The cost of productivity losses associated with allergic rhinitis.
(33/846)
OBJECTIVE: To measure the cost of absenteeism and reduced productivity associated with allergic rhinitis. METHODS: The National Health Interview Survey (NHIS) was used to obtain information on days lost from work and lost productivity due to allergic rhinitis. Wage estimates for occupations obtained from the Bureau of Labor Statistics (BLS) were used to calculate the costs. RESULTS: Productivity losses associated with a diagnosis of allergic rhinitis in the 1995 NHIS were estimated to be $601 million. When additional survey information on the use of sedating over-the-counter (OTC) allergy medications, as well as workers' self-assessments of their reduction in at-work productivity due to allergic rhinitis, were considered, the estimated productivity loss increased dramatically. At-work productivity losses were estimated to range from $2.4 billion to $4.6 billion. CONCLUSION: Despite the inherent difficulty of measuring productivity losses, our lowest estimate is several times higher than previous estimates of the indirect medical costs associated with allergic rhinitis treatment. The most significant productivity losses resulted not from absenteeism but from reduced at-work productivity associated with the use of sedating OTC antihistamines. (+info)
Influence of intranasal steroids during the grass pollen season on bronchial responsiveness in children and young adults with asthma and hay fever.
(34/846)
BACKGROUND: It has been reported that intranasal corticosteroids can influence bronchial hyperresponsiveness (BHR) in asthmatic subjects with seasonal rhinitis. The purpose of the present study was to evaluate the effect of intranasal fluticasone propionate and beclomethasone dipropionate on BHR and bronchial calibre (forced expiratory volume in one second, FEV(1)) in children and young adults with seasonal rhinitis and mild asthma during two consecutive grass pollen seasons. METHODS: In the first pollen season 25 patients aged 8-28 years were included in a double blind, placebo controlled study. The active treatment group used fluticasone aqueous spray 200 microgram once daily. In the second pollen season 72 patients aged 8-28 years participated in a double blind, placebo controlled study of a similar design to that of the previous year except that an additional treatment group of patients using beclomethasone 200 microg twice daily was included. FEV(1) was measured before and after three and six weeks of treatment; BHR to methacholine (PD(20)) was measured before and after six weeks of treatment. RESULTS: In the first season the mean (SD) logPD(20) of the patients decreased significantly both in the fluticasone group (from 2.43 (0.8) microgram to 1.86 (0.85) microgram) and in the placebo group (from 2.41 (0.42) microgram to 1.87 (0.78) microgram) without any intergroup difference in the change in logPD(20). In the second pollen season the mean logPD(20) in the fluticasone, beclomethasone, and placebo groups did not change significantly. CONCLUSIONS: Intranasal steroids did not influence BHR during two grass pollen seasons in children and young adults with seasonal rhinitis and mild asthma. (+info)
Comparison of asthma prevalence in the ISAAC and the ECRHS. ISAAC Steering Committee and the European Community Respiratory Health Survey. International Study of Asthma and Allergies in Childhood.
(35/846)
International and regional prevalence comparisons are required to test and generate hypotheses regarding the causes of increasing asthma prevalence in various age groups worldwide. The International Study of Asthma and Allergies in Childhood (ISAAC) is the first such study in children and the European Community Respiratory Health Survey (ECRHS) is the first such study in adults. Therefore, a comparison of the findings of these two surveys was conducted, for the 17 countries in which both surveys were undertaken. There was a strong correlation between the ISAAC and ECRHS prevalence data, with 64% of the variation at the country level, and 74% of the variation at the centre level, in the prevalence of "wheeze in the last 12 months" in the ECRHS phase I data being explained by the variation in the ISAAC phase I data. There was also generally good agreement in the international patterns observed in the two surveys for self-reported asthma (74% of country level and 36% of centre level variation explained), self-reported asthma before age 14 yrs (64 and 26%), hay fever (61 and 73%) and eczema (41 and 50%). Thus although there were differences in the absolute levels of prevalence observed in the two surveys, there is good overall agreement between the International Study of Asthma and Allergies in Childhood and European Community Respiratory Health Survey study findings with regard to international prevalence patterns. These findings, therefore, add support to the validity of the two studies, which provide a new picture of global patterns of asthma prevalence from child- to adulthood, and identify some of the key phenomena which future research must address. (+info)
T cell epitope-containing hypoallergenic recombinant fragments of the major birch pollen allergen, Bet v 1, induce blocking antibodies.
(36/846)
Allergen-specific immunotherapy represents one of the few curative approaches toward type I allergy. Up to 25% of allergic patients are sensitized against the major birch pollen allergen, Bet v 1. By genetic engineering we produced two recombinant (r) Bet v 1 fragments comprising aa 1-74 and aa 75-160 of Bet v 1, which, due to a loss of their native-like fold, failed to bind IgE Abs and had reduced allergenic activity. Here we show that both fragments covering the full Bet v 1 sequence induced human lymphoproliferative responses similar to rBet v 1 wild type. The C-terminal rBet v 1 fragment induced higher lymphoproliferative responses than the N-terminal fragment and represented a Th1-stimulating segment with high IFN-gamma production, whereas the N-terminal fragment induced higher IL-4, IL-5, and IL-13 secretion. Immunization of mice and rabbits with rBet v 1 fragments induced IgG Abs, which cross-reacted with complete Bet v 1 and Bet v 1-related plant allergens and strongly inhibited the IgE binding of allergic patients to these allergens. Thus, our results demonstrate that hypoallergenic T cell epitope-containing rBet v 1 fragments, despite lacking IgE epitopes, can induce Abs in vivo that prevent the IgE binding of allergic patients to the wild-type allergen. The overall demonstration of the immunogenic features of the hypoallergenic rBet v 1 fragments will now enable clinical studies for safer and more efficient specific immunotherapy. (+info)
Continued increase in the prevalence of asthma and atopy.
