J ALLERGY CLIN IMMUNOL

FEBRUARY 2011

AB116 Abstracts

SUNDAY

437 Lower Prevalence of Allergic Diseases in Korean RuralChildren is Associated with Farming Environment and RuralLifestyle

S. Lee1, J. Kwon2, J. Seo2, Y. Song2, B. Kim3, J. Yu2, G. Park4, H. Kim5, S.

Hong2; 1Department of Pediatrics, Hallym Sacred Heart Hospital, Hallym

University College of Medicine, Anyang, KOREA, REPUBLIC OF, 2De-

partment of Pediatrics, Childhood Asthma Atopy Center, Asan Medical

Center, University of Ulsan College of Medicine, Seoul, KOREA, RE-

PUBLIC OF, 3Department of Pediatrics, Inje University Haeundae Paik

Hospital, Pusan, KOREA, REPUBLIC OF, 4Department of Pediatrics,

Jeon-Ju Jesus Hospital, Jeonju, KOREA, REPUBLIC OF, 5School of Pub-

lic Health, Seoul National University, Seoul, KOREA, REPUBLIC OF.

RATIONALE: The results of recent studies suggest that factors in rural

environments may protect against the development of allergic diseases,

but the underlying mechanisms are not well understood.

METHODS: A cross-sectional study of children (n51828) aged 9-12

years from a rural village, a rural town and an urban city in Korea was con-

ducted. Demographic and disease-related information was obtained

through a detailed questionnaire, and skin prick tests for 16 allergens

were performed.

RESULTS: There were significant differences in lifestyle and environ-

mental factors between village, rural town and urban children. The preva-

lence of allergic diseases and atopy were higher in urban children. A lower

prevalence of allergic diseases and atopy was associated with farming par-

ents, contact with farm animals during pregnancy, stable and pet owner-

ship, breast feeding and having older siblings. A comparison of rural

village and rural town children revealed no evidence of an association be-

tween farming parents, farm animal contact during pregnancy or stable

ownership and allergic diseases and atopy. On the other hand, having older

siblings and antibiotic use during infancy were significantly associated

with allergic diseases and atopy in these children.

CONCLUSIONS: Protective factors associated with a farming environ-

ment and/or rural lifestylemay influence the prevalence of allergic diseases

and atopy in Korean children.

438 High Prevalence of Asthma, Obesity and Hypertension inChildren from Pittsburgh's Inner-City

J. Padden1, N. Marcotullio1, D. Gentile2, D. Skoner2; 1Duquesne Univer-

sity School of Pharmacy, Pittsburgh, PA, 2Allegheny General Hospital,

Pittsburgh, PA.

RATIONALE: Inner-city children are at risk for a variety of health prob-

lems inculding asthma, obesity and hypertension. The objective of this

study was to determine the prevalence of possible asthma, obesity and

hypertension in an inner-city pediatric population from Pittsburgh, PA.

METHODS: Sixty-one inner-city children enrolled in various after-school

programs in the community participated in a health screen consisting of a

measurement of height, weight and blood pressure, as well as completion

of a standardized survey to screen for possible asthma. Participants with

any abnormal screening results were referred for follow-up with their pri-

mary care provider.

RESULTS: Thirty-one (51%) and fifty-six (92%) of participants were fe-

male and African American, respectively. Nineteen (31%) participants

screened positive for possible asthma. Only thirty-eight percent of the

participants had a BMI in the normal range while 26% and 36%were over-

weight and obese, respectively. Seventy-six percent of participants had a

normal blood pressure while 8% and 16% were pre-hypertensive and

hypertensive, respectively.

CONCLUSIONS: There is a high prevalence of positive screens for

possible asthma in this population and a strong need for further evaluation

and treatment in these participants. Similarly, there are also high rates of

obesity and hypertension. Collectively, these results underscore the need

to develop community based interventions to improve health outcomes

in this at-risk population.

