{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T08:30:56Z","timestamp":1775205056045,"version":"3.50.1"},"reference-count":33,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[1993,3,1]],"date-time":"1993-03-01T00:00:00Z","timestamp":730944000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1993,3,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>The measurement of bronchial hyperreactivity (BHR) may give additional information to questionnaire-based studies of asthma prevalence. It is desirable to have a provocation method with high specificity that avoids the use of pharmacologic provocations in large numbers of healthy children. It was the aim of this study to establish a range of values for responsiveness to cold-air challenge in normal children, to describe its specificity and sensitivity for a diagnosis of asthma in a large unselected sample of schoolchildren in a field study, and to measure factors associated with hyperresponsiveness. All fourth-grade schoolchildren (9 to 11 yr of age) in Munich and several southern Bavarian communities (n = 9,403) were surveyed with a questionnaire (response rate, 87%), baseline lung function, and cold-air hyperventilation challenge (n = 5,697). A diagnosis of asthma was reported in 7.9% of children. In the reference group, the ninety-fifth percentile (%ile) for the change of FEV1 (DFEV,) was \u22129.0%; the 90%ile was \u22127.3%. Asymptomatic children fulfilling all criteria for the reference group showed a significantly increased reactivity if they had a family history of asthma (p = 0.038). With a cutoff for DFEV1 of \u22129.0% or \u22127.3% the respective sensitivities to \u201cdetect\u201d a diagnosis of asthma were 21.6 and 30.7%, and for asthma with symptoms during the previous 12 months it was 26.2 and 35.1%. Reactivity to cold air increased with the number of episodes of asthma in the previous 12 months. In a multiple linear regression model, factors associated with increased reactivity to cold air were diagnosed asthma, hay fever, male sex, younger age, and a positive skin test. A comparison with other population-based studies in children suggests that cold air has a lower sensitivity than does histamine (30.7% versus 52%), with a specificity of close to 90% for both methods.<\/jats:p>","DOI":"10.1164\/ajrccm\/147.3.565","type":"journal-article","created":{"date-parts":[[2013,4,4]],"date-time":"2013-04-04T17:41:07Z","timestamp":1365097267000},"page":"565-572","source":"Crossref","is-referenced-by-count":54,"title":["Reactivity to Cold-Air Hyperventilation in Normal and in Asthmatic Children in a Survey of 5,697 Schoolchildren in Southern Bavaria"],"prefix":"10.1093","volume":"147","author":[{"given":"T.","family":"Nicolai","sequence":"first","affiliation":[{"name":"Universit\u00e4tskinderklinik M\u00fcnchen, University of Munich, and GSF, Forschungzentrum f\u00fcr Umwelt und Gesundheit, Neuherberg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E. V.","family":"Mutius","sequence":"additional","affiliation":[{"name":"Universit\u00e4tskinderklinik M\u00fcnchen, University of Munich, and GSF, Forschungzentrum f\u00fcr Umwelt und Gesundheit, Neuherberg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P.","family":"Reitmeir","sequence":"additional","affiliation":[{"name":"Universit\u00e4tskinderklinik M\u00fcnchen, University of Munich, and GSF, Forschungzentrum f\u00fcr Umwelt und Gesundheit, Neuherberg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Wjst","sequence":"additional","affiliation":[{"name":"Universit\u00e4tskinderklinik M\u00fcnchen, University of Munich, and GSF, Forschungzentrum f\u00fcr Umwelt und Gesundheit, Neuherberg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[1993,3,1]]},"reference":[{"key":"p_1","doi-asserted-by":"publisher","DOI":"10.1136\/adc.64.10.1452"},{"key":"p_2","first-page":"463","volume":"96","author":"Mitchell EA","year":"1983","journal-title":"NZ Med J"},{"key":"p_3","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.302.6785.1116"},{"key":"p_4","first-page":"225","volume":"136","author":"American Thoracic Society","year":"1987","journal-title":"Am Aev Aespir Dis"},{"key":"p_5","doi-asserted-by":"publisher","DOI":"10.1136\/thx.37.6.423"},{"key":"p_6","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2222.1988.tb02856.x"},{"key":"p_7","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2222.1987.tb02015.x"},{"key":"p_8","first-page":"549","volume":"142","author":"Pattemore PK","year":"1990","journal-title":"Am Aev Aespir Dis"},{"key":"p_9","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.300.6735.1306"},{"key":"p_10","doi-asserted-by":"publisher","DOI":"10.1136\/thx.41.4.283"},{"key":"p_11","doi-asserted-by":"publisher","DOI":"10.1016\/0091-6749(79)90199-4"},{"key":"p_12","first-page":"671","volume":"133","author":"Frischer T","year":"1991","journal-title":"Munch Med Wschr"},{"key":"p_13","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.1950020107"},{"key":"p_14","doi-asserted-by":"publisher","DOI":"10.1111\/j.1651-2227.1986.tb10283.x"},{"key":"p_15","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm\/142.3.497"},{"key":"p_16","doi-asserted-by":"publisher","DOI":"10.1203\/00006450-198405000-00016"},{"key":"p_17","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.1950030410"},{"key":"p_18","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(85)80009-3"},{"key":"p_19","doi-asserted-by":"publisher","DOI":"10.1007\/BF02719703"},{"key":"p_20","first-page":"898","volume":"129","author":"Weiss ST","year":"1984","journal-title":"Am Aev Aespir Dis"},{"key":"p_21","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/16.1.121"},{"key":"p_22","doi-asserted-by":"publisher","DOI":"10.1016\/S0091-6749(74)80006-0"},{"key":"p_23","first-page":"131","volume":"113","author":"Empey DW","year":"1976","journal-title":"Am Aev Aespir Dis"},{"key":"p_24","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199012273232603"},{"key":"p_25","doi-asserted-by":"publisher","DOI":"10.1016\/0091-6749(75)90061-5"},{"key":"p_27","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2222.1977.tb01481.x"},{"key":"p_28","doi-asserted-by":"publisher","DOI":"10.2307\/2527727"},{"key":"p_29","first-page":"119","author":"Lusted LB","year":"1968","journal-title":"Springfield, IL: Charles C. Thomas"},{"key":"p_30","doi-asserted-by":"publisher","DOI":"10.2307\/2531595"},{"key":"p_31","first-page":"502","volume":"134","author":"Tager IB","year":"1986","journal-title":"Am Rev Respir Dis"},{"key":"p_32","doi-asserted-by":"publisher","DOI":"10.1016\/0091-6749(86)90330-1"},{"key":"p_33","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199110103251504"},{"key":"p_34","doi-asserted-by":"crossref","first-page":"1093","DOI":"10.1183\/09031936.93.04091093","volume":"4","author":"Backer V","year":"1991","journal-title":"Eur Respir J"}],"container-title":["American Review of Respiratory Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ajrccm\/article-pdf\/147\/3\/565\/67756162\/ajrccm_147_3_565.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ajrccm\/article-pdf\/147\/3\/565\/67756162\/ajrccm_147_3_565.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T06:41:50Z","timestamp":1775198510000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ajrccm\/article\/147\/3\/565\/8556470"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1993,3,1]]},"references-count":33,"journal-issue":{"issue":"3","published-online":{"date-parts":[[1993,3,1]]},"published-print":{"date-parts":[[1993,3,1]]}},"URL":"https:\/\/doi.org\/10.1164\/ajrccm\/147.3.565","relation":{},"ISSN":["0003-0805"],"issn-type":[{"value":"0003-0805","type":"print"}],"subject":[],"published-other":{"date-parts":[[1993,3]]},"published":{"date-parts":[[1993,3,1]]}}}