title: Early onset of allergic rhinitis and asthma in recent extra-European immigrants to Milan, Italy: the perspective of a non-governmental organisation.
abstract: BACKGROUND
  Allergy is determined by genetic and environmental factors. People immigrating from under-developed to industrialised countries are at higher risk of developing allergic diseases and immigration is as a good epidemiological model to quantify the influence of the environment. We performed the allergological assessment of 32,555 recent immigrants from different areas of the world to a polluted metropolitan area of Northern Italy.
  
  
  METHODS
  We evaluated time of onset of allergic rhinitis and/or asthma, sensitisations and clinical characteristics of 395 subjects (3.74 ± 2.94 yrs, mean ± SD) from four macro-areas (Asia, Africa, East-Europe, South America) arriving to Milan, Italy from June 2005 to June 2009. Data were compared with immigrants having access to the same medical facility for any medical problem and with resident Italians living in the same area.
  
  
  RESULTS
  Immigrants with allergic rhinitis and/or asthma days since arrival in Italy correlated with number of sensitisations (p=0.0030). Moreover, personal (2.02%) or familial (2.78%) history of allergic diseases was lower in allergic immigrants as compared to allergic residents (37.77 and 29.39%, respectively; p<0.0001 for both comparisons). Finally, the frequency of allergic immigrants from South America (63.3%) was higher than expected from the overall proportion of individuals from this macro-area who sought medical help at the same facility (40.4%; p<0.0001, OR 2.289, CI 2.1670-3.255).
  
  
  CONCLUSIONS
  Environmental factors play a relevant role in the induction of allergies in immigrants to Northern Italy. Genetics appears as a further promoting factor in the case of immigrants from South America.
authors.affiliation: San Raffaele Scientific Institute, Milan, Italy. s.burastero@hsr.it
authors.forename: S E
authors.initials: SE
authors.lastname: Burastero
authors.forename: A
authors.initials: A
authors.lastname: Masciulli
authors.forename: A M
authors.initials: AM
authors.lastname: Villa
mesh_terms: D000293:Adolescent; D000328:Adult; D000349:Africa / Q000208:ethnology; D017668:Age of Onset; D000368:Aged; D001208:Asia / Q000208:ethnology; D001249:Asthma; D054242:Emigrants and Immigrants; D004787:Environmental Pollution / Q000009:adverse effects; D005061:Europe, Eastern / Q000208:ethnology; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000453:epidemiology* / Q000208:ethnology* / Q000503:physiopathology; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009938:Organizations; D012189:Retrospective Studies; D012220:Rhinitis; D013020:South America / Q000208:ethnology