Prevalence of Respiratory Symptoms, Bronchial Hyper-Reactivity and Atopy in Young Adults in Luxembourg

Coordinating Institution: Centre Hospitalier de Luxembourg , CRP Sante
From: 01/05/2002
To: 31/12/2005
Budget: 184,927.00€
Contact(s): Nati Romain

Summary

The purpose of the project was:

• To produce epidemiological data on indicators of asthma and allergy in the adult population in Luxembourg. Luxembourg lacked internationally comparable information in order to have a full picture of the prevalence and risk factors, the process of care, measures for prevention and the main outcomes for these two conditions.

• To study differences in these indicators between the Luxembourg and the immigrant Portuguese population. Several studies carried out in different countries suggest an influence of migration on symptoms, allergic sensitisation and access to healthcare in asthma. Luxembourg’s immigration rate rose sharply in the course of the last century, with a noticeably important influx of Portuguese immigrants during the last 40 years. This particularity gave us the opportunity to study this issue and the implications of immigration on respiratory care in Luxembourg.

In stage I, a self-administered questionnaire was sent to 7,259 20 to 44 - year old persons, randomly selected for age and sex. This questionnaire was available in three languages (French, German, and Portuguese). The overall adjusted response rate was 82.1 %.

In stage II, 712 participants performed a spirometry, a methacholine challenge test, measurements of exhaled nitric oxide levels and serum testing for total and specific IgE.

Wheezing was reported by 17.5 % of the participants ; the prevalence of asthma is evaluated at 6.9 %. The use of anti-asthmatic drugs in asthmatic participants is with 62 % lower than the European mean value. Nasal allergies are reported by 23.6 % of the participants. Bronchial hyper-responsiveness was found in 15.4 %. Atopy is a very common condition present in 37.8 % of the young adults. The prevalence of chronic bronchitis is estimated at 2.6 %. 7.5 % of the smokers had an abnormal lung function compatible with a COPD stage GOLD I at least, compared to 2.5 % of the non-smokers.

Our community-based study provides consistent data to the hypothesis of a greater susceptibility of women to smoking in terms of effects on lung function, bronchial responsiveness and self-reported respiratory symptoms.
The pattern of respiratory symptoms and allergic sensitisation differs between Luxembourg residents, first generation immigrants and second generation immigrants of Portugal. Portuguese immigrants have a higher prevalence of asthma-like symptoms and a lower prevalence of nasal allergies than residents with Luxembourg nationality. The increased prevalence of different respiratory symptoms is accentuated in second generation immigrants. First generation but not second generation immigrants of Portugal show a lower prevalence of allergic sensitisation against cat and timothy grass than residents of Luxembourg nationality.