title: Onset of allergy and asthma symptoms in extra-European immigrants to Milan, Italy: possible role of environmental factors.
abstract: BACKGROUND
  Allergy and asthma are typical disorders of the affluent societies. Migrants from developing to industrialized countries seem to be at increased risk of allergy and asthma development.
  
  
  OBJECTIVE
  To evaluate time of onset, spectrum of sensitization and clinical features in a population of extra-European immigrants to Milan, Italy, complaining of allergy and asthma symptoms.
  
  
  METHODS
  Data regarding 243 extra-European immigrants checked at an allergy clinic from 1994 to 2000 were collected retrospectively. The demographic data were compared with those of the extra-European immigrants living in Milan at the end of 1999.
  
  
  RESULTS
  The patients were complaining of asthma (63.7%), rhinoconjunctivitis (56.7%), rhinitis alone (21%) or urticaria (3%). One hundred and eighty-seven out of 222 patients (84.3%) declared they were healthy before migrating and allergy/asthma symptoms started to appear after their arrival in Italy, namely after an average period of 4 years and 7 months. The proportion of male patients was lower than the proportion of men in the extra-European immigrant population (48% vs. 55%), suggesting that in adult immigrants allergy and asthma are more common in women than in men. Furthermore, there was an over-representation of Central-South Americans attending the clinic, which seemed to be due to a genetic predisposition to allergy/asthma development. When data were analysed for single countries, a trend towards an increased risk of allergy and asthma was found in immigrants from all Central-South American countries. A skin test positivity for at least one inhalant allergen was found in 196 out of 232 patients (81%), and the spectrum of allergic sensitization was similar to that of the Italian population living in the North of Italy.
  
  
  CONCLUSIONS
  Most extra-European immigrants declared that they were healthy at home and that allergy and asthma symptoms had appeared after immigration to Milan; lifestyle and environmental factors in a western industrialized city seem indeed to facilitate allergy/asthma onset in immigrants from developing countries. Allergy/asthma risk seems to be different in different ethnic groups.
authors.affiliation: First Division of Internal Medicine, IRCCS Ospedale Maggiore Policlinico, Milan, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Tedeschi
authors.forename: M
authors.initials: M
authors.lastname: Barcella
authors.forename: G A Dal
authors.initials: GA
authors.lastname: Bo
authors.forename: A
authors.initials: A
authors.lastname: Miadonna
mesh_terms: D000328:Adult; D001249:Asthma / Q000208:ethnology / Q000209:etiology; D002489:Central America / Q000208:ethnology; D016009:Chi-Square Distribution; D004641:Emigration and Immigration; D005006:Ethnicity; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D006967:Hypersensitivity / Q000208:ethnology / Q000209:etiology*; D007221:Industry; D007558:Italy; D008297:Male; D012189:Retrospective Studies; D013020:South America / Q000208:ethnology; D013997:Time Factors