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Relation of indoor heating with asthma, allergic sensitisation, and bronchial responsiveness: survey of children in South Bavaria

^a University Children's Hospital, D80337 Munich, Germany, ^b Respiratory Sciences Center, Department of Pediatrics, University of Arizona, Tucson, AZ 85724, USA

Correspondence and reprint requests for reprints to: Dr E von Mutius, Universitatskinderklinik, Lindwurmstr 4, D 80337 Munchen, Germany.

Abstract

Objective: To investigate the relation between different types of heating and the prevalence of atopic diseases, skin test reactivity, and bronchial hyperresponsiveness.
Design: Cross sectional survey among schoolchildren aged 9-11 years. Skin prick tests, pulmonary function tests, and bronchial challenge in the children and self completion of a written questionnaire by the children's parents.
Subjects: 1958 children in a rural area in southern Bavaria, Germany.
Main outcome measures: Prevalence of asthma, hay fever, and atopic dermatitis as determined by parents' answers to a questionnaire; the atopic status of the child assessed by skin prick tests; and bronchial responsiveness to cold air challenge in the children.
Results: After possible confounders were controlled for, the risk of developing hay fever (odds ratio=0.57; 95% confidence interval 0.34 to 0.98), atopy defined as at least one positive reaction to a panel of common aeroallergens (0.67; 0.49 to 0.93), sensitisation to pollen (0.60; 0.41 to 0.87), and of bronchial hyperresponsiveness (0.55;0.34-0.90) was significantly lower in children living in homes where coal or wood was used for heating than in children living in homes with other heating systems.
Conclusions: Factors directly or indirectly related to the heating systems used in rural Bavarian homes decrease the susceptibility of children to becoming atopic and to developing bronchial hyperresponsiveness.

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