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Changing trends in sex specific prevalence rates for childhood asthma, eczema, and hay fever
Author(s) -
Osman Mustafa,
Tagiyeva Nara,
Wassall Heather J.,
Ninan Titus K.,
Devenny Anne M.,
McNeill Geraldine,
Helms Peter J.,
Russell George
Publication year - 2007
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.20545
Subject(s) - wheeze , hay fever , medicine , asthma , pediatrics , demography , risk factor , relative risk , atopy , confidence interval , sociology
Numerous surveys of school‐aged children have shown increasing asthma prevalence with a less publicized but noticeable change in the male to female ratio. We sought to confirm this change in the sex ratio in four questionnaire‐based surveys and investigate possible explanations. Identical questionnaire surveys were performed in 1989 (n = 3,390), 1994 (n = 4,047), 1999 (n = 3,540) and 2004 (n = 1,920) in school‐children aged 9–11 years. Over these 15 years the male to female ratio (M:F) significantly narrowed for wheeze (1.34 to 0.98:1 P < 0.0002), for asthma (1.74 to 1.02:1 P < 0.0001), for eczema (1.42:1 to 0.81:1 P < 0.0001) and for hay fever (1.46 to 0.93:1 P < 0.0001). The diagnosis of asthma in children with wheeze was more commonly made in boys in 1989 relative risk RR 1.32 (1.12, 1.56), even in those with accompanying eczema and/or hay fever RR 1.20 (0.99, 1.45). By 2004 this sex bias in diagnosis was no longer present, RR 1.01 (0.91, 1.12) for wheeze and 1.02 (0.85, 1.21) for those with wheeze and eczema and/or hay fever. From 1989 to 2004 no significant difference in sex distribution changes between older and younger children occurred, making secular trends in the onset of puberty in females an unlikely contributory factor. The disappearance of the bias to diagnose asthma in symptomatic males but not in females may be partly responsible for the narrowing of the sex ratio, but other factors such as those enhancing the expression of asthma and atopy in females may also be implicated. Pediatr Pulmonol. 2007; 42:60–65. © 2006 Wiley‐Liss, Inc.