The association of smoking with sensitization to common environmental allergens: results from the European Community Respiratory Health Survey.

BACKGROUND

Smoking is a risk factor for sensitization to some occupational allergens, but its association with sensitization to common environmental allergens remains unclear.

OBJECTIVE

We sought to determine the association of smoking with total IgE levels and with sensitization to 3 common environmental allergens in data from the European Community Respiratory Health Survey.

METHODS

A detailed smoking history and blood sample for determination of serum total IgE and specific IgE levels to house dust mite, grass, and cat allergens was obtained from 13,002 randomly selected young adults living in the areas served by 34 centers in 14 countries. Associations with smoking status and amount smoked were determined. Because there was evidence of heterogeneity between centers in the association of age, sex, and smoking with sensitization, odds ratios (ORs) were determined for each center and combined by using random-effects meta-analysis.

RESULTS

Compared with lifetime nonsmokers, current smokers were at an increased risk of sensitization to house dust mite allergen (OR, 1.13; 95% confidence interval [CI], 1.02-1.26) but a decreased risk of sensitization to grass (OR, 0.76; 95% CI, 0.67-0.88) and cat allergens (OR, 0.69; 95% CI, 0.59-0.80). Exclusion of those with symptoms suggestive of current asthma strengthened the association of smoking with sensitization to house dust mite allergen (OR, 1.29; 95% CI, 1.11-1. 50). The geometric mean total IgE level was higher in smokers and was higher among those who currently smoked the most compared with those who smoked less than 5 cigarettes per day.

CONCLUSION

The association between smoking and sensitization to common environmental allergens is different for different allergens.