Are Environmental Factors for Atopic Eczema in ISAAC Phase Three due to Reverse Causation?

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dc.citation.issue5
dc.citation.volume139
dc.contributor.authorRutter CE
dc.contributor.authorSilverwood RJ
dc.contributor.authorWilliams HC
dc.contributor.authorEllwood P
dc.contributor.authorAsher I
dc.contributor.authorGarcia-Marcos L
dc.contributor.authorStrachan DP
dc.contributor.authorPearce N
dc.contributor.authorLangan SM
dc.contributor.authorISAAC Phase Three Study Group
dc.date.accessioned2023-07-05T23:21:42Z
dc.date.available2018-08-30
dc.date.available2023-07-05T23:21:42Z
dc.date.issued2019-05
dc.description(c) 2018 The Authors
dc.description.abstractSome previously described environmental associations for atopic eczema may be due to reverse causation. We explored the role of reverse causation by comparing individual- and school-level results for multiple atopic eczema risk factors. The International Study of Asthma and Allergies in Childhood (i.e, ISAAC) Phase Three surveyed children in schools (the sampling unit) regarding atopic eczema symptoms and potential risk factors. We assessed the effect of these risk factors on atopic eczema symptoms using mixed-effect logistic regression models, first with individual-level exposure data and second with school-level exposure prevalence. Overall, 546,348 children from 53 countries were included. At ages 6-7 years, the strongest individual-level associations were with current paracetamol use (odds ratio [OR] = 1.45, 95% confidence interval [CI] = 1.37-1.54), which persisted at school-level (OR = 1.55, 95% CI = 1.10-2.21), early-life antibiotics (OR = 1.41, 95% CI = 1.34-1.48), and early-life paracetamol use (OR = 1.28, 95% CI = 1.21-1.36), with the former persisting at the school level, whereas the latter was no longer observed (OR = 1.35, 95% CI = 1.00-1.82 and OR = 0.94, 95% CI = 0.69-1.28, respectively). At ages 13-14 years, the strongest associations at the individual level were with current paracetamol use (OR = 1.57, 95% CI = 1.51-1.63) and open-fire cooking (OR = 1.46, 95% CI = 1.33-1.62); both were stronger at the school level (OR = 2.57, 95% CI = 1.84-3.59 and OR = 2.38, 95% CI = 1.52-3.73, respectively). Association with exposure to heavy traffic (OR = 1.31, 95% CI = 1.27-1.36) also persisted at the school level (OR = 1.40, 95% CI = 1.07-1.82). Most individual- and school-level effects were consistent, tending to exclude reverse causation.
dc.description.publication-statusPublished
dc.format.extent1023 - 1036
dc.identifierhttp://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000465209400011&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=c5bb3b2499afac691c2e3c1a83ef6fef
dc.identifier.citationJOURNAL OF INVESTIGATIVE DERMATOLOGY, 2019, 139 (5), pp. 1023 - 1036
dc.identifier.doi10.1016/j.jid.2018.08.035
dc.identifier.eissn1523-1747
dc.identifier.elements-id419028
dc.identifier.harvestedMassey_Dark
dc.identifier.issn0022-202X
dc.publisherElsevier, Inc. on behalf of the Society for Investigative Dermatology
dc.relation.isPartOfJOURNAL OF INVESTIGATIVE DERMATOLOGY
dc.rightsCC BY 4.0
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/
dc.subject.anzsrc1103 Clinical Sciences
dc.subject.anzsrc1112 Oncology and Carcinogenesis
dc.titleAre Environmental Factors for Atopic Eczema in ISAAC Phase Three due to Reverse Causation?
dc.typeJournal article
pubs.notesNot known
pubs.organisational-group/Massey University
pubs.organisational-group/Massey University/College of Health
pubs.organisational-group/Massey University/College of Health/Research Centre for Hauora and Health
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