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Don't we overestimate drug allergies in children?

100%
Podlecka D., Jerzyńska J., Brzozowska A.
International Journal of Occupational Medicine and Environmental Health
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2023
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vol. 36
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issue 5
632-642
EN
Objectives On average about 10% of parents report hypersensitivity to at least 1 drug in their children. After diagnosis process a few of these reactions are being confirmed as drug hypersensitivity reactions. The aim of the study was to assess the real-life prevalence of drug hypersensitivity in children based on drug provocation tests. Material and Methods The authors included 113 children, aged 4–18 years, referred to Pediatrics and Allergy Clinic in Łódź, Poland, due to incidence of adverse reaction during treatment. Medical history regarding allergies to drugs was taken in accordance to the form developed by the United States Food and Drug Administration Adverse Event Reporting System. Skin prick tests, intradermal test and drug provocation test were performed in all patients. Results In all 113 patients suspected of drug allergy, after all diagnostic procedures, the authors proved IgE-mediated allergy to β-lactams, nonsteroid anti-inflammatory drugs, local anesthetics in 19 patients (16.8%). Previous history of allergy was a risk factor for drug allergy in studied patients (p = 0.001). The most frequent symptoms of allergy were urticaria and erythematous papular rash. Conclusions Drug allergy is a difficult problem in the practice of a doctor and is difficult to diagnose, especially in the pediatric population. It seems that too often isolated symptoms reported during infection or disease are taken as a symptom of drug allergy, and not as a symptom resulting from the course of the disease.
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When toothache results in asthma diagnosis

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Rahimo M., Jerzyńska J., Brzozowska A., Podlecka D.
International Journal of Occupational Medicine and Environmental Health
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2021
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vol. 35
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issue 1
107-110
EN
Local anesthetics (LA) have been used for a wide variety of procedures over the years due to their analgesic effect. These drugs have been seen to cause adverse events in the pediatric population, but an actual allergy must be in question. A case of an apparent hypersensitivity reaction to LA used in the setting of dental procedures in a 14.5-year-old girl with a forgotten history of asthma was reported and medical documentation review was performed. After treatment with LA during several dental procedures, the patient presented the shortness of breath, malaise and fainting, which then resolved spontaneously. After proper history taking, and skin and provocation tests, the patient was diagnosed with bronchial asthma and emotional sensitivity. The patient’s recommendation included using an antihistamine and controlling her asthma before the use of LA, and administering the drug in a supine position. It is essential to consider all possible etiologies of an adverse event after using drugs in the pediatric population and to perform proper testing before making the diagnosis of a drug allergy.
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Relationship between prenatal and postnatal exposure to BPA and its analogues (BPS, BPF) and allergic diseases

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Weteska M., Zwolińska A., Pisarska-Troczyńska K., Janc M., Polańska K., Jerzyńska J., Jankowska A.
International Journal of Occupational Medicine and Environmental Health
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2023
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vol. 36
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issue 5
575-586
EN
Bisphenols, endocrine disrupting chemicals, are widely used in daily life. Continued exposure during key developmental periods of life (pregnancy, infancy and early childhood) can contribute to adverse health consequences such as decreased lung function, wheezing/asthma, the occurrence of allergies or changes in immune system responses. The purpose of this review is to present the current state of knowledge on the effects of prenatal or postnatal exposure to bisphenol A (BPA), bisphenol S (BPS) and bisphenol F (BPF) on the development of allergic diseases in childhood. A comprehensive and systematic search of PubMed, Scopus and Web of Science databases was conducted. The review is restricted to studies published since 2015, in English in peer-reviewed journals. Based on keywords, 2648 studies were identified and reviewed for eligibility. Finally, 8 epidemiological studies were found to be appropriate for inclusion in this publication. The data collected in this review suggests that there is an association between maternal exposure during pregnancy or childhood to BPA and the development of allergic diseases. Most studies reported positive relationships between BPA exposure and at least one of the types of allergic disease. The paucity of studies and the observed differences in findings regarding the association between prenatal/postnatal exposure to BPS and/or BPF do not allow firm conclusions to be drawn. Further research is needed to identify the vulnerable population and the mechanisms responsible for the development of undesirable health consequences.
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The effect of air pollution on the respiratory system in preschool children with contribution of urban heat islands and geographic data – the aim of the study and methodological assumptions

