Multiple atopic sensitization and health care utilization in a cohort of immigrant children from a cross-sectional study of respiratory health and atopy in relation to poor-quality housing in Malmö, Sweden

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Abstract

Introduction: Exposure to allergens plays a role in the development of atopic sensitization and influences
allergic phenotype. The effects of exposure to relevant allergens both from the indoor and outdoor
environment are complex. Immigrant children and their families are exposed to new spectra of seasonal
and perennial allergens, and often new lifestyle factors, such as diet, and living conditions. Furthermore
health literacy and accessibility of healthcare systems will play a role in what impact atopic diseases will
have on these populations.
Methods: As part of a larger study into the health in its social context of an immigrant population living in
poor-quality housing in Malmö/Sweden, families with small children were identified from health care records
(child treated in primary care with respiratory illness), and school records (matched for age range). Families
were visited in their homes by health communicators fluent in their language. Family and individual level
health data, including skin-prick-tests (SPT) for a standard panel of aeroallergens, were analyzed together
with environmental exposures (mould, dampness, ETS, crowding and -in the part of the study presented
here: health care utilization over 7 years at the primary care level (data linkage to relevant registries)
Results: 130 families participated, with usable data for 359 children under the age of 13, and 230 parents.
The overall exposure to potentially harmful factors was relatively high, the burden of atopy and respiratory
diseases was significant. 232 children under the age of 13 had SPTs performed, 48 of which were positive,
of these 11 showed sensitization against 2 or more allergens. The spectrum of sensitizations was
comparable to a Swedish population (seasonal plant pollen; animal dander, moulds, and house dust mites
(HDM). Utilization of primary health care resources amongst the polysensitized children was overall
comparable to that of a gender- and age-matched non-polysensitized control group (n=20) from the same
cohort. Higher health care usage was seen in both groups only in children with a documented diagnosis of
asthma.
Conclusion: In our cohort, it was rather the presence of an asthma diagnosis than polysensitization that
drove higher utilization of primary health care resources, confirming that atopic sensitization in itself is not a
disease state, but rather a marker of potential for atopic disease.

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Subject classification (UKÄ) – MANDATORY

  • Environmental Health and Occupational Health
  • Respiratory Medicine and Allergy
Original languageEnglish
Publication statusPublished - 2017 Oct 26
Publication categoryResearch
Peer-reviewedYes

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