スギ花粉症の疫学研究

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  • Epidemiology of Japanese Cedar Pollinosis

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The present situation and future aspects in epidemiological studies of Japanese cedar pollinosis are discussed. First of all, diagnostic criteria for epidemiological studies have not been established. A study group supported by the Ministry of Health and Welfare produced a criterion in March 1992, however, we produced other criterion compensating for the former's defects. Our criterion is as follows; any nasal and/or conjunctival symptom continuing for three weeks or more in March and/or April, and positive serum IgE against Japanese cedar pollen. A tentative study was performed. According to the former criterion, prevalence rates of “definite pollinosis” were 8.3% in adults and 5.6% in children, while those of “definite and probable pollinosis” were 16.8% and 12.1%, respectively. Prevalence rates according to our criterion were 14.1% and 9.0%, respectively.<BR>Symptomatic criteria were defined as corresponding epidemiological criteria e x cept for serum examinations, and validity of symptomatic criteria was tested. Sensitivities for all criteria were 100% theoretically. Specificities for “definite pollinosis” of the study group criteria were 96.8% in adults and 97.0% in children. Those for “definite and probable pollinosis” were 88.3% and 90.3%, respectively. Those for our criteria were 89.2% in both sample groups. If the validity of these criteria are stable in other study samples, prevalence rates can be estimated by only questionnaire surveys.<BR>Risk factors of Japanese cedar pollinosis are not epidemiologically established although many candidate factors have been discussed in clinical fields. Methodological problems for case-control study are the following. Three types of case should be concerned; symptomatic patient, sensitized person including symptomatic patient, and sensitized but asymptomatic person. When the case involves a symptomatic patient, bias and confounding originating from the following types of control are a concern; a) not sensitized and asymptomatic people, b) asymptomatic people without serum examination, c) not sensitized people with or without allergic-like symptoms. The largest problem for cohort study is the need to start in childhood because sensitization during early life is assumed.

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