Henriette Steppuhn

Häufigkeit allergischer Erkrankungen in Deutschland

ZusammenfassungIn der ersten Welle der „Studie zur Gesundheit Erwachsener in Deutschland“ (DEGS1) wurden aktuelle und bundesweit repräsentative Daten zum allergischen Krankheitsgeschehen von 7988 18- bis 79-Jährigen mittels computergestützter, ärztlicher Interviews erhoben. Demnach liegt die Lebenszeitprävalenz (LZP) für Asthma bronchiale bei 8,6%, Heuschnupfen bei 14,8%, Neurodermitis und Urtikaria bei jeweils 3,5%, Kontaktekzeme bei 8,1%, Nahrungsmittelallergien bei 4,7% und Insektengiftallergien bei 2,8%. Insgesamt ist bei einem knappen Drittel der Erwachsenen mindestens eine der genannten Allergien jemals ärztlich diagnostiziert worden. Aktuell leiden fast 20% an mindestens einer Allergie. Frauen sind generell häufiger betroffen als Männer und Jüngere häufiger als Ältere. Außerdem sind Allergien in den alten Bundesländern verbreiteter als in den neuen. Ein hoher sozioökonomischer Status und das Leben in Großstädten erhöhen ebenfalls die Krankheitshäufigkeit. Im 10-Jahres-Trend stieg die Asthmaprävalenz um knapp 3%, die Prävalenzen für Urtikaria und Kontaktekzeme sanken, die LZP für Heuschnupfen, Neurodermitis und Nahrungsmittelallergie blieb unverändert. Dadurch ist die Allergieprävalenz insgesamt von 32,7% auf 28,7% rückläufig.AbstractIn the first wave of the “German Health Interview and Examination Survey for Adults” (DEGS1), up-to-date and representative data regarding allergic diseases of 7988 18- to 79-year-old subjects living in Germany were collected using computer-assisted medical interviews. The study identified a lifetime prevalence of 8.6% for asthma, 14.8% for allergic rhinoconjunctivitis, 3.5% each for atopic dermatitis and urticaria, 8.1% for contact eczema, 4.7% for food allergies and 2.8% for insect venom allergies. Overall, nearly one third of adults in Germany have been diagnosed with at least one of the above mentioned allergies during their lifetime by a physician. Currently, nearly 20% suffer from at least one allergic disease. Generally, women reported an allergic disease more frequently than men and younger subjects more frequently than older ones. Additionally, allergies are more common in the former federal states of West Germany than in the former East German federal states. A high socioeconomic status and living in large cities both increase allergy risk. During the last 10 years, asthma prevalence increased about 3%, whereas the prevalence of urticaria and contact eczema declined. The lifetime prevalence of allergic rhinoconjunctivitis, atopic dermatitis and food allergies appeared unchanged. In total, allergy prevalence has declined from 32.7–28.7% over the past decade. An English full-text version of this article is available at SpringerLink as supplemental.

Chronic disease co-morbidity of asthma and unscheduled asthma care among adults: results of the national telephone health interview survey German Health Update (GEDA) 2009 and 2010.

Background: Co-morbidities may complicate the clinical management of chronic conditions such as asthma. Aims: To quantify the strength of the relationship between asthma and other chronic diseases and to analyse whether co-morbidities contribute to unscheduled asthma care. Methods: Data from two consecutive national telephone health interview surveys (GEDA 2009 and 2010) including a total of 43,312 adults (≥18 years of age) were analysed. Persons with and without a current diagnosis of asthma were compared with respect to concurrent diagnoses (diabetes mellitus, hypertension, chronic heart failure, depression, osteoarthritis, stroke, coronary heart disease, and cancer). Logistic regression models were applied to assess the strength of the association between asthma and co-morbidities in the total study population and, among persons with asthma, between the number of co-morbidities and unscheduled inpatient (hospital admissions and/or emergency department admissions) or outpatient asthma care in the past 12 months. Results: Overall, 5.3% (95% CI 5.0% to 5.6%) of adults reported current physician-diagnosed asthma. Asthma was significantly associated with most of the conditions considered and 18% of persons with asthma had three or more co-morbidities. Adjusted odds ratios (AOR) of unscheduled asthma care increased with numbers of conditions, with AOR 3.40 (95% CI 1.39 to 8.31) for unscheduled inpatient care and AOR 2.32 (95% CI 1.30 to 4.14) for unscheduled outpatient care comparing those with three or more co-morbidities versus those with none. Conclusions: The magnitude of chronic disease co-morbidity is substantial in asthma, is related to unscheduled asthma care, and implies a significant number of adults with asthma facing complex healthcare needs.

