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Age at onset and persistence of eczema and the subsequent risk of asthma and allergic rhinitis

Bianca Angelica, John Su, Caroline Lodge, David Hill, Cliff Hosking, Erbas Bircan, Catherine Bennett, Lyle Gurrin, Christine Axelrad, Michael Abramson, Katie Allen, Shyamali Dharmage, Adrian Lowe
European Respiratory Journal 2012 40: P3400; DOI:
Bianca Angelica
1School of Public Health, University of Melbourne, Carlton, VIC, Australia
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John Su
2Pediatrics, Royal Children's Hospital, Parkville, Australia
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Caroline Lodge
1School of Public Health, University of Melbourne, Carlton, VIC, Australia
3Respiratory Diseases, Murdoch Childrens Research Institute, Parkville, Australia
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David Hill
3Respiratory Diseases, Murdoch Childrens Research Institute, Parkville, Australia
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Cliff Hosking
4Department of Paediatrics, John Hunter Children's Hospital, Newcastle, Australia
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Erbas Bircan
5School of Public Health, La Trobe University, Melbourne, Australia
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Catherine Bennett
1School of Public Health, University of Melbourne, Carlton, VIC, Australia
6Deakin Population Health, Deakin University, Melbourne, Australia
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Lyle Gurrin
1School of Public Health, University of Melbourne, Carlton, VIC, Australia
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Christine Axelrad
3Respiratory Diseases, Murdoch Childrens Research Institute, Parkville, Australia
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Michael Abramson
7Department of Epidemiology & Preventive Medicine, Monash University, Melbourne, Australia
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Katie Allen
2Pediatrics, Royal Children's Hospital, Parkville, Australia
3Respiratory Diseases, Murdoch Childrens Research Institute, Parkville, Australia
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Shyamali Dharmage
1School of Public Health, University of Melbourne, Carlton, VIC, Australia
3Respiratory Diseases, Murdoch Childrens Research Institute, Parkville, Australia
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Adrian Lowe
1School of Public Health, University of Melbourne, Carlton, VIC, Australia
3Respiratory Diseases, Murdoch Childrens Research Institute, Parkville, Australia
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Abstract

Background: Few studies have simultaneously addressed the importance of age of onset and persistence of eczema for the subsequent development of asthma and allergic rhinitis in children.

Objective: To examine age of eczema onset and eczema persistence as predictors for childhood asthma and allergic rhinitis at ages 6, 7 and 12 years.

Methods: A prospective birth cohort was recruited comprising 620 infants with a family history of allergic diseases. Telephone interviews were conducted 18 times in the first two years of life, annually from age 3 to 7, and at 12 years to document any episodes of eczema. Current asthma and allergic rhinitis were assessed at ages 6, 7 and 12.

Results: Very early-onset (<6 months) persistent eczema was related to current asthma (adjusted OR= 6.0; 95%CI 2.4-14.7) and allergic rhinitis (aOR=4.5; 95%CI 1. 9-10.9) at age 12 years. Adjustment for aero-allergen sensitisation in infancy dramatically reduced these associations. There was no evidence that early-onset remitting eczema (only present < 2 years) or late-onset eczema (onset > 2 years) were associated with current asthma and allergic rhinitis. These results were consistent with the 6-7 year findings.

Conclusion: Eczema which commences very early in life and persists into toddler years is strongly associated with childhood asthma and allergic rhinitis, and is possibly mediated by aero-allergen sensitization. However remitting and late-onset eczema do not appear to be related to these outcomes. With effective early intervention, the risk of diseases associated with early-onset eczema might be reduced.

  • Epidemiology
  • Asthma - mechanism
  • Allergy
  • © 2012 ERS
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Age at onset and persistence of eczema and the subsequent risk of asthma and allergic rhinitis
Bianca Angelica, John Su, Caroline Lodge, David Hill, Cliff Hosking, Erbas Bircan, Catherine Bennett, Lyle Gurrin, Christine Axelrad, Michael Abramson, Katie Allen, Shyamali Dharmage, Adrian Lowe
European Respiratory Journal Sep 2012, 40 (Suppl 56) P3400;

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Age at onset and persistence of eczema and the subsequent risk of asthma and allergic rhinitis
Bianca Angelica, John Su, Caroline Lodge, David Hill, Cliff Hosking, Erbas Bircan, Catherine Bennett, Lyle Gurrin, Christine Axelrad, Michael Abramson, Katie Allen, Shyamali Dharmage, Adrian Lowe
European Respiratory Journal Sep 2012, 40 (Suppl 56) P3400;
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