Detlef Laußmann

Prävalenz von Sensibilisierungen gegen Inhalations- und Nahrungsmittelallergene

In view of the increasing prevalence of allergies, up-to-date data on the prevalence of allergic sensitisation are of major interest. In the German Health Interview and Examination Survey for Adults (DEGS1) (2008-2011) blood samples from a population-based sample of 7,025 participants aged 18 to 79 years were analysed for specific IgE antibodies against 50 common single allergens and screened for common aeroallergens (SX1) and grass pollen (GX1). In all, 48.6 % of the participants were sensitised to at least one allergen. Overall, men were more frequently sensitised to at least one allergen than women were. Sensitisations to at least one allergen were more common among younger than older participants and among participants with a higher socio-economic status. In all, 33.6 % of the participants were sensitised to common aeroallergens, 25.5  % to food allergens and 22.6 % to wasp or bee venoms. Compared with the German National Health Interview and Examination Survey 1998 (GNHIES98), the prevalence of sensitisation to common aeroallergens increased from 29.8 to 33.6 %.This increase was statistically significant only in women. The results of DEGS1 still showed a high prevalence of allergic sensitisation. An English full-text version of this article is available at SpringerLink as supplemental.

[Prevalence of sensitisation to aeraoallergens and food allergens: results of the German Health Interview and Examination Survey for Adults (DEGS1)].

In view of the increasing prevalence of allergies, up-to-date data on the prevalence of allergic sensitisation are of major interest. In the German Health Interview and Examination Survey for Adults (DEGS1) (2008-2011) blood samples from a population-based sample of 7,025 participants aged 18 to 79 years were analysed for specific IgE antibodies against 50 common single allergens and screened for common aeroallergens (SX1) and grass pollen (GX1). In all, 48.6 % of the participants were sensitised to at least one allergen. Overall, men were more frequently sensitised to at least one allergen than women were. Sensitisations to at least one allergen were more common among younger than older participants and among participants with a higher socio-economic status. In all, 33.6 % of the participants were sensitised to common aeroallergens, 25.5  % to food allergens and 22.6 % to wasp or bee venoms. Compared with the German National Health Interview and Examination Survey 1998 (GNHIES98), the prevalence of sensitisation to common aeroallergens increased from 29.8 to 33.6 %.This increase was statistically significant only in women. The results of DEGS1 still showed a high prevalence of allergic sensitisation. An English full-text version of this article is available at SpringerLink as supplemental.

Soziale Ungleichheit von Lärmbelästigung und Straßenverkehrsbelastung

To study the associations of annoyance to noise and exposure to residential traffic with sociodemographic, socioeconomic and regional characteristics as well as housing conditions, a population-based sample of 7,988 adults 18-79 years of age was studied in the German Health Interview and Examination Survey for Adults (DEGS1). Annoyance to noise and exposure to residential traffic were assessed by self-administered questionnaires. A total of 6.3 % of the participants reported a high to very high exposure to residential traffic noise, 3.7 % to neighbourhood noise and 2.1 % to aircraft noise. An excessive exposure to residential traffic was reported by 21.3 % of the participants. A high annoyance to traffic and neighborhood noise was associated with a lower equivalised disposable income and poor housing conditions. Additionally annoyance to neighborhood noise was associated with low socioeconomic and occupational status. A high annoyance to aircraft noise was only associated with a low equivalised disposable income and living in apartment blocks. Exposure to residential traffic was associated with all investigated indicators. At present in Germany environmental exposures are social unequally distributed and may lead to negative health consequences in social disadvantaged groups. An English full-text version of this article is available at SpringerLink as supplemental.

Social inequities regarding annoyance to noise and road traffic intensity

To study the associations of annoyance to noise and exposure to residential traffic with sociodemographic, socioeconomic and regional characteristics as well as housing conditions, a population-based sample of 7,988 adults 18-79 years of age was studied in the German Health Interview and Examination Survey for Adults (DEGS1). Annoyance to noise and exposure to residential traffic were assessed by self-administered questionnaires. A total of 6.3 % of the participants reported a high to very high exposure to residential traffic noise, 3.7 % to neighbourhood noise and 2.1 % to aircraft noise. An excessive exposure to residential traffic was reported by 21.3 % of the participants. A high annoyance to traffic and neighborhood noise was associated with a lower equivalised disposable income and poor housing conditions. Additionally annoyance to neighborhood noise was associated with low socioeconomic and occupational status. A high annoyance to aircraft noise was only associated with a low equivalised disposable income and living in apartment blocks. Exposure to residential traffic was associated with all investigated indicators. At present in Germany environmental exposures are social unequally distributed and may lead to negative health consequences in social disadvantaged groups. An English full-text version of this article is available at SpringerLink as supplemental.