[Prevalence of allergic diseases in Germany: results of the German Health Interview and Examination Survey for Adults (DEGS1)].

ZusammenfassungIn der ersten Welle der „Studie zur Gesundheit Erwachsener in Deutschland“ (DEGS1) wurden aktuelle und bundesweit repräsentative Daten zum allergischen Krankheitsgeschehen von 7988 18- bis 79-Jährigen mittels computergestützter, ärztlicher Interviews erhoben. Demnach liegt die Lebenszeitprävalenz (LZP) für Asthma bronchiale bei 8,6%, Heuschnupfen bei 14,8%, Neurodermitis und Urtikaria bei jeweils 3,5%, Kontaktekzeme bei 8,1%, Nahrungsmittelallergien bei 4,7% und Insektengiftallergien bei 2,8%. Insgesamt ist bei einem knappen Drittel der Erwachsenen mindestens eine der genannten Allergien jemals ärztlich diagnostiziert worden. Aktuell leiden fast 20% an mindestens einer Allergie. Frauen sind generell häufiger betroffen als Männer und Jüngere häufiger als Ältere. Außerdem sind Allergien in den alten Bundesländern verbreiteter als in den neuen. Ein hoher sozioökonomischer Status und das Leben in Großstädten erhöhen ebenfalls die Krankheitshäufigkeit. Im 10-Jahres-Trend stieg die Asthmaprävalenz um knapp 3%, die Prävalenzen für Urtikaria und Kontaktekzeme sanken, die LZP für Heuschnupfen, Neurodermitis und Nahrungsmittelallergie blieb unverändert. Dadurch ist die Allergieprävalenz insgesamt von 32,7% auf 28,7% rückläufig.AbstractIn the first wave of the “German Health Interview and Examination Survey for Adults” (DEGS1), up-to-date and representative data regarding allergic diseases of 7988 18- to 79-year-old subjects living in Germany were collected using computer-assisted medical interviews. The study identified a lifetime prevalence of 8.6% for asthma, 14.8% for allergic rhinoconjunctivitis, 3.5% each for atopic dermatitis and urticaria, 8.1% for contact eczema, 4.7% for food allergies and 2.8% for insect venom allergies. Overall, nearly one third of adults in Germany have been diagnosed with at least one of the above mentioned allergies during their lifetime by a physician. Currently, nearly 20% suffer from at least one allergic disease. Generally, women reported an allergic disease more frequently than men and younger subjects more frequently than older ones. Additionally, allergies are more common in the former federal states of West Germany than in the former East German federal states. A high socioeconomic status and living in large cities both increase allergy risk. During the last 10 years, asthma prevalence increased about 3%, whereas the prevalence of urticaria and contact eczema declined. The lifetime prevalence of allergic rhinoconjunctivitis, atopic dermatitis and food allergies appeared unchanged. In total, allergy prevalence has declined from 32.7–28.7% over the past decade. An English full-text version of this article is available at SpringerLink as supplemental.

