The influence of sensitisation to pollens and moulds on seasonal variations in asthma attacks

1. C. Canova*, 
2. J. Heinrich#, 
3. J.M. Anto¶,+,§,f, 
4. B. Leynaert**, 
5. M. Smith##,
6. N. Kuenzli¶¶,++, 
7. J.-P. Zock¶,+,§, 
8. C. Janson§§, 
9. I. Cerveriff,
10. R. de Marco***, 
11. K. Toren###, 
12. T. Gislason¶¶¶, 
13. D. Nowak+++, 
14. I. Pin§§§,
15. M. Wjstfff, 
16. J. Manfreda****, 
17. C. Svanes####, 
18. J. Crane¶¶¶¶,
19. M. Abramson++++, 
20. M. Burr§§§§, 
21. P. Burney* and 
22. Deborah Jarvis*⇓

+Author Affiliations

1. ^*Respiratory Epidemiology and Public Health and MRC-HPA Centre for Environment and Health, National Heart and Lung Institute, Imperial College, London, UK
2. ^#Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
3. ^¶Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
4. ⁺Hospital del Mar Research Institute (IMIM), Barcelona, Spain
5. ^§CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
6. ^fDept of Life and Experimental Sciences, Universitat Pompeu Fabra, Barcelona, Spain
7. ^**National Institute of Health and Medical Research, INSERM Unit 700, Paris, France
8. ^##Medical University of Vienna, Dept of Oto-Rhino-Laryngology, Research Unit Aerobiology and Pollen information, Vienna, Austria
9. ^¶¶University of Basel, Basel, Switzerland
10. ⁺⁺Swiss Tropical and Public Health Institute (Swiss TPH), Basel, Switzerland
11. ^§§Dept of Medical Sciences, Respiratory Medicine and Allergology, Uppsala University, Uppsala, Sweden
12. ^ffClinica di Malattie dell'Apparato Respiratorio, Fondazione Ricovero e Cura a Carattere Scientifico Policlinico S. Matteo, Università di Pavia, Pavia, Italy
13. ^***Unit of Epidemiology and Medical Statistics, Dept of Medicine and Public Health, University of Verona, Verona, Italy
14. ^###Section of Occupational and environmental medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
15. ^¶¶¶Faculty of Medicine, University of Iceland, Iceland
16. ⁺⁺⁺Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Ludwig-Maximilians-University, Munich, Germany
17. ^§§§CHU de Grenoble; INSERM, U823, Institut Albert Bonniot, University Joseph Fourier, Grenoble, France
18. ^fffInstitute of Lung Biology and Disease, CPC - Comprehensive Pneumology Center, Helmholtz Center Munich - German Research Center for Environmental Health, Munich, Germany
19. ^****Dept of Medicine, University of Manitoba, Winnipeg, Canada
20. ^####Institute of Medicine, University of Bergen, Bergen, Norway
21. ^¶¶¶¶Wellington Asthma Research Group, University of Otago, Wellington, New Zealand
22. ⁺⁺⁺⁺Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
23. ^§§§§Dept of Primary Care and Public Health, Cardiff University, Cardiff, UK

1. Deborah Jarvis, MBBS MRCP MD FFPHM, Respiratory Epidemiology and Public Health, Imperial College, London, Emmanuel Kaye Building, Manresa Road, London. SW3 6LR, E-mail: d.jarvis@imperial.ac.uk

Abstract

No large study has described seasonal variation in asthma attacks in population based asthmatics in whom sensitisation to allergen has been measured.

2,637 young adults with asthma living in 15 countries reported months in which they usually had attacks of asthma and had skin prick tests performed. Differences in seasonal patterns by sensitisation status were assessed using generalised estimating equations.

Most young adults with asthma reported periods of the year when their asthma attacks were more common (range 47% in Sweden to 86% in Spain). Seasonal variation in asthma was not modified by sensitisation to house dust mite or cat. Asthmatics sensitised to grass, birch and Alternaria had different seasonal patterns to those not sensitised to each allergen, with some geographical variation. In Southern Europe, those sensitised to grass were more likely to report attacks occurred in spring/summer than in winter (ORMarch/April=2.60; 95%CI 1.70–3.97; ORMay/June=4.43; 95%CI 2.34–8.39) and smaller later peaks were observed in Northern Europe (ORMay/June=1.25; 95%CI 0.60–2.64; ORJuly/August1.66; 95%CI 0.89–3.10). Asthmatics reporting hayfever but who were not sensitised to grass showed no seasonal variations.

Seasonal variation in asthma attacks in young adults is common and is different depending on sensitisation to outdoor, but not indoor, allergens.

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This Article

1. Published online before print March 7, 2013, doi:10.1183/09031936.00097412ERJ March 7, 2013erj00974-2012

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