Ethnicity, childhood environment and atopic disorder.
BACKGROUND
The International Study of Asthma and Allergies in Childhood (ISAAC) has demonstrated large differences in the prevalence of atopic disorders in children between different regions in the world. Populations with a higher standard of living and a more westernized lifestyle tend to have higher rates of atopy and asthma. Many hypotheses regarding environmental causes of atopic disorder focus on the early childhood environment.


OBJECTIVE
To study the influence of ethnicity and country of birth for the prevalence of atopic disorders.


METHODS
The prevalence of atopic disorders in Swedish residents born in Turkey and Chile, who settled in Sweden as adults in the 1980s, was compared with their own Swedish-born children and a sample of Swedish-born parents and their children in interview data from the Survey of Living Conditions in 1996. The study group included 1734 adults 27-60 years of age and their 2964 children aged 3-15.


RESULTS
The Chilean-born parents and their children had the highest risk for allergic asthma; adjusted odds ratios (ORs) 2.2 (1.2-4.0) and 2.7 (1.6-4.5), respectively, and allergic rhino-conjunctivitis; OR 1.6 (1.1-3) and 1.6 (1.1-2.5) in both groups, when compared with the Swedish-born parents and their children. The Turkish-born parents and their children had the lowest risk for allergic rhino-conjunctivitis; both groups had OR 0.6 (0. 4-0.9) and the children in this group also had the lowest risk for eczema; OR; 0.4 (0.3-0.7). The risk for all atopic disorders was lower in the Turkish group compared with the Chileans.


CONCLUSIONS
This study demonstrates that ethnicity is an important determinant of atopic disorder independent of the external childhood environment. The value of international comparisons of environment and risk for atopic disorders can be questioned until more is known about factors related to ethnicity, such as genetic susceptibility and diet, for the development of atopy.
Hjern
A
A
Department of Clinical Sciences, Huddinge University Hospital, Karolinska Institutet, Stockholm; Centre for Epidemiology, National Board of Health and Welfare, Stockholm, Sweden.
Haglund
B
B
Hedlin
G
G
D000328:Adult; D002677:Chile / Q000208:ethnology; D005260:Female; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000208:ethnology*; D008297:Male; D015995:Prevalence; D013548:Sweden / Q000453:epidemiology; D014421:Turkey / Q000208:ethnology