Education as a health risk
(Vienna, 25 May 2010) Within the framework of the international ISAAC study, which was carried out under the supervision of Ao.Univ. Prof. Dr. Gerald Haidinger, Centre of Public Health of MedUni Vienna, it was possible to prove a clear link between the prevalence of neurodermatitis and the parents' educational attainment.
In the periods from 1995 to 1997 and between 2001 and 2003, Gerald Haidinger carried out a cross-sectional study among more than 23,000 Upper Austrian schoolchildren. He found a conspicuous connection between their parents' educational attainment and the prevalence of atopic eczema (neurodermatitis) - independent of the occurrence of the disease in the parents.
In the comparison of the two study cycles, a rate of increase of the diseases of more than ten percent was observed. Independent of this growth rate, a similar increase was found to have occurred at the same time in their parents' educational level, with the mothers playing a decisive role. With this statistically significant odds ratio of between 1.13 and 1.37, the parents' educational level seems to constitute an independent risk factor for neurodermatitis. However, more studies which focus on this specific topic are needed to prove this hypothesis.
In principle, at least two factors seem to be relevant in order to establish such a connection between educational attainment and the disease. On the one hand, higher education could possibly lead to the parents paying increased attention to the children's symptoms, therefore might simply have a positive impact on the recognition rate at the same disease severity. On the other hand, however, excessive hygiene behaviour in a low-germ environment can change the immune system and consequently lead to related dermatological responses.
"In a nutshell we can say that we have identified the parents' education level as an independent risk factor for neurodermatitis. But as it is impossible to confirm 'evidence' for such connections from cross-sectional studies, we need to wait for future trials to uncover or refute this connection. The reason is that cross-sectional studies can merely serve to derive hypotheses for possible links," explains Gerald Haidinger, the national coordinator of the international ISAAC study.
For the autumn it is planned to repeat the complete survey, which was conducted in 2006 on about 10,000 6-7-year-old children, in six districts of the province of Styria. In these districts, the parents of all children in the first and second years of primary school will be questioned about risk factors for atopic diseases and the prevalence of these diseases in their children.
Information about the study: Weber AS, Haidinger G. "The prevalence of atopic dermatitis in children is influenced by their parents' education: results of two cross-sectional studies conducted in Upper Austria". Pediatr Allergy Immunol 2010 (within the framework of the international ISAAC study "Asthma and Allergies in Childhood")
» ISAAC (International Study of Asthma and Allergies in Childhood): This programme was established in 1991 to investigate asthma, rhinitis (inflammation of the nasal mucosa) and eczema in children. The study aims to identify whether and how strong these diseases are on the increase in the industrialised and developing countries. The study is conducted in around 100 countries on more than two million children.