title: Factors associated with the development and remission of allergic diseases in an epidemiological survey of high school students in Japan.
abstract: BACKGROUND
  Allergic diseases are an important health problem for children and adults. It is important to know how allergic diseases develop and remit from infancy to adolescence. Early intervention is effective in treating allergic diseases.
  
  
  OBJECTIVE
  We performed a large-scale questionnaire survey of high school students in Fukui Prefecture, Japan, and analyzed the factors associated with the development and remission of allergic diseases.
  
  
  METHODS
  A total of 21,802 students participated in the epidemiologic survey, and the valid response rate was 89.3% (19,461). We applied an inverse probability weighting method with propensity scores.
  
  
  RESULTS
  The present prevalence rate of allergic rhinitis (AR) was 19.2%. The remission rate of AR was 15.3%. Only children and firstborns had a significantly higher risk of developing symptoms of allergic diseases [only child: AR, 1.37; bronchial asthma (BA), 1.30; food allergy (FA), 1.33 and firstborn: AR, 1.38; BA, 1.10]. Constipation was an associated factor for development of atopic dermatitis (AD) (1.17) and AR (1.17), regular intake of lactic acid bacteria was not an associated factor for development of allergic diseases but was a factor for remission of AD (1.22). Hypohidrosis was an associated factor for development of AD (1.25). High academic performance was an associated factor for development of AR (1.20) but was a negative factor for development of BA (0.89). The values in parentheses are significant adjusted odds ratios.
  
  
  CONCLUSIONS
  This epidemiologic survey showed that the hygiene hypothesis and intestinal bacterial flora might influence the development of symptoms and remission of allergic diseases.
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, Department of Sensory and Locomotor Medicine, Faculty of Medical Science, University of Fukui, Fukui, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Tokunaga
authors.forename: Takahiro
authors.initials: T
authors.lastname: Ninomiya
authors.forename: Yoko
authors.initials: Y
authors.lastname: Osawa
authors.forename: Yoshimasa
authors.initials: Y
authors.lastname: Imoto
authors.forename: Yumi
authors.initials: Y
authors.lastname: Ito
authors.forename: Tetsuji
authors.initials: T
authors.lastname: Takabayashi
authors.forename: Norihiko
authors.initials: N
authors.lastname: Narita
authors.forename: Akiko
authors.initials: A
authors.lastname: Kijima
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Murota
authors.forename: Ichiro
authors.initials: I
authors.lastname: Katayama
authors.forename: Shigeharu
authors.initials: S
authors.lastname: Fujieda
mesh_terms: D000293:Adolescent; D003248:Constipation / Q000453:epidemiology*; D017449:Dermatitis, Allergic Contact / Q000453:epidemiology*; D018450:Disease Progression; D005260:Female; D000069196:Gastrointestinal Microbiome; D006801:Humans; D061148:Hygiene Hypothesis; D007007:Hypohidrosis / Q000453:epidemiology*; D015994:Incidence; D007564:Japan; D008297:Male; D009863:Only Child; D011153:Population; D015995:Prevalence; D012075:Remission, Spontaneous; D065631:Rhinitis, Allergic / Q000453:epidemiology*; D012307:Risk Factors; D011795:Surveys and Questionnaires