Leung R C, Carlin J B, Burdon J G, Czarny D
St Vincent's Hospital, Fitzroy, Vic.
Med J Aust. 1994 Oct 3;161(7):418-25. doi: 10.5694/j.1326-5377.1994.tb127522.x.
To compare the prevalence of asthma, hay fever and atopy in Asian immigrants in Melbourne with that in Australian-born non-Asians and Australian-born Asians, and to investigate the association of these conditions with atopic status, length of stay in Australia and IgE levels in Asian immigrants.
We performed a cross-sectional study by telephone interviews, using standard questionnaire items on respiratory and allergic symptoms. A random sample of 636 recent Asian immigrants of ethnic Chinese origin, 109 Australian-born Asians and 424 Australian-born non-Asians were selected from the 1991 Melbourne Telephone Directory, using a presumptive surname list. Skin tests to determine atopic status were performed on 269 Asian immigrants and 167 of these also had serum levels of total and specific IgE estimated.
In the under 20 years age group the prevalence of wheeze or asthma ever was higher in Australian-born non-Asians and Australian-born Asians than in Asian immigrants (P < 0.001), and the prevalence of hay fever was higher in Asian immigrants and Australian-born Asians than in Australian-born non-Asians. In those older than 20 years, hay fever was almost twice as common in Asian immigrants as in Australian-born non-Asians (P < 0.001 for 20-40 years age group; P < 0.01 for > 40 years). The prevalence of hay fever and, to a lesser degree, asthma in Asian immigrants increased significantly with length of stay in Australia, independent of age at arrival, sex and atopic status (trend test: P < 0.001 for hay fever; P = 0.05 for asthma). Atopy was more common in Asian immigrants and Australian-born Asians than in Australian-born non-Asians (P < 0.001) and was very strongly associated with both hay fever and asthma, irrespective of length of stay. Pollen and mite sensitivities were more common in Asian subjects (twice as common for Asian-born and 1.5 times for Australian-born) than non-Asian subjects (P < 0.01). Among Asian immigrants, elevated total IgE level (> 100 IU/mL) was strongly associated with a history of hay fever (P < 0.01) and wheeze or asthma ever (P < 0.05), atopy (P < 0.001) and the presence of specific IgE antibodies to grass pollen, dust mite, cockroach and Ascaris antigens (P < 0.05 for all).
We found substantial differences in the prevalence of asthma, hay fever and atopy between Asian immigrants, Australian-born Asians and non-Asians. The prevalence of hay fever and asthma in Asian immigrants was strongly associated with length of stay in Australia, suggesting that environmental factors are important in the pathogenesis of these diseases.
比较墨尔本亚洲移民中哮喘、花粉热和特应性疾病的患病率与澳大利亚出生的非亚洲人和澳大利亚出生的亚洲人的患病率，并调查这些疾病与亚洲移民的特应性状态、在澳大利亚的停留时间和免疫球蛋白E（IgE）水平之间的关联。
我们通过电话访谈进行了一项横断面研究，使用了关于呼吸道和过敏症状的标准问卷项目。从1991年墨尔本电话簿中，利用一个推测姓氏列表，随机抽取了636名近期华裔亚洲移民、109名澳大利亚出生的亚洲人和424名澳大利亚出生的非亚洲人。对269名亚洲移民进行了皮肤试验以确定特应性状态，其中167人还检测了总IgE和特异性IgE的血清水平。
在20岁以下年龄组中，澳大利亚出生的非亚洲人和澳大利亚出生的亚洲人曾经患喘息或哮喘的患病率高于亚洲移民（P<0.001），亚洲移民和澳大利亚出生的亚洲人患花粉热的患病率高于澳大利亚出生的非亚洲人。在20岁以上人群中，亚洲移民患花粉热的几率几乎是非亚洲出生者的两倍（20至40岁年龄组P<0.001；40岁以上P<0.01）。亚洲移民中花粉热以及在较小程度上哮喘的患病率随着在澳大利亚停留时间的增加而显著上升，与抵达时的年龄、性别和特应性状态无关（趋势检验：花粉热P<0.001；哮喘P=0.05）。特应性疾病在亚洲移民和澳大利亚出生的亚洲人中比在澳大利亚出生的非亚洲人中更常见（P<0.001），并且与花粉热和哮喘都密切相关，与停留时间无关。亚洲受试者对花粉和螨虫的敏感性比非亚洲受试者更常见（亚洲出生者为两倍，澳大利亚出生者为1.5倍）（P<0.01）。在亚洲移民中，总IgE水平升高（>100 IU/mL）与花粉热病史（P<0.01）、曾经患喘息或哮喘（P<0.05）、特应性疾病（P<0.001）以及对草花粉、尘螨、蟑螂和蛔虫抗原存在特异性IgE抗体密切相关（所有P<0.05）。
我们发现亚洲移民、澳大利亚出生的亚洲人和非亚洲人在哮喘、花粉热和特应性疾病的患病率上存在显著差异。亚洲移民中花粉热和哮喘的患病率与在澳大利亚的停留时间密切相关，表明环境因素在这些疾病的发病机制中很重要。
