Abstract
The skin reflects the border between body and environment and is therefore exposed to numerous environmental influences. This may lead to specific and unspecific reactions or diseases. The atopic eczema in this context is of special importance because of its high frequency and susceptibility to several environmental factors. Questionnaire-based investigation revealed a frequency between 7.9% and 17.3% in German (pre-) schoolchildren. Only few studies estimated the prevalence using an actual dermatological examination. According to these investigations the prevalence of atopic eczema is up to 12.9% in pre-schoolchildren and 3.4% in adults. There are several reports showing a significant increase in prevalence over the past decades. For Germany there are no sufficient data so far allowing statements on changes in the frequency. The manifestation of the atopic eczema is influenced by genetic and environmental factors. Relevant environmental factors include aero- and food allergens, climatic and psychological conditions as well as irritants. Pollutants and especially air pollutants may also play a role. According to a Bavarian study the risk for the child to get eczema is more than doubled when the mother had smoked during pregnancy or lactation (OR = 2.30, CI 1.32 - 3.12). Furthermore, several traffic-related parameters had been connected with atopic eczema. In East-West-German comparison studies significant associations between atopic eczema and the distance to a high traffic road (OR = 1.71, CI 1.07 - 2.73), the frequency of truck traffic (OR = 1.8, CI 1.3 - 2.6), and traffic noise (OR = 1.6, CI 1.2 - 2.2) had been reported. Also indoor air-pollutant exposure may influence atopic eczema. An East-West-German study again yielded a significant association between atopic eczema and the use of gas (OR = 1.7, CI 1.1 - 2.6). Only few reports are available concerning other pollutants. According to a survey following the accident in a chemical plant in Frankfurt/Main 1993 the prevalence of eczema was significantly higher in exposed children (OR = 2.4, CI 1.3 - 4.8). Another environmental health study from Hamburg showed a significant association between actual diagnosed eczema and the body burden of arsenic (OR = 4.2, CI 1.03 - 16.6). This preliminary evidence for an influence of environmental pollutants on atopic eczema has to be confirmed by further studies.
| Translated title of the contribution | Environmental influences and atopic eczema (neurodermitis): Epidemiologic studies from Germany |
|---|---|
| Original language | German |
| Pages (from-to) | 38-47 |
| Number of pages | 10 |
| Journal | Allergologie |
| Volume | 22 |
| Issue number | 1 |
| State | Published - Jan 1999 |