Environmental exposure and sensitization patterns in a Swiss alpine pediatric cohort

Karin B Fieten; José M Maya-Manzano; Beate Rückert; Joana Candeias; Gudrun Pusch; CK-CARE Study Group; Jeroen Buters; Cezmi A Akdis; Claudia Traidl-Hoffmann

doi:10.1016/j.waojou.2023.100847

Environmental exposure and sensitization patterns in a Swiss alpine pediatric cohort

World Allergy Organ J. 2023 Dec 3;16(12):100847. doi: 10.1016/j.waojou.2023.100847. eCollection 2023 Dec.

Authors

Karin B Fieten^{1

2

3}, José M Maya-Manzano^{4

5}, Beate Rückert², Joana Candeias⁴, Gudrun Pusch⁴; CK-CARE Study Group; Jeroen Buters⁴, Cezmi A Akdis^{2

3}, Claudia Traidl-Hoffmann^{3

6

7}

Collaborators

CK-CARE Study Group:
Peter Schmid-Grendelmeier, Roger Lauener, Thomas Bieber, Marie-Charlotte Brüggen, Ellen Renner, Claudia Traidl-Hoffmann, Cezmi Akdis

Affiliations

¹ Hochgebirgsklinik Davos, Davos, Switzerland.
² Swiss Institute for Allergy and Asthma Research (SIAF), University of Zürich, Davos, Switzerland.
³ Christine Kühne Center for Allergy Research and Education (CK-CARE), Davos, Switzerland.
⁴ Center of Allergy & Environment (ZAUM), Member of the German Center for Lung Research (DZL), Technische Universität München/Helmholtz Center, Munich, Germany.
⁵ Department of Plant Biology, Ecology and Earth Sciences, University of Extremadura, Badajoz, Spain.
⁶ Environmental Medicine, Faculty of Medicine, University of Augsburg, Augsburg, Germany.
⁷ Institute of Environmental Medicine, Helmholtz Center Munich - German Research Center for Environmental Health, Augsburg, Germany.

Abstract

Background: The level of environmental exposure throughout life may contribute to the prevalence of allergic sensitization and allergic disease. The alpine climate has been considered a healthy climate with little allergen exposure and pollution. We conducted a cross-sectional study to investigate local environmental exposure and concomitant prevalence of allergic sensitization among local school children born and raised in an alpine environment.

Methods: Clinical and demographic data were collected with a questionnaire. Allergen content was assessed in residential settled dust samples, lifetime exposure to pollen and air pollution was calculated using data from national pollen and air pollution monitoring stations, and the allergic sensitization profile was determined with component resolved diagnostics (ISAC®). Univariate and multivariate regression models were used to estimate the relation between exposure and sensitization.

Results: In a cohort of children born and raised in an alpine environment, sensitization to aeroallergens is quite common (38%), especially to grass (33%) and cat (16%). House dust mite allergen was detected in up to 38% of residential dust samples, but sensitization to HDM was low (2.5%). Pollutant levels were low, but an increasing trend was observed in the amount of ozone and PM₁₀. Living close to a busy road was associated with increased odds OR (95% CI) for being sensitized to any allergen 2.7 (1.0-7.2), to outdoor allergens 2.8 (1.1-7.1) and being sensitized plus reporting symptoms of rhinoconjunctivitis 4.4 (1.3-14.8) and asthma 5.5 (1.4-21). Indoor living conditions, including the presence of visible mold, increased the odds of being sensitized to indoor allergens (1.9 (1.1-3.2) and being sensitized plus reporting symptoms of rhinoconjunctivitis 1.9 (1.0-3.6) and asthma 2.1 (1.0-4.1).

Conclusion: In a healthy alpine environment, pollution might still be an important factor contributing to allergic sensitization.

Keywords: Allergic sensitization; Alpine; Environment; Exposure; Pollution.