439 Recent Trends in Asthma Mortality in Ohio and CuyahogaCounty: African Americans and Residents of Poverty AreasRemain Disproportionately Burdened

S. K. Silvers1, M. Xu1, D. R. Stukus2, D. M. Lang1; 1Cleveland Clinic

Foundation, Cleveland, OH, 2Children’s Hospital of Pittsburgh,

Pittsburgh, PA.

RATIONALE: Annual US asthma mortality(AM) rates have declined

since 1999. The demographic characteristics of this most recent trend

have not been described. Prior studies found AM disproportionately af-

fected minorities residing in urban poverty areas.

METHODS:We obtained demographic data from the Ohio Public Health

Department, including age, gender, race, date of death, and zip code of

residence for AM cases from 1999-2006(Period 2, ICD10:J45,J46) and

1990-1998(Period 1, ICD9:493.X) for residents of Ohio and Cuyahoga

County (CC).

RESULTS: In Ohio, there were 1598 asthma deaths in Period 1, 1064 in

Period 2. There was a decrease from Period 1 to Period 2 in the annual

AM rate per 100,000 in Ohio (1.64 to 1.36, p<0.001) and CC (2.10 to

1.38, p50.004), with a greater decline in CC (34.5% vs. 13.9%, p50.015). Rates also declined for 5-34 year olds in Ohio (0.50 to 0.36,

p50.004), and CC (0.91 to .59,p50.09). Declines in Ohio AM rates

were observed in males (1.24 to 0.85, p<0.001), females (2.01 to 1.84,

p50.053), Caucasians (1.42 to 1.18, p5<0.001), and African Americans

(3.34 to 2.61, p50.002); in CC a dramatic decline (46%) in AM rates

(3.64 to 1.98 per 100,000) was observed among African-Americans.

Rates of AM were significantly higher in poverty areas in both periods

in Ohio and CC; the ratio of AM in poverty/non-poverty areas in CC

increased from 5.2 to 7.3

CONCLUSIONS: Declines in AM rates have occurred from period 1 to

period 2 in residents of Ohio. AM in more recent years continues to dispro-

portionately affect African Americans and residents of poverty areas.

440 Prevalence Of Positive Atopy Patch Test In A PediatricPopulation

N. Fuiano1, S. Fusilli2, C. Incorvaia3; 1ASL Foggia, SAN SEVERO,

ITALY, 2Health Service IRCCS ‘‘Casa Sollievo della Sofferenza’’, San

Giovanni Rotondo, ITALY, 3Allergy/Pulmonary Rehabilitation, ICP Hos-

pital, Milano, ITALY.

BACKGROUND: The atopy patch test (APT) assesses the cell-mediated

component of the allergic response to enviromental allergens and is gain-

ing increasing importance in the diagnosis of allergic diseases. We evalu-

ated the prevalence of positive APT in an unselected population of

children.

METHODS: All children attending a primary and middle school in San

Marco in Lamis (Puglia region, Italy, 12000 inhabitants) were included

in the study. They were 456 subjects (244 males, 212 females, age ranging

from 88 and 167 months, mean age 129.4 months). All children underwent

APTand skin prick tests (SPT) with the most common allergens present in

the area (grass, cypress, Parietaria, and Compositae pollen, Alternaria,

house dust mites, cat epithelium) by material from Chemotecnique

(Sweden) for APTand from Stallergenes (France) for SPT. A questionnaire

dealing with nose, eye, lungs, and skin symptoms was administered to

parents.

RESULTS: Seventy-eight subjects (17.1%) had a positive SPT, and 57

(12.5%) had a positive APT; 61 subjects (13.4%) were positive only to

SPT, 40 (8.8%) only to APT and 17 (3.7%) to both tests. The allergen

most frequently positive was the dust mite (41 SPT and 55 APT).

CONCLUSIONS: These findings show that a positive APT is quite com-

mon in the pediatric population. The exclusive positivity to APT in almost

9% of subjects strengthens the need to performAPT, in order to recognize a

cell-mediated sensitization in subjects otherwise classified as nonallergic.

This seems particularly important when house dust mites are the causative

allergen.