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1 Respiratory and Environmental Health Research Unit, IMIM, Barcelona, Spain, 2 Dept of Clinical Epidemiology and Public Health, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain, 3 Worldwide Epidemiology, GlaxoSmithKline R and D, Greenford, Middlesex, UK, 4 Dept of Public Health Sciences, Guy's, King's and St. Thomas' School of Medicine, Guy's Hospital, London, UK and 5 Dept of Experimental and Health Sciences, Universitat Pompeu Fabra (UPF), Barcelona, Spain
CORRESPONDENCE: P. Burney, Dept of Public Health Sciences, Kings College, 5th floor Capital House, 42 Weston Street, London, SE1 3QD, UK. Fax: 44 20784 6605
Keywords: asthma, atopy, bronchial responsiveness, European Community Respiratory Health Survey, healthcare, migration
Received: March 20, 2000
Accepted May 14, 2001
Migration studies on asthma may provide information on its environmental causes. The European Community Respiratory Health Survey has potential advantages due to the number of countries involved, standardized collection of information, assessment of directionality of migration, and availability of physiological data on bronchial responsiveness and atopy.
Prevalence rates of symptoms associated with asthma were compared for immigrants, emigrants and nonmigrants living in centres mostly in western Europe. Similar analyses were carried out for bronchial responsiveness (provocative concentration causing a 20% fall in forced expiratory volume in one second and slope) and atopy. Medication and use of health services were also explored.
Overall, 1,678 (8.6%) of 19,516 participants were immigrants in the 18 countries participating in the study, of whom 581 were emigrants from one of the participating countries. Rates of asthma symptoms were higher in immigrants (odds ratio (OR): 1.21, 95% confidence interval (CI): 1.00–1.51) and emigrants (OR: 1.31, 95% CI: 0.96–1.51) compared to nonmigrants after controlling for area, sex, age and smoking status. However, bronchial responsiveness and atopy were equally distributed between immigrants, emigrants and nonmigrants. Use of health services was observed to be similar in migrants and nonmigrants with asthma.
In the European Community Respiratory Health Survey, migrants reported more asthma symptoms, but had similar bronchial responsiveness, atopy, and use of health services when compared with the nonmigrant population.
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