, CNMRT (90MR/10, 91AF/6), Ministre delegué de la santé, RNSP; Germany: GSF, and the Bundesminister für Forschung und Technologie, Bonn; Greece: The Greek Secretary General of Research and Technology, Fisons, Astra and Boehringer-Ingelheim; India: Bombay Hospital Trust; Italy: Ministero dell’Università e della Ricerca Scientifica e Tecnologica, CNR, Regione Veneto grant RSF n. 381/05.93; New Zealand: Asthma Foundation of New Zealand, Lotteries Grant Board, Health Research Council of New Zealand; Norway: Norwegian Research Council project no. 101422/310; Portugal: Glaxo Farmacêutica Lda, Sandoz Portugesa; Spain: Ministero Sanidad y Consumo FIS grants #91/0016060/00E-05E and #93/0393, and grants from Hospital General de Albacete, Hospital General Juan Ramón Jiménenz, Consejeria de Sanidad Principado de Asturias; Sweden: The Swedish Medical Research Council, the Swedish Heart Lung Foundation, the Swedish Association against Asthma and Allergy; Switzerland: Swiss national Science Foundation grant 4026-28099; United Kingdom: National Asthma Campaign, British Lung Foundation, Department of Health, South Thames Regional Health Authority; USA: United States Department of Health, Education and Welfare Public Health Service Grant #2 S07 RR05521-28.
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Reprint requests: Deborah Jarvis, MRCP, MFPHM, Department of Public Health Medicine, 5th Floor, Capital House, 42 Weston St, London SE1 3QD.
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