BACKGROUND:There is only little and furthermore conflicting knowledge about the relationship between passive smoking and allergy in adults. In this work, we assess the association between exposure to environmental tobacco smoke (ETS) at home or at work, and allergic sensitization and allergic rhinitis in 4093 German adults.METHODS:Our study population comes from the German National Health Survey 1998 of which we analyzed 4093 adults (17-79 years) being non-smokers and having complete information on passive smoking and allergy. The association between ETS exposure and allergic sensitization and allergic rhinitis was assessed using logistic regression models.RESULTS:The effect of ETS exposure on allergic sensitization was biggest at the workplace [adjusted OR = 1.17 (0.97, 1.41)]; the same could be observed with respect to allergic rhinitis [adjusted OR = 1.20 (0.96, 1.51)]. There was no effect of ETS exposure at home on both allergic sensitization [adjusted OR = 0.99 (0.76, 1.29)] and allergic rhinitis [adjusted OR = 1.05 (0.76, 1.43)] in our analysis.CONCLUSIONS:The findings from our study show a statistically non-significant tendency that exposure to ETS at the workplace increases allergic sensitization and allergic rhinitis in adults. This tendency could not be observed with respect to ETS exposure at home.PRACTICAL IMPLICATIONS:Exposure to ETS at the workplace should be minimized in order to reduce the risk of allergic sensitization, and allergic rhinitis.

PURPOSE: To examine whether frequent intake of margarine is associated with allergy prevalence in adults using data of a representative national health survey.METHODS: Data on 7124 subjects aged 18 to 79 years were obtained from the German National Health Survey 1998. Confounder-adjusted odds ratios (aOR) with 95% confidence intervals (CI) were calculated by multiple logistic regression, using the frequency of intake of low-fat butter, regular and low-fat margarine as explanatory variable in relation to frequent intake of regular butter as reference group.RESULTS: Frequent intake of margarine of any kind was positively associated with current asthma during the past 12 months in young adults aged 18 to 29 years (aOR, 2.33; 95% CI, 1.03-5.26). In subgroup analysis, the positive association was confined to frequent intake of low-fat margarine (4.51; 1.78-11.43) or the combination of low-fat margarine and low-fat butter (4-79; 1.84-12-44). Consumption of margarine of any kind was not related to hay fever, atopic dermatitis, and atopic sensitization to inhalant allergens.CONCLUSIONS: Frequent intake of margarine rich in n-6 PUFA is not consistently associated with allergic diseases in adults. Other constituents of low-fat margarine or certain dietary habits and lifestyle factors, characterized by use of low-fat margarine, may be related to current asthma. (c) 2004 Elsevier Inc. All rights reserved.

Motor vehicle traffic contributes to more than 50% of PM10 in Europe and might have far reaching impacts on human health. We investigated the relationship between residential street type as a surrogate for traffic intensity and the prevalence of respiratory symptoms, atopic diseases, and allergic sensitization in adults. Data from 6896 subjects of the German Health Survey 1998 with complete information on residential street type were used. Multiple logistic regression analyses were applied to model associations between street type categories, and respiratory and atopic outcomes were assessed by screening questionnaire of The European Respiratory Health Survey and specific IgE measurements. Living at extremely or considerably busy roads (23.9% of total study population) compared to roads with no or rare traffic (64.5%) was statistically significantly associated with chronic bronchitis (aOR 1.36 (95% CI) (1.01-1.83)) while nocturnal coughing attacks (past 12 months) (1.24 (0.98-1.57)), wheeze during the past 12 months (1.21 (0.93-57)), and hay fever (1.16 (0.94-1.42)) were marginally increased after adjustment for several potential confounders and for multiple testing. No increased risks were found for asthma (0.97 (0.67-1.42)) and allergic sensitization (1.05 (0.91-1.20)). We conclude that exposure to traffic-related air pollutants increases the risk of nonallergic respiratory symptoms and to a lesser degree the risk of hay fever and allergic sensitization but not the risk of asthma in adults.