Zeitliche Trends in der Inzidenz und Sterblichkeit respiratorischerKrankheiten von hoher Public-Health-Relevanz in Deutschland

Erkrankungen der Atemwege und der Lunge sind weltweit wichtige Ursachen von Krankheitslast und Sterblichkeit. In Deutschland haben neben akuten respiratorischen Erkrankungen (ARE) vor allem chronische Lungenerkrankungen – darunter Lungenkrebs, chronisch obstruktive Lungenerkrankung (COPD) und Asthma bronchi ale – hohe gesellschaftliche und wirtschaftliche Bedeutung. ARE-Neuerkrankungsraten unterscheiden sich deutlich nach Alter, Jahreszeit und Jahr. Sie werden als wöchentliche Konsultationsinzidenz über ausgewählte Einrichtungen der ambulanten und stationären Versorgung erfasst. Zwischen 2009 und 2016 liegen die Neuerkrankungsraten im ambulanten sowie im stationären Bereich (für schwere Krankheitsverläufe, SARI) bei Kleinkindern mit Werten von bis zu 9,4 % bzw. 0,2 % am höchsten. Auch die ARE-Sterblichkeit unterliegt saisonalen und jähr lichen Schwankungen. Sie wird mit jährlich mehr als 17.000 Todesfällen über die amtliche Todesursachenstatistik nur unzureichend erfasst, da häufig ein vorbestehendes chronisches Grundleiden anstelle der akuten Infektion als zum Tode führende Ursache kodiert wird. Zusätzlich sind daher Einschätzungen der ARE-Übersterblichkeit im Zusammenhang mit Grippewellen notwendig. Bei Lungenkrebs, COPD und Asthma ist insbesondere die langfristige zeitliche Entwicklung des Neuerkrankungsund Sterbegeschehens von gesundheitspolitischem Interesse. Daten der amtlichen Todesursachenstatistik von 1998 bis 2015 zeigen, dass Sterberaten für Lungenkrebs und COPD bei Männern im Mittel um 1,8 % bzw. 1,1 % pro Jahr sanken, während sie bei Frauen um 2,5 % bzw. 2,3 % anstiegen. Dennoch starben im Jahre 2015 immer noch mehr Männer als Frauen an Lungenkrebs (29.378 vs. 15.881) bzw. COPD (17.300 vs. 13.773). Sterberaten für Asthma bronchiale sind im gleichen Zeitraum pro Jahr um durchschnittlich 8,3 % bei Frauen und 11,2 % bei Männern gesunken und dabei zuletzt auf 659 Todesfälle bei Frauen und 393 bei Männern zurückgegangen. Neuerkrankungsraten für Lungenkrebs bewegen sich ab 1998 auf fast gleichem Niveau wie die Sterberaten. Für COPD und Asthma sind keine entsprechenden Daten verfügbar. Ausbau und Verstetigung von koordinierten Surveillance-Aktivitäten zu respiratorischen Krankheiten im Rahmen internationaler Aktionspläne zur Krankheitsprävention sind notwendig. RESPIRATORISCHE ERKRANKUNGEN · LUNGENERKRANKUNGEN · INZIDENZ · MORTALITÄT · SURVEILLANCE Journal of Health Monitoring Zeitliche Trends in der Inzidenz und Sterblichkeit respiratorischer Krankheiten von hoher Public-Health-Relevanz in Deutschland

Vergleich mykologischer und chemisch-analytischer Labormethoden zum Nachweis von Schimmelpilzbefällen in Innenräumen

