Background The aim of this study was to investigate the associations between attention deficit hyperactivity disorder (ADHD), the most common neuropsychiatric disorder in school children, and childhood allergic disease by evaluating their respective prevalence. Methods Subjects were comprised of first and second grade students in twenty two elementary schools in a city in the Republic of Korea. The mode of measurement for ADHD was based on DSM-IV from clinical interviews conducted by child psychiatrists. Along with the diagnostic interviews, we also used the epidemiological questionnaires, Computerized Attention Deficit-Hyperactivity Disorder Diagnostic System, the abbreviated Conner’s Parent Rating Scale (CPRS), and DuPaul’s ADHD Rating Scales. Allergic conditions, such as asthma, have been separately evaluated based on the questionnaire items whose validity and reliability were proved by the International Study of Asthma and Allergies in Children (ISAAC). All questionnaires were completed by the subjects’ parents. Results The lifetime prevalence rate of asthma in ADHD patients was 36.6%, compared to a prevalence of 24.3% in control subjects. The lifetime prevalence rate of allergic rhinitis in ADHD patients was 59.0%, compared to a prevalence of 47.0% in control subjects. Statistically significant difference has been found between the two groups. In the logistic regression model of the ADHD and the control group, the relative risk of asthma was 1.60 times higher (confidence interval 1.301-1.964), the relative risk of allergic rhinitis was 1.38 times higher (confidence interval 1.124-1.681), which showed statistical significance. Conclusions The findings of this study suggest significant association between ADHD and childhood asthma and allergic rhinitis. Therefore, appropriate evaluation and treatment are needed for asthmatic children with attention-deficit symptoms, or allergic rhinitis with ADHD. Besides, further research is needed to determine the etiological approach towards ADHD, asthma, and allergic rhinitis.

Purpose: Sensitization to allergens is considered as major mechanism of allergy and related to the development of allergic diseases. The objective of this study was to evaluate overall sensitization rates of inhalant allergens and the relationship between polysensitization and prevalence of allergic diseases in children and adolescents.Methods: A cross-sectional pilot study of 122 elementary school students, 114 middle school students, and 115 high school students from Incheon and Asan was conducted by using the International Study of Asthma and Allergies in Childhood (ISSAC) questionnaire. The skin prick tests were performed with 14 common inhalant allergens on 339 students.Results: The inhalant allergen that has a significantly different sensitization rate according to age was Dermatophagoides farinae. And the inhalant allergen that has significantly different sensitization rate according to region was Japanese hop. In addition, girls have higher sensitization rate to any mold allergens than boys. In case of having sensitization more than two allergens, the risks of diagnosis of asthma and allergic rhinitis on questionnaire were increased. Asthma is related to sensitization of dog or cat and allergic rhinitis is related to sensitization of house dust mites. However, atopic dermatitis is not related to sensitization of any inhalant allergens.Conclusion: The sensitization rates of inhalant allergens may differ among age, gender, and region in children and adolescents of Incheon and Asan area. The polysensitized children and adolescents with inhalant allergens showed higher prevalences of allergic diseases such as asthma and allergic rhinitis on questionnaire than monosensitized group.

