Atopic eczema and the home environment

Background There is strong evidence to suggest that the prevalence of atopi c eczema is increasing in developed countries. Environmental factors have b een implicated in the disease. Objectives This descriptive case-control study sheds light on the possible association between atopic eczema in school children and various home envir onmental factors, and generates hypotheses for further studies. Methods The study uses data on reported atopic eczema symptoms collected vi a a cross-sectional parental postal survey (n=1350) in Nottingham, U.K. Est imates of the risk of reported eczema associated with various home environm ental factors were calculated by means of odds ratios (OR), along with popu lation attributable risk percentages. Results The study showed statistically significant associations between ato pic eczema symptoms and dampness in the home [OR 1.40; 95% confidence inter val (CI) 1.00-1.97], the use of a radiator to heat the child's bedroom (OR 1.50; 95% CI 1.05-2.16) and the use of synthetic pillows (OR 1.51; 95% CI 1 .01-2.28). Frequent vacuuming in the home was associated with a decreased p revalence of atopic eczema (OR 0.74; 95% CI 0.58-0.94). The associations wi th dampness in the home, synthetic pillows and frequency of vacuuming were not altered significantly after adjustment for age, sex and socio-economic status. Population attributable risk percentages for the use of a radiator and synthetic pillows indicate that although the relative risk estimates fo r these factors may be small, the population impact of these factors is con siderable (26% and 28%, respectively), owing to the high prevalence of expo sure to these factors among this group of school children. Conclusions Further research is needed to confirm these associations and ad ditional research is needed to see whether they might be causative. Practic al public health advice about the importance of controlling the home enviro nment may then be targeted at families with atopic eczema.