Prevalence of allergic diseases in Germany

ZusammenfassungIn der ersten Welle der „Studie zur Gesundheit Erwachsener in Deutschland“ (DEGS1) wurden aktuelle und bundesweit repräsentative Daten zum allergischen Krankheitsgeschehen von 7988 18- bis 79-Jährigen mittels computergestützter, ärztlicher Interviews erhoben. Demnach liegt die Lebenszeitprävalenz (LZP) für Asthma bronchiale bei 8,6%, Heuschnupfen bei 14,8%, Neurodermitis und Urtikaria bei jeweils 3,5%, Kontaktekzeme bei 8,1%, Nahrungsmittelallergien bei 4,7% und Insektengiftallergien bei 2,8%. Insgesamt ist bei einem knappen Drittel der Erwachsenen mindestens eine der genannten Allergien jemals ärztlich diagnostiziert worden. Aktuell leiden fast 20% an mindestens einer Allergie. Frauen sind generell häufiger betroffen als Männer und Jüngere häufiger als Ältere. Außerdem sind Allergien in den alten Bundesländern verbreiteter als in den neuen. Ein hoher sozioökonomischer Status und das Leben in Großstädten erhöhen ebenfalls die Krankheitshäufigkeit. Im 10-Jahres-Trend stieg die Asthmaprävalenz um knapp 3%, die Prävalenzen für Urtikaria und Kontaktekzeme sanken, die LZP für Heuschnupfen, Neurodermitis und Nahrungsmittelallergie blieb unverändert. Dadurch ist die Allergieprävalenz insgesamt von 32,7% auf 28,7% rückläufig.AbstractIn the first wave of the “German Health Interview and Examination Survey for Adults” (DEGS1), up-to-date and representative data regarding allergic diseases of 7988 18- to 79-year-old subjects living in Germany were collected using computer-assisted medical interviews. The study identified a lifetime prevalence of 8.6% for asthma, 14.8% for allergic rhinoconjunctivitis, 3.5% each for atopic dermatitis and urticaria, 8.1% for contact eczema, 4.7% for food allergies and 2.8% for insect venom allergies. Overall, nearly one third of adults in Germany have been diagnosed with at least one of the above mentioned allergies during their lifetime by a physician. Currently, nearly 20% suffer from at least one allergic disease. Generally, women reported an allergic disease more frequently than men and younger subjects more frequently than older ones. Additionally, allergies are more common in the former federal states of West Germany than in the former East German federal states. A high socioeconomic status and living in large cities both increase allergy risk. During the last 10 years, asthma prevalence increased about 3%, whereas the prevalence of urticaria and contact eczema declined. The lifetime prevalence of allergic rhinoconjunctivitis, atopic dermatitis and food allergies appeared unchanged. In total, allergy prevalence has declined from 32.7–28.7% over the past decade. An English full-text version of this article is available at SpringerLink as supplemental.

Asthma management practices in adults – findings from the German Health Update (GEDA) 2010 and the German National Health Interview and Examination Survey (DEGS1) 2008–2011

Abstract Objectives: In Germany, population-wide data on adherence to national asthma management guidelines are lacking, and performance measures (PM) for quality assurance in asthma care are systematically monitored for patients with German national asthma disease management program (DMP) enrollment only. We used national health survey data to assess variation in asthma care PM with respect to patient characteristics and care context, including DMP enrollment. Methods: Among adults 18–79 years with self-reported physician-diagnosed asthma in the past 12 months identified from a recent German National Health Interview Survey (GEDA 2010: N = 1096) and the German National Health interview and Examination Survey 2008–2011 (DEGS1: N = 333), variation in asthma care PM was analyzed using logistic regression analysis. Results: Overall, 38.4% (95% confidence interval: 32.5–44.6%) of adults with asthma were on current inhaled corticosteroid therapy. Regarding non-drug asthma management, low coverage was observed for inhaler technique monitoring (35.2%; 31.2–39.3%) and for provision of an asthma management plan (27.3%; 24.2–30.7%), particularly among those with low education. Specific PM were more complete among persons with than without asthma DMP enrollment (adjusted odds ratios ranging up to 10.19; 5.23–19.86), even if asthma patients were regularly followed in a different care context. Conclusions: Guideline adherence appears to be suboptimal, particularly with respect to PM related to patient counseling. Barriers to the translation of recommendations into practice need to be identified and continuous monitoring of asthma care PM at the population level needs to be established.

