Are Environmental Factors for Atopic Eczema in ISAAC Phase Three due to Reverse Causation?
Cast your vote
You can rate an item by clicking the amount of stars they wish to award to this item.
When enough users have cast their vote on this item, the average rating will also be shown.
Your vote was cast
Thank you for your feedback
Thank you for your feedback
AuthorsRutter, Charlotte E
Silverwood, Richard J
Williams, Hywel C
Strachan, David P
Langan, Sinéad M
ISAAC Phase Three Study Group
Major clinical study
MetadataShow full item record
JournalJournal of Investigative Dermatology
AbstractSome previously described environmental associations for atopic eczema may be due to reverse causation. We explored the role of reverse causation by comparing individual- and school-level results for multiple atopic eczema risk factors. The International Study of Asthma and Allergies in Childhood (i.e, ISAAC) Phase Three surveyed children in schools (the sampling unit) regarding atopic eczema symptoms and potential risk factors. We assessed the effect of these risk factors on atopic eczema symptoms using mixed-effect logistic regression models, first with individual-level exposure data and second with school-level exposure prevalence. Overall, 546,348 children from 53 countries were included. At ages 6–7 years, the strongest individual-level associations were with current paracetamol use (odds ratio [OR] = 1.45, 95% confidence interval [CI] = 1.37–1.54), which persisted at school-level (OR = 1.55, 95% CI = 1.10–2.21), early-life antibiotics (OR = 1.41, 95% CI = 1.34–1.48), and early-life paracetamol use (OR = 1.28, 95% CI = 1.21–1.36), with the former persisting at the school level, whereas the latter was no longer observed (OR = 1.35, 95% CI = 1.00–1.82 and OR = 0.94, 95% CI = 0.69–1.28, respectively). At ages 13–14 years, the strongest associations at the individual level were with current paracetamol use (OR = 1.57, 95% CI = 1.51–1.63) and open-fire cooking (OR = 1.46, 95% CI = 1.33–1.62); both were stronger at the school level (OR = 2.57, 95% CI = 1.84–3.59 and OR = 2.38, 95% CI = 1.52–3.73, respectively). Association with exposure to heavy traffic (OR = 1.31, 95% CI = 1.27–1.36) also persisted at the school level (OR = 1.40, 95% CI = 1.07–1.82). Most individual- and school-level effects were consistent, tending to exclude reverse causation.
- Are environmental risk factors for current wheeze in the International Study of Asthma and Allergies in Childhood (ISAAC) phase three due to reverse causation?
- Authors: Silverwood RJ, Rutter CE, Mitchell EA, Asher MI, Garcia-Marcos L, Strachan DP, Pearce N, ISAAC Phase Three Study Group.
- Issue date: 2019 Apr
- Association between paracetamol use in infancy and childhood, and risk of asthma, rhinoconjunctivitis, and eczema in children aged 6-7 years: analysis from Phase Three of the ISAAC programme.
- Authors: Beasley R, Clayton T, Crane J, von Mutius E, Lai CK, Montefort S, Stewart A, ISAAC Phase Three Study Group.
- Issue date: 2008 Sep 20
- Comparison of individual-level and population-level risk factors for rhinoconjunctivitis, asthma, and eczema in the International Study of Asthma and Allergies in Childhood (ISAAC) Phase Three.
- Authors: Rutter CE, Silverwood RJ, Asher MI, Ellwood P, Pearce N, Garcia-Marcos L, Strachan DP, ISAAC Phase Three Study Group.
- Issue date: 2020 Jun
- [Prevalence of symptoms of asthma, allergic rhinitis, conjunctivitis and atopic eczema: ISAAC (International Study of Asthma and Allergies in Childhood) in a population of schoolchildren in Zagreb].
- Authors: Stipić-Marković A, Pevec B, Pevec MR, Custović A
- Issue date: 2003
- Association between environmental factors and current asthma, rhinoconjunctivitis and eczema symptoms in school-aged children from Oropeza Province--Bolivia: a cross-sectional study.
- Authors: Solis-Soto MT, Patiño A, Nowak D, Radon K
- Issue date: 2013 Nov 5