BACKGROUND:Moderate alcohol consumption has been suggested to facilitate elimination of Helicobacter pylori infection. AIM:To investigate the relationship between alcohol consumption and infection with H. pylori, with particular consideration of the role of age, different alcoholic beverages and specific drinking habits. METHODS:These issues were addressed in the German National Health Survey, conducted in a representative population sample between October 1997 and March 1999. Overall, 6545 subjects provided data on frequency and average amount of different alcoholic beverages consumed. H. pylori infection status was measured by serum immunoglobulin G antibodies. RESULTS:Seroprevalence of the infection was highest among subjects who reported drinking no alcohol (49.3%) and lowest among subjects consuming 25-50 g alcohol/day (35.2%, adjusted odds ratio = 0.60, 95% confidence interval: 0.48-0.75). This inverse association was consistently seen for different alcoholic beverages and in all age groups and it was particularly pronounced among women and among regular but moderate drinkers. There was also an inverse dose-response relationship between the frequency of alcohol consumption and H. pylori infection. CONCLUSIONS:This analysis supports suggestions that regular but moderate consumption of alcohol from various sources may facilitate elimination of H. pylori infection.

Objective The objective of this study was to investigate the associations of sero-positivity for Helicobacter pylori (HP) and hepatitis A virus infection (HAV) with prevalence of cardiovascular diseases (CVD) and CVD-risk markers in a large population-based sample of patients with diabetes mellitus (DM), who are at high risk of developing CVD. Background Several studies have suggested that chronic infections are associated with the development of atherosclerosis and coronary heart diseases (CHD). Methods This analysis is based on the German National Health Interview and Examination Survey which was conducted in 1998. We identified all subjects with prevalent DM aged 40–79 years. Helicobacter pylori and HAV status were measured by serum immunoglobulin G antibodies. Prevalence of several CVD events (myocardial infarction, stroke and CHD) was recorded. In addition, serum levels of total triglycerides, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol and lipoprotein (a) were measured. Results Among the 4285 participants of the German Health Survey aged 40–79 years, we identified 365 patients with DM. Of these, 32.1% had at least one CVD and there was a clear increase of CVD with age. Sero-prevalence of HP or HAV and their combination was not associated with the prevalence of CVD nor with mean levels of blood lipids after multivariate adjustment for covariates. Conclusion In this large group of 365 patients with diabetes mellitus no association of HP and HAV sero-prevalence with presence of CVDs or the level of serum lipids was established. Therefore it seems unlikely that HP and HAV sero-prevalence strongly influence CVD progression in patients with diabetes.

The German National Health Interview and Examination Survey for Children and Adolescents aims at obtaining generalisable and practically convertible data and knowledge of the health situation of children and adolescents aged between 0 and 18 and living in Germany. After an extensive preparatory period of conceptional work by the Robert Koch Institute the beginning of this study is planned for spring 2003. Over a period of three years a representative sample of 18,000 young people will be medically examined and will be interviewed together with their parents. The investigational programme of the survey consists of a central part encompassing questionnaires and medical analyses of the most important health topics in childhood and adolescence. In addition, complementary modules will analyse subpopulations in-depth and extensively for specific aspects and questions. These modules are usually developed and financed by cooperating partners of the Robert Koch Institute. Soon after completion of the survey data first results will be made freely available to the scientific community in Public Use Files. These Files will become relevant sources for future health reporting addressing children and adolescents. Furthermore, they represent a reliable data base for epidemiological research and prevention programmes.

In the pilot study of the National Health Survey for Children and Adolescents which has been conducted under the responsibility of the Robert Koch Institute from March 12th 2001 to March 15th 2002, 1,630 children and adolescents from 0 to 17 years as well as their parents have been included. Methodological issues have been very prominent. Questionnaires regarding properties, indicators (for example for psychic well-being) were developed and evaluated, different methods of access to the study participants as well as methods to increase the motivation to participate in the study were tested, and the property for generalisation or validity of the obtained information was investigated. The conduct of the pilot study resulted in a number of experiences and findings that will contribute to an optimised approach in the main course of the survey.

