Respiratory epidemiology review (February 9, 2010)

Work-related respiratory diseases in the EU [Sigsgaard et al – ERJ]
New European Respiratory Society report surveys the epidemiology of the major occupational respiratory diseases in the EU, with a look at historic and contemporary risk factors, and an update on regulation. Highlights the emerging burden of occupational lung disease in “newer professions, such as public administration, education and occupational cleaning,” as well as the continued prevalence in traditional high-risk occupations, such as mining, farming, manufacturing and service work.

Social determinants of asthma [Cruz et al. – ERJ]
Editorial accompanying a report in ERJ by Sembajwe et al. on the relationship between gross national income, the prevalence of symptoms and doctor diagnosis of asthma. Cruz et al. review the interesting bimodal association between socioeconomic status and asthma and offer some thoughts on the puzzle, and the important distinction between risk of asthma ever and current symptoms: “Gross national product per capita is generally associated with both an increasing prevalence of wheezing ever and wheezing in the last 12 months. However, the prevalence of current symptoms is modifiable by current exposures (to allergens and environmental pollution,as well as other factors) and by effective treatment. Thus,even where prevalence is low, the burden of disease may be high, and poverty emerges as an important risk factor for current symptoms of asthma.”

What Genes Tell us about the Pathogenesis of Asthma and COPD [Weiss – AJRCCM]
“Recently a series of Genome Wide Association Study manuscripts (GWAS) in asthma and COPD have been published. These papers suggest that, in part, asthma and COPD have a common genetic origin, and that this common origin, is due to polymorphisms in genes that are involved with the development of the lung.”

Hygiene Hypothesis wanted: Dead or Alive [Linneberg letter and Douwes and Pearce reply – IJE]
This month IJE has published an interesting exchange between Allan Linneberg ( and Douwes and Pearce (, who suggest that “detailed exposure assessment strategies for both allergens and other potentially protective co-exposures are likely to shed new light on the roles of these exposures in the development of asthma and the validity of the hygiene and allergen tolerance hypotheses more generally.”

Follow up discussion to an editorial (PDF) published in 2008 by Jeroen Douwes and Neal Pearce, called, “The end of the hygiene hypothesis?” which concluded that “New aetiological theories of global asthma prevalence are, therefore, required that are more consistent with the epidemiological evidence and which take into account factors affecting the time trends for both allergic and non-allergic asthma.”

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