title: Time trends, ethnicity and risk factors for eczema in New Zealand children: ISAAC Phase Three.
abstract: BACKGROUND
  Eczema is a common chronic disease which has significant morbidity and costs for children and their families. Phase One (1993) of the International Study of Asthma and Allergies in Childhood (ISAAC) found a high prevalence of symptoms of eczema in New Zealand.
  
  
  OBJECTIVE
  In Phase Three (2001-3) we aimed to answer these three questions: Is the prevalence of eczema changing over time?; Are there ethnic differences in prevalence?; and What are the risk factors for eczema?
  
  
  METHODS
  Five New Zealand centres participated in ISAAC Phases One and Three using the same methodology. Questionnaires about ethnicity, symptoms of eczema and environmental factors were completed by parents of 6-7 year olds (children) and self-completed by 13-14 year olds (adolescents). Prevalence and change per year were calculated by centre, ethnicity and gender. Prevalence differences between centres and associations with environmental factors were examined using logistic regression.
  
  
  RESULTS
  There was little change in prevalence over time for the children, and a decrease in prevalence for the adolescents. Prevalence was higher among Māori and even higher among Pacific participants than among European children. Positive associations with current eczema symptoms were found for both age groups for truck traffic in the street of residence, and current paracetamol consumption, and for children only, antibiotics or paracetamol in the 1st year of life. Inverse associations were found with residence in New Zealand less than 5 years, consumption of milk, seafood, and eggs, and presence of a dog in the home.
  
  
  CONCLUSIONS
  Eczema remains a significant problem, particularly for young Māori and Pacific New Zealanders in whom less recognition of eczema and poorer access to effective, sustained eczema management may be contributing factors. Reverse causation may explain all the environmental findings apart from truck traffic which is increasing in New Zealand.
authors: Department of Paediatrics: Child and Youth Health, The University of Auckland, Auckland 1142, New Zealand.
authors: Tadd
authors: T
authors: Clayton
authors: M Innes
authors: MI
authors: Asher
authors: Julian
authors: J
authors: Crane
authors: Philippa
authors: P
authors: Ellwood
authors: Richard
authors: R
authors: Mackay
authors: Edwin A
authors: EA
authors: Mitchell
authors: Chris D
authors: CD
authors: Moyes
authors: Philip
authors: P
authors: Pattemore
authors: Neil
authors: N
authors: Pearce
authors: Alistair W
authors: AW
authors: Stewart
keywords: Adolescents; Children; Eczema; Environment; Ethnicity; New Zealand
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