76%
Bobrowska-Korzeniowska M., Jerzyńska J., Polańska K., Kaleta D., Stelmach I., Kunert A., Stelmach W.
International Journal of Occupational Medicine and Environmental Health
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2021
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vol. 34
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issue 4
453-460
EN
It has been proven that outdoor and indoor air pollutants can cause adverse health effects and are able to promote the onset of atopic diseases. The current manuscript is focused on methodological issues. The aim of the study is to determine the effect of air pollution, urban environment, and urban heat islands (UHIs) on the occurrence of respiratory diseases including allergic rhinitis, asthma and wheezing in preschool children. The study group consists of 276 five-year-old children attending randomly selected kindergartens in the urban and rural areas of the Łódź Voivodeship. The questionnaire including data on the child’s state of health and socio-economic data will be filled by the caregivers. The children will undergo skin prick testing and the measurement of volatile organic compounds in exhaled breath. The key components of air pollution – particulate matter (PM) will be measured by personal meters. The PM sampling planned in the study will take 12 h for PM2.5 and for PM10 alike. Data on the level of outdoor air pollution will be collected based on the results obtained from air monitoring stations. The impact of air pollution, UHIs and the environment on the respiratory system and the presence of allergies in children, including chronic respiratory diseases, will be assessed. The project results will provide a scientific basis for the development of preventive programs in the population of children in the Łódź Voivodeship, adapted to the real health needs of society.
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Duration of breastfeeding and psychomotor development in 1-year-old children – Polish Mother and Child Cohort Study

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Stelmach I., Kwarta P., Jerzyńska J., Stelmach W., Krakowiak J., Karbownik M., Podlecka D., Hanke W., Polańska K.
International Journal of Occupational Medicine and Environmental Health
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2019
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vol. 32
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issue 2
175-184
EN
Objectives The objective of this study was to evaluate the association between breastfeeding duration and child neurodevelopment based on the Polish Mother and Child Cohort Study. Material and Methods The current analysis included 501 mother–child pairs. The analysis evaluating the association between the length of breastfeeding and child neurodevelopment considered the following variables: maternal age and body mass index, weight gain during pregnancy, parental level of education, marital status, socioeconomic status, child gender, birthweight, type of delivery, preterm delivery, pre- and postnatal exposure to tobacco constituents and child day care attendance. Psychomotor development was assessed in 1-year-olds on the Bayley Scales of Infant and Toddler Development. Results The length of breastfeeding correlated positively with maternal age at delivery (ρ = 0.13), maternal and paternal level of education (ρ = 0.2 and ρ = 0.14 respectively), birthweight (ρ = 0.1) and marital status (ρ = 0.16) (p < 0.05). A negative correlation between the length of breastfeeding and maternal smoking status during the first year after delivery (ρ = –0.19) and weight gain during pregnancy (r = –0.1) was observed (p < 0.05). The association between the duration of breastfeeding and child development was not statistically significant in the model with the inclusion of confounding variables. A significant association between language development and maternal level of education (p = 0.004), gender of the child (p = 0.0007) and maternal weight gain during pregnancy (p = 0.01) was found. A negative association between cognitive development and maternal salivary cotinine during pregnancy (p = 0.03) and a negative association between motor development and maternal smoking status during the first year after delivery (p = 0.007) were also found. Conclusions This study found no significant association between the duration of breastfeeding and child development after adjustment for confounders. Int J Occup Med Environ Health. 2019;32(2):175–84
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Polish Mother and Child Cohort Study (REPRO_PL) – Methodology of the follow-up of the children at the age of 7

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Polańska K., Hanke W., Król A., Potocka A., Waszkowska M., Jacukowicz A., Gromadzińska J., Wąsowicz W., Jerzyńska J., Stelmach W., Stelmach I.
International Journal of Occupational Medicine and Environmental Health
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2016
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vol. 29
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issue 6
883-893
EN
Effects of environmental exposures in utero and in the first years of life on early life health and development is a growing research area with major public health implications. The main aim of this work has been to provide an overview of the next step of the Polish Mother and Child Cohort Study (REPRO_PL) covering exposure, health and neurodevelopment assessments of children at 7 years of age. Details regarding methodology of the follow-up of the children are crucial for cross-cohort collaboration and a full understanding of the future research questions. Phase III of the REPRO_PL cohort covers a follow-up of 900 children at the age of 7 years old. The questionnaire filled in by the mothers is composed of: socio-demographic, child exposure and home environment information, nutritional status and health data. In the case of 400 children, environmental (including collection of urine, saliva and buccal cells), health status and psychomotor assessments are performed. Health and development check consists of physical measurements, child health status assessment (including lung function tests, skin prick testing, an interview/examination by an allergist) and psychomotor development tests (the Strength and Difficulties Questionnaire and the Intelligence and Development Scales). The results of the study will become available within the next few years. Extension of the REPRO_PL cohort with examinations of children at the age of 7 years old may provide a better understanding of the relationship between environmental and lifestyle-related factors and children’s health and neurodevelopment; and may further strengthen scientific base for policies and interventions promoting healthy lifestyle. Int J Occup Med Environ Health 2016;29(6):883-893
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