Atopy and nonspecific bronchial responsiveness. A population-based assessment. Spanish Group of the European Community Respiratory Health Survey.

The relative importance of specific immunoresponse in explaining nonspecific bronchial responsiveness (BR) has scarcely been examined. We provide quantitative estimates of the proportion of BR attributable to specific atopy to different common aeroallergens. We used data from a cross-sectional study on a random sample of the general population 20 to 44 yr of age from five Spanish areas. There were 1,816 participants who performed a methacholine challenge and had atopy assessed. BR was defined as a 20% or more fall in FEV1. Atopy was assessed by measuring serum-specific IgE or skin tests to cat, Dermatophagoides pteronyssinus, Cladosporium, Alternaria, timothy grass, olive, birch, Parietaria, or ragweed. The strongest associations between BR and specific IgE response were against timothy grass (prevalence rate ratio = 1.78; 95% confidence interval 1.2 to 2.6), Dermatophagoides pteronyssinus = 1.64 (1.2 to 2.2), and olive = 2.36 (1.5 to 3.7), all after adjustment by age, sex, area of residence, smoking, and a positive response to any of the other eight allergens measured. The population attributable risk of BR for a positive response to any of the nine allergens measured was 20.96% (10.2 to 43.2%) when adjusting for area of residence, age, sex, and smoking. Nonspecific bronchial responsiveness in the general population was found to be related to atopy against single specific allergens, but the population risk attributable to atopy may be lower than previously suggested.