Airway diseases and allergies in East and West German children during the first 5 years after reunification: Time trends and the impact of sulphur dioxide and total suspended particles

Background. East-West comparison studies in Europe find higher prevalences of infectious airway diseases and lower prevalences of allergies in eastern areas. Pollution from sulphur dioxide (SO₂) or total suspended particles (TSP) are discussed as causes of this difference. Methods. In four differently polluted areas of East Germany where pollution decreased dramatically between 1989 and 1995 cross-sectional studies in about 7-year-old children were repeated every year between 1991 and 1995. In two differently polluted areas of West Germany studies with the same design were done in 1991 and 1994. In all, 19,090 children participated in the study. Thirteen different questions about airway diseases and allergies were evaluated. Logistic regression was used to adjust for confounding. Results. With the exception of pneumonia, all infectious airway diseases and irritations of the airways show a steeper temporal decrease in East than in West Germany or are positively associated with either SO₂ or TSP in East Germany. For allergies and related symptoms no differences in time trends could be detected or no association with SO₂ or TSP could be seen in East Germany. Conclusion. Most airway diseases were more frequent in East than in West Germany in 1991 and were associated with SO₂ or TSP. The decrease in these pollutants between 1991 and 1995 has already had a favourable effect. An effect of SO₂ or TSP pollution on allergies and related symptoms could not be detected. This pollution does not protect against the development of allergies.