gms | German Medical Science

Kongress Medizin und Gesellschaft 2007

17. bis 21.09.2007, Augsburg

Childhood social position and associations between environmental exposures and health outcomes

Meeting Abstract

  • Barbara Hoffmann - Universität Duisburg-Essen, Essen
  • Bita Kolahgar - Universität Duisburg-Essen, Essen
  • Knut Rauchfuss - Landesamt für Natur, Umwelt und Verbraucherschutz NRW, Essen
  • Georg Eberwein - Landesamt für Natur, Umwelt und Verbraucherschutz NRW, Essen
  • Isabelle Franzen-Reuter - Ministerium für Umwelt und Naturschutz, Landwirtschaft und Verbraucherschutz, Düsseldorf
  • Martin Kraft - Ministerium für Umwelt und Naturschutz, Landwirtschaft und Verbraucherschutz, Düsseldorf
  • Karl-Heinz Jöckel - Universität Duisburg-Essen, Essen

Kongress Medizin und Gesellschaft 2007. Augsburg, 17.-21.09.2007. Düsseldorf: German Medical Science GMS Publishing House; 2007. Doc07gmds157

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/gmds2007/07gmds157.shtml

Veröffentlicht: 6. September 2007

© 2007 Hoffmann et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Background: Growing evidence indicates that environmental exposures are more prevalent among socially disadvantaged groups. We investigated the distribution of environmental exposures in preschool children, stratified by different indicators of social position, and examined the role of social position on the associations between environmental exposures and health outcomes.

Methods: We analyzed data from a cross-sectional study on 968 preschool children, conducted in three districts in the Ruhr Area and in one rural community in North Rhine-Westphalia in 2000. Parents filled in a questionnaire on socio-demographic characteristics, environmental exposures and respiratory/atopic diseases. Residential annual total suspended particulate matter (TSP) mass concentrations were derived from a small scale dispersion model. Lung function, allergic sensitization and immunologic function were assessed. We analyzed the associations between environmental exposures and health outcomes in socially defined subgroups with logistic regression.

Results: High TSP concentrations at the home address and unfavourable living conditions were more prevalent in the socially disadvantaged groups. The odds ratio for the association between TSP and history of allergic diseases was 1.17 (95% CI 0.95-1.45) in children without immigration background and 0.71 (95% CI 0.53-0.95) in those with immigration background. Heterogeneity for several exposure-outcome associations was also seen between TSP and lung function as well as unfavourable living conditions and allergic sensitization and between subgroups characterized by nationality and poverty.

Conclusions: Possible explanations for heterogeneity between social subgroups include selection bias, measurement bias (i.e. over- and underreporting bias), and effect measure modification, which can not be corrected by statistical adjustment in multivariable models. When examining associations between environment and health, it is advisable to perform stratified analyses according to social position.

This analysis was funded by the "Action Program Environment and Health North Rhine-Westphalia" which is coordinated by the North Rhine-Westphalian Ministry of the Environment and Conservation, Agriculture and Consumer Protection.