INGA (1994 – 2004)

Indoor factors and genetics in asthma

Study objectives:
To determine the impact of indoor factors on incidence, and prevalence of asthma and allergic diseases.

Specific aims:

  • To determine the prevalence, incidence, and trend of asthma and allergic diseases.
  • To describe the distribution of exposure to known or suspected environmental risk factors (indoor) associated with asthma and allergic diseases for cases and controls in the study regions of Erfurt and Hamburg (adults), Bitterfeld, Hettstedt, and Zerbst (children).
  • To determine the impact of indoor allergens and indoor air pollutants on the prevalence and incidence of asthma and allergic diseases.
  • To determine the risk attributable to chronic exposure to these environmental risk factors for the differences in prevalence and incidence of asthma and allergic diseases between East and West Germany.
  • To determine the risk attributable to chronic exposure to these environmental risk factors for the incidence and prognosis of asthma and allergic diseases.

Study design:
Cross-sectional study: Prevalence
Repeated cross-sections: Trends of prevalence and indoor factors
Longitudinal study: Incidence
Case-control-study: Impact of indoors factors on asthma and allergic diseases.

Study population:
Part I: Adults

  • Erfurt (East Germany), Hamburg (West Germany).
  • 200 participants per center (approximately 100 cases and 100 controls) aged 20-44 years selected from the participants of the European Respiratory Health Survey (ECRHS, 1990-1992) in the two cities.

Part II: Children

  • East Germany, state of Sachsen-Anhalt: Bitterfeld, Hettstedt, and Zerbst,
  • 454 children selected from the participants of the 1st and 2nd Bitterfeld-Survey (1992/93 and 1995/96, respectively).

Study area:

  • Erfurt (East Germany), Hamburg (West Germany)
  • East Germany, state of Sachsen-Anhalt: Bitterfeld, Hettstedt, and Zerbst

Study methods:
Part I: Adults
Questionnaire, lung function testing, bronchial responsiveness to methacholine challenge or to a bronchodilator testing, skin prick test, serum total and specific IgE measurements

Part II: Children
Questionnaire answered by the parents of the children, lung function testing, skin prick test, serum total and specific IgE measurements, analysis of blood samples, bronchial responsiveness to cold air challenge.

Adults and Children

  • Indoor questionnaire
  • Determination of concentrations of mite and cat allergens (WZ, SZ, MA), molds (WZ), endotoxins (WZ) and ß-glucan (WZ) in house dust
  • Determination of the concentrations volatile organic components (WZ, SZ, OU), formaldehyde (WZ, SZ) and nitrogen dioxide (WZ, SZ, OU) in the air
  • Determination of temperature and humidity (WZ)

WZ = living room, SZ = bedroom, MA = mattress, OU = outdoor

Study period:
1994 - 2006.

Current status:
Part I: Adults
The medical examinations and the home visits of the first cross-section are completed. Statistical evaluations of the trend of respiratory symptoms, lung function, and bronchial hyperresponsiveness were made. Description and statistical modeling of the relationships between indoor factors and housing characteristics and occupant behavior are completed for most of the indoor factors. The impact of various indoor factors on the prevalence of asthma and allergic diseases was analyzed.

Part II: Children
The medical examinations and the home visits of the first cross-section are completed. The impact of various indoor factors on the prevalence of asthma and allergic diseases was analyzed.

Investigators:
Josef Cyrys (exposure assessment), Joachim Heinrich (Co-PI), H.-Erich Wichmann (Co-PI).

Collaboration:
Helmholtz Zentrum München, Neuherberg
  - Institute of Epidemiology
  - Institute of Ecological Chemistry
Friedrich-Schiller-University, Jena
  - Institute of Occupational, Social and Environmental Medicine
  - Institute of Clinical Immunology
Großhansdorf Hospital, Hamburg
  - Center for Pneumology and Thoracic Surgery
Utrecht University
  - Environmental and Occupational Health Group

Funding:
Federal Ministry for Education, Science, Research, and Technology.