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

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

12-month prevalence of known chronic obstructive pulmonarydisease (COPD) in Germany

Chronic obstructive pulmonary disease (COPD) is associated with a high disease burden and is one of the leading causes of death worldwide. Smoking is the key modifiable risk factor for COPD in Germany. GEDA 2014/2015-EHIS surveyed the 12-month prevalence of known COPD using the European indicator on self-reported chronic bronchitis, chronic obstructive pulmonary disease, emphysema. Among adults aged 18 years or older with complete information on the indicator (n=22,702), the 12-month prevalence of known COPD is 5.8% (5.8% for women and 5.7% for men). In both genders, the prevalence increases strongly with age. Overall, the presence of COPD was more often reported by women and men with a low educational level than by those with a higher one. In a comparison of federal states, the 12-month prevalence of known COPD varies between 3.6% and 7.5% for women and 4.3% and 11.2% for men. CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) · PREVALENCE · ADULTS · HEALTH MONITORING · GERMANY Introduction Chronic obstructive pulmonary disease (COPD) is associated with a high disease burden and is one of the leading causes of death in Germany and globally [1-3]. COPD is a prevalent chronic disease of middle and older age [1, 4-7]. It is marked by chronic inflammation and progressive obstruction (narrowing) of the airways and destruction of lung tissue (parenchyma) [1, 8]. Chronic cough and phlegm production (chronic bronchitis) as well as a permanent over-inflation of the air sacks (emphysema) are common among COPD patients and often occur together [1, 8]. Moreover, shortness of breath under physical strain is a typical symptom. At more progressed stages of the disease, patients may also suffer from shortness of breath even at rest [1, 8]. Smoking is the most important modifiable risk factor for COPD in Germany [1, 7-9]. The risk of developing COPD is thereby related to the total amount of cigarette smoking over time (pack years) [7, 9]. Moreover, specific occupational exposures (e.g., coal dust) are important COPD risk factors [1, 7, 9, 10]. COPD is therefore considered a potentially preventable disease [1, 8]. However, impaired growth and functional development of the lungs also affect a person’s COPD risk [1, 9, 11]. Besides genetic factors and prenatal influences (e.g., maternal smoking during pregnancy), repeated respiratory infections in early childhood, exposure to airborne pollutants, or childhood asthma potentially contribute to developing COPD in later life [1, 7, 9, 12, 13]. Journal of Health Monitoring · 2017 2(3) DOI 10.17886/RKI-GBE-2017-065 Robert Koch Institute, Berlin Authors: Henriette Steppuhn, Ronny Kuhnert, Christa Scheidt-Nave

12-month prevalence of asthma among adults in Germany

Asthma is a chronic inflammatory disease of the airways affecting people of all ages. The disease is characterised by a variable narrowing of the bronchia, which may be accompanied by symptoms such as wheezing or shortness of breath. In GEDA 2014/2015-EHIS, 6.2% of respondents aged 18 years or older with complete information on the respective indicator (n=22,671) reported having had asthma during the past 12 months. The 12-month prevalence among women (7.1%) is higher than among men (5.4%). Overall, women and men with a low level of education more often reported having had asthma than those with a higher level of education. In analyses stratified by age and gender, differences in asthma prevalence with regard to educational level are evident among women under 30 years of age. In a comparison of federal states, the prevalence of asthma ranges from 3.0% to 9.7% among women and from 2.9% to 7.0% among men. ASTHMA · PREVALENCE · ADULTS · HEALTH MONITORING · GERMANY Introduction According to the World Health Organization (WHO), asthma is one of the most common chronic diseases affecting around 235 million people globally [1]. Asthma can occur among people of all ages [2-5]. The disease is characterised by chronic inflammation and increased sensitivity (hyperresponsiveness) of the airways to diverse inhaled stimuli [5, 6]. Asthma patients moreover suffer from variable narrowing of the bronchia (airway obstruction) accompanied by symptoms such as wheezing, shortness of breath, chest tightness or coughing which vary over time and in intensity [5, 6]. Some patients with mild asthma may experience periods when they are completely free of symptoms [5, 7]. In particular, in case of an asthma onset in childhood, remission of symptoms during puberty is frequently observed [4, 8]. Asthma is a heterogeneous disease which results from different underlying disease mechanisms [5, 9]. Allergic asthma and also other forms of non-allergic asthma are marked by a characteristic type of inflammation [5, 9]. This (TH2) type of inflammation is indicated by elevated concentrations of specific immune cells (eosinophils) in the airway mucosa and in the blood (eosinophilic asthma) [5, 6, 9]. Further, mainly adult-onset, forms of asthma exist, where such an overproduction of eosinophils cannot be observed (non-eosinophilic asthma) [5, 6, 9]. It is important to distinguish between eosinophilic and non-eosinophilic asthma, when treating patients with severe asthma [5, 6, 9]. A family history of asthma or of certain allergies (such as hay fever) is an important predisposing factor [5, 10-12]. Asthma thereby results from complex interactions Journal of Health Monitoring · 2017 2(3) DOI 10.17886/RKI-GBE-2017-064 Robert Koch Institute, Berlin Authors: Henriette Steppuhn, Ronny Kuhnert, Christa Scheidt-Nave

