{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T08:01:02Z","timestamp":1761897662989},"reference-count":34,"publisher":"Oceanside Publications Inc.","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["allergy asthma proc"],"published-print":{"date-parts":[[2022,1,1]]},"abstract":"<jats:p><jats:bold>Background:<\/jats:bold> The prevalence of childhood asthma, rhinoconjunctivitis, and eczema in the city of Patras, Greece, has been followed in four consecutive surveys since 1991. After a continuous rise in the prevalence of all three of these disorders, a plateau was reached for asthma\n between 2003 and 2008, whereas the prevalence of rhinoconjunctivitis and eczema continued to increase.  <jats:bold>Objective:<\/jats:bold> To investigate these trends in the same population into the following decade.  <jats:bold>Methods:<\/jats:bold> We repeated two methodologically identical cross-sectional\n parental questionnaire surveys in 2013 and 2018 among 8\u20109-year-old schoolchildren (N = 2554 and N = 2648, respectively). In 2018, spirometry and fractional exhaled nitric oxide (FeNO) measurements were also performed.  <jats:bold>Results:<\/jats:bold> Current asthma (i.e., wheeze\/asthma\n in the past 2 years) decreased from 6.9% in 2008 to 5.2% in 2013 and 4.3% in 2018 (p for trend &lt; 0.001). The prevalence of lifetime (\u201cever had\u201d) rhinoconjunctivitis also declined (5.1% in 2008, 4.4% in 2013, 3.0% in 2018; p for trend &lt; 0.001), whereas that of lifetime eczema\n increased (10.8%, 13.6%, and 16.1%, respectively; p for trend &lt; 0.001). The relative risk of current asthma in children with ever-had rhinoconjundtivitis was 7.73 in 2008, 6.00 in 2013, and 6.69 in 2018, whereas the relative risk in those with ever-had eczema was 5.15, 2.80, and 2.22, respectively.\n Among children with asthma, those with rhinoconjunctivitis had lower forced expiratory volume in the first second of expiration and higher FeNO values than those with eczema.  <jats:bold>Conclusion:<\/jats:bold> The prevalence of asthma and rhinoconjunctivitis declined during the past decade in\n Greek schoolchildren, whereas the prevalence of eczema continued to rise. Nevertheless, the relationship between rhinoconjunctivitis and asthma remained strong, whereas the association between eczema and asthma appears to have weakened.<\/jats:p>","DOI":"10.2500\/aap.2022.43.210110","type":"journal-article","created":{"date-parts":[[2022,1,5]],"date-time":"2022-01-05T12:03:14Z","timestamp":1641384194000},"page":"e17-e24","source":"Crossref","is-referenced-by-count":5,"title":["Diverging trends of respiratory allergies and eczema in Greek schoolchildren: Six surveys during 1991\u20102018"],"prefix":"10.2500","volume":"43","author":[{"given":"Styliani","family":"Malliori","sequence":"first","affiliation":[{"name":"From the Pediatric Respiratory Unit, University Hospital of Patras, University of Patras Medical School, Rion, Patras, Greece; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexandros","family":"Ntzounas","sequence":"additional","affiliation":[{"name":"From the Pediatric Respiratory Unit, University Hospital of Patras, University of Patras Medical School, Rion, Patras, Greece; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Panagiotis","family":"Lampropoulos","sequence":"additional","affiliation":[{"name":"From the Pediatric Respiratory Unit, University Hospital of Patras, University of Patras Medical School, Rion, Patras, Greece; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eleana","family":"Koliofoti","sequence":"additional","affiliation":[{"name":"From the Pediatric Respiratory Unit, University Hospital of Patras, University of Patras Medical School, Rion, Patras, Greece; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kostas N.","family":"Priftis","sequence":"additional","affiliation":[{"name":"Third Department of Paediatrics, \u201cAttikon\u201d Hospital, University of Athens Medical School, Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sotirios","family":"Fouzas","sequence":"additional","affiliation":[{"name":"From the Pediatric Respiratory Unit, University Hospital of Patras, University of Patras Medical School, Rion, Patras, Greece; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael B.","family":"Anthracopoulos","sequence":"additional","affiliation":[{"name":"From the Pediatric Respiratory Unit, University Hospital of Patras, University of Patras Medical School, Rion, Patras, Greece; and"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1355","reference":[{"key":"B1","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1542\/peds.2004-2709","article-title":"Changes in the prevalence of asthma and allergies among children and adolescents in Italy: 1994\u20132002","volume":"117","author":"Galassi","year":"2006","journal-title":"Pediatrics"},{"key":"B2","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1136\/bmj.38139.666447.F7","article-title":"Respiratory symptoms and atopy in children in Aberdeen: questionnaire studies of a defined school population repeated over 35 years","volume":"329","author":"Devenny","year":"2004","journal-title":"BMJ"},{"key":"B3","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1136\/thx.2005.045682","article-title":"Asthma prevalence in 1973, 1988 and 2003","volume":"61","author":"Burr","year":"2006","journal-title":"Thorax"},{"key":"B4","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1183\/09031936.98.12020315","article-title":"Worldwide variations in the prevalence of asthma symptoms: the International Study of Asthma and Allergies in Childhood (ISAAC)","volume":"12","year":"1998","journal-title":"Eur Respir J"},{"key":"B5","doi-asserted-by":"crossref","first-page":"758","DOI":"10.1136\/thx.2006.070169","article-title":"Worldwide trends in the prevalence of asthma symptoms: phase III of the International Study of Asthma and Allergies in Childhood (ISAAC)","volume":"62","author":"Pearce","year":"2007","journal-title":"Thorax"},{"key":"B6","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1111\/j.1399-3038.2007.00601.x","article-title":"Worldwide time trends for symptoms of rhinitis and conjunctivitis: phase III of the International Study of Asthma and Allergies in Childhood","volume":"19","author":"Bj\u00f6rkst\u00e9n","year":"2008","journal-title":"Pediatr Allergy Immunol"},{"key":"B7","doi-asserted-by":"crossref","first-page":"1251","DOI":"10.1016\/j.jaci.2009.10.009","article-title":"Global variations in prevalence of eczema symptoms in children from ISAAC phase three","volume":"124","author":"Odhiambo","year":"2009","journal-title":"J Allergy Clin Immunol"},{"key":"B8","first-page":"1","article-title":"Trends in allergic conditions among children: United States, 1997\u20132011","volume":"121","author":"Jackson","year":"2013","journal-title":"NCHS Data Brief"},{"key":"B9","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1542\/peds.2015-2354","article-title":"Changing trends in asthma prevalence","volume":"137","author":"Akinbami","year":"2016","journal-title":"Pediatrics"},{"key":"B10","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1002\/ppul.20545","article-title":"Changing trends in sex specific prevalence rates for childhood asthma, eczema, and hay fever","volume":"42","author":"Osman","year":"2007","journal-title":"Pediatr Pulmonol"},{"key":"B11","doi-asserted-by":"crossref","first-page":"e008446","DOI":"10.1136\/bmjopen-2015-008446","article-title":"Diverging prevalence and different risk factors for childhood asthma and eczema: a cross-sectional study","volume":"5","author":"Barnish","year":"2015","journal-title":"BMJ Open"},{"key":"B12","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1111\/j.1399-3038.2008.00752.x","article-title":"Increase in chronic or recurrent rhinitis, rhinoconjunctivitis and eczema among schoolchildren in Greece: three surveys during 1991\u20132003","volume":"20","author":"Anthracopoulos","year":"2009","journal-title":"Paediatr Allergy Immunol"},{"key":"B13","doi-asserted-by":"crossref","first-page":"56","DOI":"10.2500\/aap.2011.32.3504","article-title":"Prevalence trends of rhinoconjunctivitis, eczema, and atopic asthma in in Greek schoolchildren: four surveys during 1991\u20132008","volume":"32","author":"Anthracopoulos","year":"2011","journal-title":"Allergy Asthma Proc"},{"key":"B14","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1136\/thx.56.7.569","article-title":"Prevalence of asthma among schoolchildren in Patras, Greece: three surveys over 20 years","volume":"56","author":"Anthracopoulos","year":"2001","journal-title":"Thorax"},{"key":"B15","doi-asserted-by":"crossref","first-page":"1000","DOI":"10.1111\/j.1651-2227.2011.02255.x","article-title":"Sex-specific trends in prevalence of childhood asthma over 30 years in Patras, Greece","volume":"100","author":"Anthracopoulos","year":"2011","journal-title":"Acta Paediatr"},{"key":"B16","doi-asserted-by":"crossref","first-page":"3242","DOI":"10.1002\/ppul.25575","article-title":"Changing trends in the prevalence of childhood asthma over 40 years in Greece","volume":"56","author":"Ntzounas","year":"2021","journal-title":"Pediatr Pulmonol"},{"key":"B17","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1183\/09031936.05.00034805","article-title":"Standardisation of spirometry","volume":"26","author":"Miller","year":"2005","journal-title":"Eur Respir J"},{"key":"B18","doi-asserted-by":"crossref","first-page":"1324","DOI":"10.1183\/09031936.00080312","article-title":"Multi-ethnic reference values of spirometry for the 3-95-yr age range: the Global Lung Function 2012 equations","volume":"40","author":"Quanjer","year":"2012","journal-title":"Eur Respir J"},{"key":"B19","doi-asserted-by":"crossref","first-page":"602","DOI":"10.1164\/rccm.9120-11ST","article-title":"An official ATS clinical practice guideline: interpretation of exhaled nitric oxide levels (FENO) for clinical applications","volume":"184","author":"Dweik","year":"2011","journal-title":"Am J Respir Crit Care