Contact:
Helmholtz Zentrum München
Institute of Epidemiology
Dr. Joachim Heinrich
P.O. Box 1129
D-85758 Neuherberg
Tel. +49-(0)89-3187 4150
Fax +49-(0)89-3187 3380

Related publications:

Gehring U, Brunekreef B, Fahlbusch B, Wichmann HE, Heinrich J and the INGA study group:
Are house dust mite allergen levels influenced by cold winter weather?
Allergy 2005; 60:1079-1082.
Abstract

Gehring U, Bischof W, Schlenvoigt G, Richter K, Fahlbusch B, Wichmannn HE, Heinrich J for the INGA study group:
Exposure to house dust endotoxin and allergic sensitization in adults.
Allergy 2004; 59:946-952.
Abstract

Topp R, Cyrys J, Gebefügi I, Schnelle-Kreis, J, Richter K, Wichmann HE, Heinrich J:
Indoor and outdoor air concentrations of BTEX and NO2: Correlation of repeated measurements.
JEM 2004; 6:807-812.
Abstract

Fahlbusch B, U Gehring, K Richter, HE Wichmann, J Heinrich.
Predictors of Cat Allergen (Fel d 1) in House Dust of German Homes With/Without Cats.
J Invest Allergol Clin Immunol 2002; 12(1): 12-20.
Abstract

Gehring U, Bischof W, Fahlbusch B, Wichmann H-E, Heinrich J.
House dust endotoxin and allergic sensitization in children.
Am J Respir Crit Care Med 2002; 166(7).
Abstract

Jacob B, B Ritz, U Gerhing, A Koch, W Bischof, HE Wichmann, J Heinrich for the INGA-Study Group.
Indoor Exposure to Molds and Allergic Sensitization.
Environmental Health Perspectives. 2002; 110/7: 647-653.
Abstract

Heinrich J, U Gehring, J Douwes, A Koch, B Fahlbusch, W Bischof and HE Wichmann for the INGA-Study Group.
Pets and Vermin are associated with high endotoxin levels in house dust.
Clinical and Experimental Allergy 2001; 31:1839-1845.
Abstract

Schneider P, I Gebefügi, K Richter, G Wölke, J Schnelle, HE Wichmann, J Heinrich.
Indoor and outdoor BTX levels in German cities.
The Science of the Total Environment 2001; 267:41-51.
Abstract

Gehring U, Douwes J, Doekes G, Koch A, Bischof W, Fahlbusch B, Richter K, Wichmann HE, Heinrich J for the INGA Study Group.
Beta (1->3)-Glucan in House Dust of German Homes: Housing Characteristics, Occupant Behaviour, and Relations with Endotoxins, Allergens, and Molds.
Environmental Health Perspectives 2001; Vol. 109, Nr. 2: 139-144.
Abstract

Cyrys J, J Heinrich, K Richter, G Wölke, HE Wichmann.
Sources and concentrations of indoor nitrogen dioxide in Hamburg (west Germany) and Erfurt (east Germany).
The Science of the Total Environment (2000) 250:51-62.
Abstract

Groß I, J. Heinrich, B Fahlbusch, L Jäger, W Bischof, HE Wichmann.
Indoor determinants of Der p 1 and Der f 1 concentrations in house dust are different.
Clinical and Experimental Allergy (2000) 30:376-382.
Abstract

Richter K, J Heinrich, RA Jörres, H Magnussen, HE Wichmann for the INGA Study Group.
Trends in bronchial hypperresponsiveness, respiratory symptoms and lung function among adults: West and East Germany.
Respiratory Medicine (2000) 94:668-677.
Abstract

Fahlbusch B, D Hornung, J Heinrich, HM Dahse, L Jäger.
Quantification of group 5 grass pollen allergens in house dust.
Clinical and Experimental Allergy (2000) 30:1645-1652.
Abstract

Koch A, KJ Heilemann , W Bischof, J Heinrich, HE Wichmann.
Indoor viable mold spores – a comparison between two cities, Erfurt (eastern Germany) and Hamburg (western Germany).
Allergy (2000) 55: 176-180.
Abstract

Bischof W, Koch A, Gehring U, Fahlbusch B, Heinrich J, Wichmann HE.
Predictors of high endotoxin concentrations in German homes.
Proceedings of Healthy Buildings (2000) 1:251-256.
Abstract

Fahlbusch B, Heinrich J, Groß I, Jäger L, Richter K, Wichmann HE.
Allergens in house-dust samples in Germany: Results of an East-West German comparison.
Allergy 54, 2196-2203 (1999).
Abstract

Douwes, J, Doekes, G, Heinrich, J, Koch, A, Bischof, W, Brunekreef, B.
Endotoxin and ß(1 3)-glucan in house dust and the relation with home characteristics: a pilot study in 25 German houses.
In: Indoor Air 1998, 8: 255-263 (1998).

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