At the beginning of the 21st century, the German Health Interview and Examination Survey of Children and Adolescents will for the first time provide the data essential for programmes of disease prevention and health promotion as well as for the development of health targets. This it will create key information for an evidence-based health policy. The results of the study can be projected to the general population of children and adolescents in Germany. The data will be collected conjunct at the level of the individual subject. They will facilitate valid and distinct description of prevalent physical, psychological and social health problems, as well as on who has them under which circumstances and settings. Information on the impact, e.g., in terms of utilisation of the health system or impairments of quality of life, will also be available from the same subjects. In addition, indicators of risks to health in later life are included. Hence, the data will support prevention of health problems in infancy, childhood and adolescence as well as of chronic diseases in later life. Finally, the data shall be a basis for the definition of new reference values for many variables. This will improve valid and clear judgement not only in epidemiological studies but also in medical care.

Zusammenfassung Die aktuelle epidemiologische Datenlage zur Gesundheit von Kindern und Jugendlichen offenbart die Notwendigkeit einer repräsentativen Gesundheitserhebung für die 0- bis 17-Jährigen. Ein über mehrere Jahre entwickeltes Konzept für einen Kinder- und Jugendgesundheitssurvey wurde in einer einjährigen Pilotphase mit 1630 Kindern und Jugendlichen getestet. Die dabei gewonnenen Erfahrungen sowie Gutachterempfehlungen werden in einem im Jahr 2003 beginnenden Gesundheitssurvey für ca. 20.000 Kinder und Jugendliche umgesetzt. Diese bislang größte repräsentative Studie zur Gesundheit der heranwachsenden Generation in Deutschland wird gemeinsam vom Bundesministerium für Gesundheit, dem Bundesministerium für Bildung und Forschung und dem Robert Koch-Institut finanziert. Dabei sollen über drei Jahre in der ganzen Bundesrepublik zufällig ausgewählte Kinder und Jugendliche im Alter von 0 bis 17 Jahren gesundheitlich untersucht und befragt werden. Bei den jüngeren Kindern sind die Angaben der Eltern wesentliche Informationsquelle zum Gesundheitszustand der Kinder. Die durch den Survey gewonnenen Informationen werden nicht nur die Basis für eine fundierte bundesweite Gesundheitsberichterstattung zu Kindern und Jugendlichen sein, sondern auch Ansatzpunkte für Interventions- und Präventionsstrategien liefern. Die Daten werden schnellstmöglich der Fachöffentlichkeit als Public Use File zur weiteren Analyse zur Verfügung gestellt.

The first German Health Survey for Children and Adolescents will start in 2003. During three years, a representative sample of children and adolescents between 0 and 18 years of age shall be examined and will, together with their parents, be interviewed on health-relevant issues. With this survey, health information on about 18,000 children will be gathered. The health behaviour of the parents as far as their children's health is concerned, as well as the personal health behaviour during adolescence will be assessed, since this will be highly relevant for future health. Questions on nutrition behaviour, eating disorders, alcohol consumption, smoking as well as leisure-time behaviour, with special emphasis on physical activity, will be asked. These questions were tested for feasibility in a one-year pilot study. With this survey, the occurrence of certain unhealthy behaviour characteristics may be documented and risk groups may be identified. This may help to conceptualize prevention measures.

At the beginning of the 21st century, the German Health Interview and Examination Survey of Children and Adolescents will for the first time provide the data essential for programmes of disease prevention and health promotion as well as for the development of health targets. This it will create key information for an evidence-based health policy. The results of the study can be projected to the general population of children and adolescents in Germany. The data will be collected conjunct at the level of the individual subject. They will facilitate valid and distinct description of prevalent physical, psychological and social health problems, as well as on who has them under which circumstances and settings. Information on the impact, e.g., in terms of utilisation of the health system or impairments of quality of life, will also be available from the same subjects. In addition, indicators of risks to health in later life are included. Hence, the data will support prevention of health problems in infancy, childhood and adolescence as well as of chronic diseases in later life. Finally, the data shall be a basis for the definition of new reference values for many variables. This will improve valid and clear judgement not only in epidemiological studies but also in medical care.