ZusammenfassungFür die Bewertung der prädiktiven Wertigkeit häufig angewandter Methoden, die zum Nachweis von Schimmelpilzbefällen in Innenräumen eingesetzt werden, wurden in 45 Schimmel- und in 47 Nichtschimmelwohnungen mykologische und chemisch- analytische Untersuchungen vorgenommen. Die Studie wurde laborverblindet in Bezug auf den durch Inspektion ermittelten Schimmelstatus der Wohnungen durchgeführt. Die Ergebnisse der einzelnen Bestimmungsmethoden wurden anhand ihrer Receiver Operating Characteristic-(ROC-)Kurven miteinander verglichen. Im Ergebnis dieser statistischen Analyse zeigte sich, dass die etablierten mykologischen Bestimmungsmethoden: Erfassung luftgetragener Schimmelpilze mit dem Andersen-Impaktor, sedimentierender Schimmelpilze auf Petri-Schalen und sedimentierter Schimmelpilze in Hausstaub unter den gewählten Studienbedingungen eine hohe diskriminatorische Fähigkeit zur Unterscheidung von Schimmel- und Nichtschimmelwohnungen besitzen, wenn ein Summenscore aus den Gattungen Aspergillus und Penicillium verwendet wurde. Die errechneten Flächen unter den jeweiligen ROC-Kurven (AUC) reichten von AUC=0,992 (95%-KI 0,942–0,997) für die Methode der Bestimmung sedimentierter Pilze im Hausstaub über AUC=0,996 (95%-KI 0,940–0,998) für das Sedimentationsverfahren bis zu AUC=0,999 (95%-KI 0,957– 1,000) für die Methode der Erfassung luftgetragener Schimmelpilze mittels Andersen- Impaktor. Im paarweisen Vergleich erwiesen sich diese Flächen unter den ROC-Kurven als nicht statistisch signifikant voneinander verschieden. Diese Ergebnisse wurden mit DG-18-Agar als Kulturmedium erzielt. Gleichwertige Ergebnisse ergaben sich für Malzextrakt-Agar. Im Vergleich dazu war die Methode der Bestimmung von mikrobiell bedingten flüchtigen organischen Verbindungen (MVOC) mithilfe eines aus 8 Einzelverbindungen gebildeten Summenwertes den mykologischen Verfahren deutlich unterlegen: AUC=0,620 (95%-KI 0,509–0,723). Betrachtet man die untere Grenze des 95%-Konfidenzintervalls der Fläche unter der ROC-Kurve, so ist diese kaum von 0,5 verschieden. Dieses Ergebnis bedeutet, dass sich die Diskriminationsfähigkeit dieser Methode nur geringfügig von der einer zufälligen Klassifizierung unterscheidet. Mögliche methodische Einflüsse, die zu dieser Einschätzung geführt haben, werden diskutiert.AbstractTo evaluate frequently used methods that discriminate between moldy and nonmoldy indoor environments, 45 homes with visible mold growth and 47 definitively non-infested homes, both confirmed by inspection, were investigated by microbiological and chemical analytical methods. The study was laboratory blinded in relation to the confirmed mold status of the rooms. Statistical evaluation of the results of the applied mycological methods with the Receiver Operating Characteristic (ROC) curve analysis showed that these methods (impaction, open Petri dish method, and determination of mold spores in house dust samples) performed very well in discriminating between rooms with visible mold growth and nonmoldy rooms when the sum score of the mold genera Aspergillus and Penicillium was used as an indicator. The calculated areas under the ROC curves (AUC) of the three mycological methods were: 0.992 (95% CI 0.942–0.997) for mold spores in house dust samples, 0.996 (95% CI 0.940–0.998) for the open Petri dish method, and 0.999 (95% CI 0.957–1.000) for the determination of airborne spores with the Andersen impactor, respectively. A perfect discrimination would lead to an AUC of 1. These results were obtained with DG 18-agar as well as with malt extract agar. In contrast to the results of the mycological methods, the chemical analytical method under the same study conditions showed a distinctly lower performance in discriminating rooms according to their mold status when a sum score (concentration of eight typical MVOC) was used as an indicator. The area under the ROC curve (AUC) had a value of 0.620 (95% CI 0.509–0.723). A completely useless test would have an AUC of 0.5. As the lower limit of the 95% confidence interval of the area under the ROC curve is close to 0.5, the results obtained with the MVOC method do not differ from the classification results which can be obtained simply by chance. Possible methodological biases which could have lead to this interpretation are discussed.

Time trends in incidence and mortality of respiratory diseases ofhigh public health relevance in Germany

Respiratory diseases are major causes of disease burden and mortality throughout the world. In Germany, alongside acute respiratory infections (ARI), chronic lung diseases – including lung cancer, chronic obstructive pulmonary disease (COPD), and asthma – are of particular socioeconomic importance. ARI incidence rates differ significantly according to age, season and year. They are recorded as weekly consultation rates as reported by selected outpatient and inpatient care facilities. Between 2009 and 2016, the highest incidence rates of severe acute respiratory infection (SARI) were recorded among young children in outpatient (9.4%) and inpatient (0.2%) care. Mortality rates for ARI are also subject to seasonal and annual fluctuations. However, the official statistics on causes of death, which lead to estimates of more than 17,000 annual deaths, provide an inadequate measure of death rates because chronic underlying illnesses are often recorded as the cause of death rather than a more recently acquired acute infection. Therefore, the excess mortality caused by ARI needs to be assessed in the context of influenza outbreaks. Regarding lung cancer, COPD and asthma, the long-term time trends in disease incidence and mortality rates are of particular interest from a health policy perspective. Analyses of data from the official statistics on causes of death for the years 1998 through 2015 show that mortality rates for lung cancer and COPD decreased on average by 1.8% and 1.1% per year respectively, among men, whereas among women they increased by 2.5% (lung cancer) and 2.3% (COPD) annually. Nevertheless, more men than women died of lung cancer or COPD in 2015 in Germany: 29,378 men and 15,881 women died from lung cancer, and 17,300 men and 13,773 women died from COPD. During the same period, the asthma mortality rates decreased on average by 8.3% annually among women and by 11.2% annually among men, and the absolute number of deaths came down to 659 among women and 393 among men. Lung cancer incidence rates have been at similar levels as lung cancer death rates since 1998. No such data are available on time trends in COPD or asthma incidence rates. Coordinated surveillance of respiratory diseases needs to be expanded within the framework of international action plans for disease prevention. RESPIRATORY DISEASES · LUNG DISEASES · INCIDENCE · MORTALITY · SURVEILLANCE Journal of Health Monitoring · 2017 2(3) DOI 10.17886/RKI-GBE-2017-061 Robert Koch Institute, Berlin Authors: Henriette Steppuhn*, Silke Buda*, Antje Wienecke*, Klaus Kraywinkel, Kristin Tolksdorf, Jörg Haberland, Detlef Laußmann, Christa Scheidt-Nave *contributed equally

