title: Chronic respiratory symptoms in Croatian Adriatic island metapopulations.
abstract: OBJECTIVE
  To investigate the prevalence of chronic respiratory symptoms in 9 metapopulations on Adriatic islands in Croatia, and the relationship between respiratory symptoms and individual genetic background.
  
  
  METHODS
  We obtained random sample of 1001 adult inhabitants of 9 Adriatic island villages in Croatia, that also included immigrants to these villages. European Union respiratory health questionnaire and World Health Organization non-communicable diseases questionnaire were used. Personal genetic histories were reconstructed, based on the two-generation ancestral pedigrees. Bivariate and multivariate methods were used in the analysis.
  
  
  RESULTS
  Women reported the occurrence of acute dyspnea (P=0.017), cough (P=0.002), and asthma (P=0.002) more often than men. Gender was the strongest predictor for acute and/or chronic cough (odds ratio [OR], 1.69; 95% confidence interval [CI], 1.23-2.33) and asthma (OR, 2.00; 95% CI, 1.00-4.01), whereas smoking was the strongest risk factor for acute and chronic dyspnea (OR, 1.90; 95% CI, 1.21-2.99) and airway narrowing (OR, 1.84; 95% CI, 1.18-2.87). Residence on the northern islands increased the odds of allergy, whereas the highest odds ratio of 3.20 was associated with the interaction of northern residence and immigrant background. Genetic background was a significant predictor only for the occurrence of allergy symptoms.
  
  
  CONCLUSIONS
  Differences in respiratory findings among the island inhabitants were often associated with smoking prevalence. Interaction of residence on northern Adriatic islands and immigrant background proved to be the strongest predictor for the occurrence of allergy symptoms. This study indicated that environmental factors played a very important role in the occurrence of respiratory symptoms.
authors.affiliation: Department of Environmental and Occupational Health, Andrija Stampar School of Public Health, Zagreb University School of Medicine, Zagreb, Croatia. ezuskin@snz.hr
authors.forename: Eugenija
authors.initials: E
authors.lastname: Zuskin
authors.forename: Nina
authors.initials: N
authors.lastname: Smolej Narancić
authors.forename: Tatjana
authors.initials: T
authors.lastname: Skarić-Jurić
authors.forename: Maja
authors.initials: M
authors.lastname: Barbalić
authors.forename: Pavao
authors.initials: P
authors.lastname: Rudan
authors.forename: Mirjana
authors.initials: M
authors.lastname: Kujundzić-Tiljak
authors.forename: Jasna
authors.initials: J
authors.lastname: Pucarin-Cvetković
authors.forename: E Neil
authors.initials: EN
authors.lastname: Schachter
mesh_terms: D000328:Adult; D000368:Aged; D001249:Asthma / Q000453:epidemiology; D002908:Chronic Disease; D003371:Cough / Q000453:epidemiology; D017523:Croatia / Q000453:epidemiology; D004417:Dyspnea / Q000453:epidemiology; D005260:Female; D005843:Geography; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012130:Respiratory Hypersensitivity / Q000453:epidemiology; D012140:Respiratory Tract Diseases / Q000453:epidemiology*