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Childhood eczema: disease of the advantaged?

1994; BMJ; Volume: 308; Issue: 6937 Linguagem: Inglês

10.1136/bmj.308.6937.1132

0959-8138

Hywel C Williams, D P Strachan, Roderick J. Hay,

Allergic Rhinitis and Sensitization

Abstract Objective : To determine whether the increased prevalence of childhood eczema inadvantaged socioeconomic groups is due to increased parental reporting. Design : Comparison of parental reports of eczema with visible eczema recorded by medical officers during a detailed physical examination. Setting : National birth cohort study. Subjects : 8279 children from England, Wales, and Scotland born during 3-9 March 1958 and followed up at the ages of 7, 11, and 16. Main outcome measures : Prevalence of eczema according to parental report compared with medical officer9s examination at the ages of 7, 11, and 16. Results : Prevalence of both reported and examined eczema increased with rising social class at the ages of 7, 11, and 16 years. The point prevalence of examined eczema at age 7 was 4.8%, 3.6%, 3.6%, 2.4%, 2.2%, and 2.4% in social classes I, II, III non-manual, III manual, IV, and V respectively (X 2 value for linear trend 12.6, P<0.001). This trend persisted after adjustment for potential confounders such as region and family size and was not present for examined psoriasis or acne. Conclusions : Eczema is more prevalent among British schoolchildren in social classes I and II than those in lower classes. Exposures associated with social class are probably at least as important as genetic factors in the expression of childhood eczema.