Med"},{"key":"B20","doi-asserted-by":"crossref","first-page":"386","DOI":"10.1136\/bmj.328.7436.386","article-title":"Prevalence of asthma and allergy in schoolchildren in Belmont, Australia: three cross sectional surveys over 20 years","volume":"328","author":"Toelle","year":"2004","journal-title":"BMJ"},{"key":"B21","doi-asserted-by":"crossref","first-page":"506","DOI":"10.1111\/j.1365-3016.2009.01057.x","article-title":"Changes in the prevalence of asthma, eczema, and hay fever in pre-pubertal children: a 40-year perspective","volume":"23","author":"McNeill","year":"2009","journal-title":"Paediatr Perinat Epidemiol"},{"key":"B22","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1111\/apa.13433","article-title":"Allergic rhinoconjunctivitis continued to increase in Swedish children up to 2007, but asthma and eczema levelled off from 1991","volume":"106","author":"Hicke-Roberts","year":"2017","journal-title":"Acta Paediatr"},{"key":"B23","doi-asserted-by":"crossref","first-page":"360","DOI":"10.1016\/j.jaci.2015.02.003","article-title":"Incidence rates of atopic dermatitis, asthma, and allergic rhinoconjunctivitis in Danish and Swedish children","volume":"136","author":"Henriksen","year":"2015","journal-title":"J Allergy Clin Immunol"},{"key":"B24","doi-asserted-by":"crossref","first-page":"1068","DOI":"10.1016\/j.jaci.2006.07.028","article-title":"Noninvasive methods for the detection of upper and lower airway inflammation in atopic children","volume":"118","author":"Profita","year":"2006","journal-title":"J Allergy Clin Immunol"},{"key":"B25","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1111\/j.1365-2230.2008.03142.x","article-title":"Measurement of nitric oxide and 8-isoprostane in exhaled breath of children with atopic eczema","volume":"34","author":"Zinelli","year":"2009","journal-title":"Clin Exp Dermatol"},{"key":"B26","doi-asserted-by":"crossref","first-page":"44","DOI":"10.3389\/fped.2017.00044","article-title":"The nose and the lung: united airway disease","volume":"5","author":"Licari","year":"2017","journal-title":"Front Pediatr"},{"key":"B27","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1016\/j.aller.2017.09.025","article-title":"Small-airway dysfunction precedes the development of asthma in children with allergic rhinitis","volume":"46","author":"Skylogianni","year":"2018","journal-title":"Allergol Immunopathol (Madr)"},{"key":"B28","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1016\/j.jaci.2018.11.006","article-title":"The atopic march and atopic multimorbidity: many trajectories, many pathways","volume":"143","author":"Paller","year":"2019","journal-title":"J Allergy Clin Immunol"},{"key":"B29","doi-asserted-by":"crossref","first-page":"1076","DOI":"10.1038\/ni.3829","article-title":"The immunology of the allergy epidemic and the hygiene hypothesis","volume":"10","author":"Lambrecht","year":"2017","journal-title":"Nat Immunol"},{"key":"B30","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1016\/j.anai.2020.12.020","article-title":"Atopic dermatitis in the pediatric population: a cross-sectional, international epidemiological study","volume":"126","author":"Silverberg","year":"2021","journal-title":"Ann Allergy Asthma Immunol"},{"key":"B31","doi-asserted-by":"crossref","first-page":"373","DOI":"10.3345\/cep.2020.00822","article-title":"Prevalence, comorbidities, diagnosis, and treatment of nonallergic rhinitis: real-world comparison with allergic rhinitis","volume":"64","author":"Yum","year":"2021","journal-title":"Clin Exp Pediatr"},{"key":"B32","doi-asserted-by":"crossref","first-page":"905","DOI":"10.1056\/NEJMoa1414123","article-title":"Association of improved air quality with lung development in children","volume":"372","author":"Gauderman","year":"2015","journal-title":"N Engl J Med"},{"key":"B33","first-page":"20190314","article-title":"A chronology of global air quality","volume":"378","author":"Fowler","year":"2020","journal-title":"Philos Trans A Math Phys Eng Sci"},{"key":"B34","article-title":"Atmospheric pollution in urban areas in Greece and economic crisis. Trends in air quality and atmospheric pollution data, research and adverse health effects","author":"Valavanidis"}],"container-title":["Allergy and Asthma Proceedings"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ingentaconnect.com\/content\/ocean\/aap\/2022\/00000043\/00000001\/art00006","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,6,6]],"date-time":"2022-06-06T08:21:29Z","timestamp":1654503689000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ingentaconnect.com\/content\/10.2500\/aap.2022.43.210110"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1,1]]},"references-count":34,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2022,1,1]]}},"alternative-id":["1088-5412(20220101)43:1L.17;1-"],"URL":"https:\/\/doi.org\/10.2500\/aap.2022.43.210110","relation":{},"ISSN":["1088-5412"],"issn-type":[{"value":"1088-5412","type":"print"}],"subject":[],"published":{"date-parts":[[2022,1,1]]}}}