Dear Editor,

We read the study by Zollner and colleagues published recently in Thorax about the leveling off of asthma and allergies among children in Germany between 1992 and 2001.[1] We have published a study looking at the same issue and using much of the same methodology (ISAAC) to assess asthma and allergies symptoms, diagnosis, and severity in more than 15,000 children (6–7 and 13–14 year olds) between 1995 and 2000 in Muenster, Germany.[2] We found a tendency towards an increase in current symptoms of asthma and allergies in both age groups, but more so among girls.[2]

Indices of diagnosis either remained the same or increased in parallel to the increase in symptoms, arguing against a change in diagnostic behaviour as an explanation for our results. Indices of severity also showed a homogenous increase in the 5-year study period pointing towards an increase in the overall burden of asthma and allergies within the society.[2]

Regrettably, these results, coming from Germany, were not considered either in the discussion of Zollner’s report nor in the affirmative title that no increase in asthma and allergies occurred in Germany in the nineties. Regrettably more so, when our study was alluded to in the discussion and conclusion of Zollner’s report it was cited, contrary to our results, as one of the studies (from China!!) showing a decrease or leveling off of asthma and allergies among children. [1] Remarkably our study had the word Germany in the title.

Regards

Wasim Maziak and Ulrich Keil,
Institute of Epidemiology and Social Medicine,
University Clinic of Muenster, Muenster, Germany

References

1. Zollner IK, Weiland SK, Piechotowski I, Gabrio T, von Mutius E, Link B, Pfaff G, Kouros B, Wuthe J. No increase in the prevalence of asthma, allergies, and atopic sensitisation among children in Germany: 1992-2001. Thorax 2005; 60(7):545-8.

2. Maziak W, Behrens T, Brasky TM, Duhme H, Rzehak P, Weiland SK, Keil U. Are asthma and allergies in children and adolescents increasing? Results from ISAAC phase I and phase III surveys in Munster, Germany. Allergy 2003;58(7):572-579.