Prevalence of sensitisation to aeroallergens and food allergens

In view of the increasing prevalence of allergies, up-to-date data on the prevalence of allergic sensitisation are of major interest. In the German Health Interview and Examination Survey for Adults (DEGS1) (2008-2011) blood samples from a population-based sample of 7,025 participants aged 18 to 79 years were analysed for specific IgE antibodies against 50 common single allergens and screened for common aeroallergens (SX1) and grass pollen (GX1). In all, 48.6 % of the participants were sensitised to at least one allergen. Overall, men were more frequently sensitised to at least one allergen than women were. Sensitisations to at least one allergen were more common among younger than older participants and among participants with a higher socio-economic status. In all, 33.6 % of the participants were sensitised to common aeroallergens, 25.5  % to food allergens and 22.6 % to wasp or bee venoms. Compared with the German National Health Interview and Examination Survey 1998 (GNHIES98), the prevalence of sensitisation to common aeroallergens increased from 29.8 to 33.6 %.This increase was statistically significant only in women. The results of DEGS1 still showed a high prevalence of allergic sensitisation. An English full-text version of this article is available at SpringerLink as supplemental.

Soziale Ungleichheit von Lärmbelästigung und StraßenverkehrsbelastungSocial inequities regarding annoyance to noise and road traffic intensity

To study the associations of annoyance to noise and exposure to residential traffic with sociodemographic, socioeconomic and regional characteristics as well as housing conditions, a population-based sample of 7,988 adults 18-79 years of age was studied in the German Health Interview and Examination Survey for Adults (DEGS1). Annoyance to noise and exposure to residential traffic were assessed by self-administered questionnaires. A total of 6.3 % of the participants reported a high to very high exposure to residential traffic noise, 3.7 % to neighbourhood noise and 2.1 % to aircraft noise. An excessive exposure to residential traffic was reported by 21.3 % of the participants. A high annoyance to traffic and neighborhood noise was associated with a lower equivalised disposable income and poor housing conditions. Additionally annoyance to neighborhood noise was associated with low socioeconomic and occupational status. A high annoyance to aircraft noise was only associated with a low equivalised disposable income and living in apartment blocks. Exposure to residential traffic was associated with all investigated indicators. At present in Germany environmental exposures are social unequally distributed and may lead to negative health consequences in social disadvantaged groups. An English full-text version of this article is available at SpringerLink as supplemental.

Soziale Ungleichheit von Lärmbelästigung und Straßenverkehrsbelastung@@@Social inequities regarding annoyance to noise and road traffic intensity: Ergebnisse der Studie zur Gesundheit Erwachsener in Deutschland (DEGS1)@@@Results of the German Health Interview and Examination Survey for Adults (DEGS1)

To study the associations of annoyance to noise and exposure to residential traffic with sociodemographic, socioeconomic and regional characteristics as well as housing conditions, a population-based sample of 7,988 adults 18-79 years of age was studied in the German Health Interview and Examination Survey for Adults (DEGS1). Annoyance to noise and exposure to residential traffic were assessed by self-administered questionnaires. A total of 6.3 % of the participants reported a high to very high exposure to residential traffic noise, 3.7 % to neighbourhood noise and 2.1 % to aircraft noise. An excessive exposure to residential traffic was reported by 21.3 % of the participants. A high annoyance to traffic and neighborhood noise was associated with a lower equivalised disposable income and poor housing conditions. Additionally annoyance to neighborhood noise was associated with low socioeconomic and occupational status. A high annoyance to aircraft noise was only associated with a low equivalised disposable income and living in apartment blocks. Exposure to residential traffic was associated with all investigated indicators. At present in Germany environmental exposures are social unequally distributed and may lead to negative health consequences in social disadvantaged groups. An English full-text version of this article is available at SpringerLink as supplemental.