PREVALENCE OF ASTHMA AND ATOPY IN 2 AREAS OF WEST-GERMANY AND EAST-GERMANY

The German reunification offers a unique opportunity to study the impa ct of environmental factors on the development of childhood respirator y and allergic disorders in ethnically similar populations. We investi gated the prevalence of asthma, hay fever, atopy, and bronchial hyperr esponsiveness (BHR) in 9- to 11-year old children in West Germany (n = 5,030) and East Germany (n = 2,623). A self-administered questionnair e was distributed to the parents. Children underwent cold air challeng e and allergy skin prick tests. Atopic sensitization was considerably more frequent in West German children than in their peers in East Germ any (36.7% versus 18.2%; odds ratio [OR] = 2.6, p < 0.0001). The preva lence of current asthma and hay fever was significantly higher in West Germany when compared with that in East Germany (5.9% versus 3.9%; OR = 1.5, p < 0.0001 and 8.6% versus 2.7%; OR = 3.4, p < 0.0001, respect ively). Bronchitis, however, was more prevalent in East Germany than i n the western part of the country. The prevalence of BHR as assessed b y cold air challenge was higher in West Germany compared with that in East Germany (8.3% versus 5.5%, OR = 1.6, p < 0.001). Logistic regress ion showed that the West German study area was no longer a significant independent determinant of asthma once sensitization to mites, cats, and pollen was taken into account. We conclude that sensitization to a eroallergens is strikingly more frequent in West Germany than in East Germany and this may explain the differences in the prevalence of asth ma and hay fever between the two parts of the country. We speculate th at Western lifestyle is a risk factor for the development of atopy