ISEE-0726 Background and Objective: Because blood lead has been associated with attention deficit hyperactivity disorder (ADHD), we examined whether improvement of ADHD symptoms correlates with lower blood lead or mercury levels among children involved in the Children’s Health and Environmental Research (CHEER). Methods: CHEER is a prospective cohort study of children who were first grade elementary school at baseline from 10 Korean cities. Of 2,722 first grade children who participated in the 2006 survey, 1,949 children were followed up in the 2008 survey (follow-up rate, 71.6%). We examined the relationship between changes of blood lead and mercury level and ADHD symptoms assessed using the Dupaul’s parental scale. Results: Prevalence of ADHD was decreased from 12.3% in 2006 to 9.2% in 2008. Blood lead level was decreased from 1.8 ug/dl in 2006 to 1.6 ug/dl in 2008 among the same children while blood mercury was slightly increased from 2006 to 2008. Of 1,710 who did not have ADHD symptoms in 2006, 87 children (5.1%) were reported as having ADHD symptoms in 2008. Of 239 children who had ADHD in 2006, 147 children (61.5%) were reported as not having ADHD in 2008. Blood lead levels were decreased amongst children whose ADHD status changed from positive in 2006 to negative in 2008 (P = 0.01) while changes in blood lead levels amongst the other children were not significant. Blood mercury levels were also significantly lower among children whose ADHD symptoms changed from positive to negative during the two years. The findings were not altered after considering children’s age, gender, residential area and household income, which might influence the changes in blood levels of lead or mercury as well as ADHD symptoms. Conclusion: Lower blood lead and mercury levels is associated with ADHD symptom improvement which may have important implications in children’s environmental health.

OBJECTIVES:An increase in the serum gamma-glutamyltransferase (GGT) concentration has been regarded as a marker of alcohol drinking or liver disease. Some reports, however, have suggested that the serum GGT may be a sensitive and early biomarker for the development of prediabetes and diabetes. In this study we investigated whether serum GGT is a reliable predictor of the incident impaired fasting glucose (IFG), including diabetes. METHODS:We performed a prospective study for two years (2002-2004). We analyzed the periodic health examination data from a total of 4,711 men. The examinations were done in the years 2002 and 2004. The analyzed data included a self-questionnaire, a physical examination and the laboratory results. Both IFG and diabetes were defined as a serum fasting glucose concentration of more than 100 mg/dL and 126 mg/dL, respectively. RESULTS:A total of 738 cases (15.7%) of incident IFG and 13 cases (0.3%) of diabetes occurred. The mean serum GGT concentrations were quite different between the normal (38.0 IU) and incident IFG groups (50.3 IU), and the incident diabetes group (66.0 IU) (p <0.001). After multivariable adjustment, the relative risks for incident IFG or diabetes across the baseline GGT categories (<10th, 10th-20th, 30th-40th, 50th-60th, 70th-80th and >90th percentile) were 1.0, 1.172 (0.769-1.785), 1.107 (0.725-1.689), 1.444 (0.934-2.232), 2.061 (1.401-3.031) and 2.545 (1.784-3.631) (p-value for trend: <0.001). The risks significantly increased with increasing levels of GGT for 2 years; when comparing the increased groups (<10%, .10-20%, >20%) versus the decreased over 20% group of GGT, the risks for IFG or diabetes were 1.334 (1.002-1.776), 1.613 (1.183-2.199) and 1.399 (1.092-1.794). CONCLUSIONS:Our findings suggest that serum GGT concentrations within its normal range may be an early predictor of the development of IFG and diabetes. As serum GGT is a relatively inexpensive test and a reliable marker, it might have important implications in public health promotion.

OBJECTIVES:This study was performed to examine the influence of smoking on the blood cadmium concentration in university students.METHODS:The study included 300 university students. A questionnaire interview was used to collect data. The urine cotinine and blood cadmium levels were measured as biological exposure indices. The data were analyzed using t-tests ANOVA and ANCOVA.RESULTS:The median value of blood cadmium concentration was equal in both males and females (0.8microgram/liter). This level was relatively low in comparison with the reference value suggested by WHO (2001). ANCOVA showed that smoking related variables, urine cotinine and smoking amount, were significantly associated with the blood cadmium level (P=0.004, 0.015). However, the values with regard to traffic related air pollution were not significantly associated with the blood cadmium level.CONCLUSIONS:Smoking is an important source of nonoccupational cadmium exposure in young people. The Blood cadmium level is at least 10% higher in active smokers than in passive or nonsmokers. The level of urine cotinine can be used as an indicator of non-occupational exposure of respirable cadmium due to smoking, as there is a good correlation bestween smoking amount and the urine cotinine level.