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AIMS: To describe the change in the prevalence of wheeze, diagnosed asthma, and atopy in Wagga Wagga, NSW, Australia, between 1992 and 1997, and to compare this to the increase in prevalence reported between 1982 and 1992. METHODS: A cross sectional study of the prevalence of respiratory symptoms and atopy in schoolchildren aged 8-11 years (n = 1016, response rate 71%) in 1997 compared with studies of similar design in 1992 (response rate 83%, n = 850) and 1982 (response rate 88%, n = 769). Main outcome measures were respiratory symptoms measured by parent completed questionnaire and atopy measured by skin prick tests. RESULTS: Between 1992 and 1997, the prevalence of wheeze increased by 5.1% (95% CI 1.2 to 9.0), asthma diagnosis by 8.1% (95% CI 3.8 to 12.4), and atopy by 6.7% (95% CI 2.2 to 11.2). Similar increases in prevalence had been found between 1982 and 1992. CONCLUSIONS: The prevalence of wheeze, asthma diagnosis, and atopy in Wagga Wagga has continued to increase. (+info)
Seasonal rhinitis in a cat sensitized to Japanese cedar (Cryptomeria japonica) pollen.
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A cat showing seasonal allergic symptoms of rhinitis was examined for reactivities to Japanese cedar (Cryptomeria japonica, CJ) pollen allergen by intradermal skin test (IDST), Prausnitz-Kustner (P-K) test, and lymphocyte blastogenic response. In IDST for 26 common allergens. the cat showed a positive reaction to CJ pollen allergen. P-K test using CJ pollen allergen also showed a positive reaction, indicating the presence of serum IgE specific to CJ pollen. In the lymphocyte blastogenic response, the stimulation index in the presence of CJ pollen allergen was 2.4. These data suggested that the seasonal rhinitis observed in the cat was caused by the sensitization to CJ pollen allergen. (+info)
Association between air pollution and daily consultations with general practitioners for allergic rhinitis in London, United Kingdom.
(39/846)
Few published studies have looked at the health effects of air pollution in the primary care setting, and most have concentrated on lower rather than upper respiratory diseases. The authors investigated the association of daily consultations with general practitioners for allergic rhinitis with air pollution in London, United Kingdom. Generalized additive models were used to regress time series of daily numbers of patients consulting for allergic rhinitis against 1992--1994 measures of air pollution, after control for possible confounders and adjustment for overdispersion and serial correlation. In children, a 10th--90th percentile increase in sulfur dioxide (SO(2)) levels 4 days prior to consultation (13-31 microg/m(3)) was associated with a 24.5% increase in consultations (95% confidence interval: 14.6, 35.2; p < 0.00001); a 10th--90th percentile increase in averaged ozone (O(3)) concentrations on the day of consultation and the preceding 3 days (6--29 parts per billion) was associated with a 37.6% rise (95% confidence interval: 23.3, 53.5; p < 0.00001). For adults, smaller effect sizes were observed for SO(2) and O(3). The association with SO(2) remained highly significant in the presence of other pollutants. This study suggests that air pollution worsens allergic rhinitis symptoms, leading to substantial increases in consultations. SO(2) and O(3) seem particularly responsible, and both seem to contribute independently. (+info)
Increased frequency of asymptomatic bronchial hyperresponsiveness in nonasthmatic patients with food allergy.
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Subclinical inflammation in gut mucosa has been demonstrated in bronchial asthma suggesting the whole mucosal system is involved in allergic diseases. The presence of subclinical bronchial involvement was assessed by nonspecific bronchial hyperresponsiveness (BHR) in nonasthmatic patients with food allergy (FA). BHR was studied in 35 patients with various manifestations of FA without food-induced asthma. Sixteen had a previous history of asthma and/or rhinitis to aeroallergens (group A), whereas 19 patients (group B) did not. BHR was defined by a provocative dose causing a 20% fall in forced expiratory volume in one second of (PC20) <8 mg.mL(-1) of methacholine. Asymptomatic BHR occurred frequently in nonasthmatic patients with FA (10 of 19, 53%); this did not significantly differ from patients with FA and a previous history of asthma and/or rhinitis to aeroallergens (13 of 16, 81%). PC20 was significantly lower in group A (1.84+/-0.53 mg.mL(-1)) than in group B (3.35+/-0.74 mg.mL(-1); p<0.05). The number of patients with positive skin tests to aeroallergens was similar between groups. Sequential evaluation, performed 1 year after initial evaluation, in 7 nonasthmatic patients (group B) demonstrated a similar level of BHR. The present study demonstrated that BHR is a frequent finding in nonasthmatic patients with food allergy which may be due, at least in part, to a subclinical inflammatory process in the bronchi. (+info)