The German National. Health Interview and Examination Survey for Children and Adolescents aims at obtaining generalisable and practically convertible data and knowledge of the health situation of children and adolescents aged between 0 and 18 and living in Germany. After an extensive preparatory period of conceptional work by the Robert Koch Institute the beginning of this study is planned for spring 2003. Over a period of three years a representative sample of 18,000 young people will be medically examined and will be interviewed together with their parents. The investigational programme of the survey consists of a central part encompassing questionnaires and medical analyses of the most important health topics in childhood and adolescence. In addition, complementary modules will analyse subpopulations in-depth and extensively for specific aspects and questions. These modules are usually developed and financed by cooperating partners of the Robert Koch Institute.Soon after completion of the survey data first results will be made freely available to the scientific community in Public Use Files. These Files will become relevant sources for future health reporting addressing children and adolescents. Furthermore, they represent a reliable data base for epidemiological research and prevention programmes.

Laboratory tests will be performed as part of the National Health Survey for Children and Adolescents to identify health risks and to determine the seroprevalence of disease markers. The parameters were selected from haematology, clinical chemistry, allergology, endocrinology and serology of infectious diseases as indicators of individual health risks, to validate information collected by means of the questionnaires and to identify age specific immunity gaps of vaccine-preventable diseases.

Der Kinder- und Jugendgesundheitssurvey hat das Ziel, für Deutschland verallgemeinerungsfähige, umsetzungsrelevante Daten und Erkenntnisse zur gesundheitlichen Situation von Kindern und Jugendlichen im Altersbereich zwischen 0 und 18 Jahren zu gewinnen. Nach umfangreichen Konzipierungs- und Vorbereitungsarbeiten durch das Robert Koch-Institut ist geplant, die Erhebung im Frühjahr 2003 zu beginnen. Über drei Jahre lang sollen an 150 verschiedenen Orten der Bundesrepublik Deutschland ca. 18 000 repräsentativ ausgewählte Kinder und Jugendliche untersucht und zusammen mit ihren Eltern befragt werden. Das Erhebungsprogramm besteht aus einem Kernsurvey, der Befragungen und Untersuchungen zu den inhaltlich wichtigsten Themenbereichen des gesundheitlichen Geschehens im Kindes- und Jugendalter umfasst. Zusätzlich gibt es von externen Kooperationspartnern konzipierte und finanzierte Module, bei denen an Unterstichproben der Studienpopulation thematisch vertiefende Untersuchungen durchgeführt werden.

The first German Health Survey for Children and Adolescents will start in 2003. During three years, a representative sample of children and adolescents between 0 and 18 years of age shall be examined and will, together with their parents, be interviewed on health-relevant issues. With this survey, health information on about 18,000 children will be gathered. The health behaviour of the parents as far as their children's health is concerned, as well as the personal health behaviour during adolescence will be assessed, since this will be highly relevant for future health. Questions on nutrition behaviour, eating disorders, alcohol consumption, smoking as well as leisure-time behaviour, with special emphasis on physical activity, will be asked. These questions were tested for feasibility in a one-year pilot study.With this survey, the occurrence of certain unhealthy behaviour characteristics may be documented and risk groups may be identified. This may help to conceptualise prevention measures.

In the pilot study of the National Health Survey for Children and Adolescents which has been conducted under the responsibility of the Robert Koch Institute from March 12th 2001 to March 15th 2002, 1,630 children and adolescents from 0 to 17 years as well as their parents have been included. Methodological issues have been very prominent. Questionnaires regarding properties, indicators (for example for psychic well-being) were developed and evaluated, different methods of access to the study participants as well as methods to increase the motivation to participate in the study were tested, and the property for generalisation or validity of the obtained information was investigated. The conduct of the pilot study resulted in a number of experiences and findings that will contribute to an optimised approach in the main course of the survey.