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Open AccessArticle

Modifiable Risk Factors for Common Ragweed (Ambrosia artemisiifolia) Allergy and Disease in Children: A Case-Control Study

1
School of Environmental Sciences, University of East Anglia, Norwich NR4 7TJ, UK
2
Department Children’s Hospital Srebrnjak, Srebrnjak 100, 10000 Zagreb, Croatia
3
Division of Immunology, Allergy and Infectious Diseases, Department of Dermatology, Währinger Gürtel 18–20, Room 4P9.02, 1090 Vienna, Austria
*
Author to whom correspondence should be addressed.
These authors contribute equally to this article.
Int. J. Environ. Res. Public Health 2018, 15(7), 1339; https://doi.org/10.3390/ijerph15071339
Received: 24 May 2018 / Revised: 21 June 2018 / Accepted: 22 June 2018 / Published: 26 June 2018
(This article belongs to the Special Issue The Epidemiology of Allergy)
Ragweed allergy is a major public health concern. Within Europe, ragweed is an introduced species and research has indicated that the amounts of ragweed pollen are likely to increase over Europe due to climate change, with corresponding increases in ragweed allergy. To address this threat, improving our understanding of predisposing factors for allergic sensitisation to ragweed and disease is necessary, specifically focusing upon factors that are potentially modifiable (i.e., environmental). In this study, a total of 4013 children aged 2–13 years were recruited across Croatia to undergo skin prick tests to determine sensitisation to ragweed and other aeroallergens. A parental questionnaire collected home environment, lifestyle, family and personal medical history, and socioeconomic information. Environmental variables were obtained using Geographical Information Systems and data from nearby pollen, weather, and air pollution stations. Logistic regression was performed (clustered on school) focusing on risk factors for allergic sensitisation and disease. Ragweed sensitisation was strongly associated with ragweed pollen at levels over 5000 grains m–3 year−1 and, above these levels, the risk of sensitisation was 12–16 times greater than in low pollen areas with about 400 grains m–3 year−1. Genetic factors were strongly associated with sensitisation but nearly all potentially modifiable factors were insignificant. This included measures of local land use and proximity to potential sources of ragweed pollen. Rural residence was protective (odds ratio (OR) 0.73, 95% confidence interval (CI) 0.55–0.98), but the factors underlying this association were unclear. Being sensitised to ragweed doubled (OR 2.17, 95% CI 1.59–2.96) the risk of rhinoconjunctivitis. No other potentially modifiable risk factors were associated with rhinoconjunctivitis. Ragweed sensitisation was strongly associated with ragweed pollen, and sensitisation was significantly associated with rhinoconjunctivitis. Apart from ragweed pollen levels, few other potentially modifiable factors were significantly associated with ragweed sensitisation. Hence, strategies to lower the risk of sensitisation should focus upon ragweed control. View Full-Text
Keywords: ragweed; allergy; climate change; rhinoconjunctivitis; sensitization; Ambrosia artemisiifolia ragweed; allergy; climate change; rhinoconjunctivitis; sensitization; Ambrosia artemisiifolia
MDPI and ACS Style

Agnew, M.; Banic, I.; Lake, I.R.; Goodess, C.; Grossi, C.M.; Jones, N.R.; Plavec, D.; Epstein, M.; Turkalj, M. Modifiable Risk Factors for Common Ragweed (Ambrosia artemisiifolia) Allergy and Disease in Children: A Case-Control Study. Int. J. Environ. Res. Public Health 2018, 15, 1339.

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