Occupational & Environmental Medicine, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
Clin Exp Allergy. 2011 Aug;41(8):1108-15. doi: 10.1111/j.1365-2222.2011.03744.x. Epub 2011 Apr 11.
Studies of asthma in migrant populations illustrate the effects of environmental changes.
In this register study we investigated the importance of exposure to a western lifestyle in different phases of development in Swedish residents with an origin in regions in the world where asthma usually is less prevalent.
The study population comprised 24,252 international adoptees, 47,986 foreign-born and 40,971 Swedish-born with foreign-born parents and 1,770,092 Swedish-born residents with Swedish-born parents (age 6-25 years). Purchased prescribed inhaled corticosteroids (ICS) during 2006 were used as an indicator of asthma.
International adoptees and children born in Sweden by foreign-born parents had three- to fourfold higher rates of asthma medication compared with foreign-born children. The odds ratios (ORs) of asthma medication declined persistently with age at immigration. For adoptees the ORs compared with infant adoptees were 0.78 [95% confidence interval (CI) 0.71-0.85] for those adopted at 1-2 years, 0.51 (0.42-0.61) at 3-4 years and 0.35 (0.27-0.44) after 5 or more years of age. Corresponding ORs for foreign-born children with foreign-born parents immigrating at 0-4 years, at 5-9 years, at 10-14 years and at 15 years or more were 0.73 (0.63-0.86), 0.56 (CI 0.46-0.68) and 0.35 (CI 0.28-0.43), respectively. The ORs were only marginally affected by adjustment for region of birth and socio-economic indicators.
Age at immigration is a more important determinant of purchased ICS than population of origin. This indicates the importance of environmental factors for asthma in schoolchildren and young adults.
移民人群中的哮喘研究说明了环境变化的影响。
在这项注册研究中，我们调查了在世界上哮喘发病率通常较低的地区出生的瑞典居民在不同发育阶段接触西方生活方式的重要性。
研究人群包括 24252 名国际领养者、47986 名外国出生者和 40971 名外国出生者的瑞典出生父母以及 1770092 名瑞典出生者的瑞典出生父母（年龄 6-25 岁）。2006 年购买的处方吸入性皮质类固醇（ICS）被用作哮喘的指标。
国际领养者和外国出生父母在瑞典出生的儿童的哮喘药物使用率比外国出生的儿童高出三到四倍。与外国出生的儿童相比，移民时的年龄与哮喘药物使用的比值比（ORs）呈持续下降趋势。对于领养者，与婴儿期被领养者相比，1-2 岁被领养者的 OR 为 0.78（95%置信区间（CI）0.71-0.85），3-4 岁时为 0.51（0.42-0.61），5 岁或以上时为 0.35（0.27-0.44）。对于外国出生的父母在 0-4 岁、5-9 岁、10-14 岁和 15 岁或以上移民的外国出生儿童，相应的 OR 分别为 0.73（0.63-0.86）、0.56（0.46-0.68）和 0.35（0.28-0.43）。调整出生地和社会经济指标后，OR 值仅略有影响。
移民年龄是购买 ICS 的比原籍国更重要的决定因素。这表明环境因素对学龄儿童和青少年哮喘的重要性。