Häufigkeit allergischer Erkrankungen in Deutschland@@@Prevalence of allergic diseases in Germany: Ergebnisse der Studie zur Gesundheit Erwachsener in Deutschland (DEGS1)@@@Results of the German Health Interview and Examination Survey for Adults (DEGS1)

ZusammenfassungIn der ersten Welle der „Studie zur Gesundheit Erwachsener in Deutschland“ (DEGS1) wurden aktuelle und bundesweit repräsentative Daten zum allergischen Krankheitsgeschehen von 7988 18- bis 79-Jährigen mittels computergestützter, ärztlicher Interviews erhoben. Demnach liegt die Lebenszeitprävalenz (LZP) für Asthma bronchiale bei 8,6%, Heuschnupfen bei 14,8%, Neurodermitis und Urtikaria bei jeweils 3,5%, Kontaktekzeme bei 8,1%, Nahrungsmittelallergien bei 4,7% und Insektengiftallergien bei 2,8%. Insgesamt ist bei einem knappen Drittel der Erwachsenen mindestens eine der genannten Allergien jemals ärztlich diagnostiziert worden. Aktuell leiden fast 20% an mindestens einer Allergie. Frauen sind generell häufiger betroffen als Männer und Jüngere häufiger als Ältere. Außerdem sind Allergien in den alten Bundesländern verbreiteter als in den neuen. Ein hoher sozioökonomischer Status und das Leben in Großstädten erhöhen ebenfalls die Krankheitshäufigkeit. Im 10-Jahres-Trend stieg die Asthmaprävalenz um knapp 3%, die Prävalenzen für Urtikaria und Kontaktekzeme sanken, die LZP für Heuschnupfen, Neurodermitis und Nahrungsmittelallergie blieb unverändert. Dadurch ist die Allergieprävalenz insgesamt von 32,7% auf 28,7% rückläufig.AbstractIn the first wave of the “German Health Interview and Examination Survey for Adults” (DEGS1), up-to-date and representative data regarding allergic diseases of 7988 18- to 79-year-old subjects living in Germany were collected using computer-assisted medical interviews. The study identified a lifetime prevalence of 8.6% for asthma, 14.8% for allergic rhinoconjunctivitis, 3.5% each for atopic dermatitis and urticaria, 8.1% for contact eczema, 4.7% for food allergies and 2.8% for insect venom allergies. Overall, nearly one third of adults in Germany have been diagnosed with at least one of the above mentioned allergies during their lifetime by a physician. Currently, nearly 20% suffer from at least one allergic disease. Generally, women reported an allergic disease more frequently than men and younger subjects more frequently than older ones. Additionally, allergies are more common in the former federal states of West Germany than in the former East German federal states. A high socioeconomic status and living in large cities both increase allergy risk. During the last 10 years, asthma prevalence increased about 3%, whereas the prevalence of urticaria and contact eczema declined. The lifetime prevalence of allergic rhinoconjunctivitis, atopic dermatitis and food allergies appeared unchanged. In total, allergy prevalence has declined from 32.7–28.7% over the past decade. An English full-text version of this article is available at SpringerLink as supplemental.