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BCG Immunization at Birth and Atopic Diseases in a Homogeneous Population of Spanish Schoolchildren

García-Marcos L.a · Morales Suárez-Varela M.b · Miner Canflanca I.c · Batlles Garrido J.d · Blanco Quirós A.e · López-Silvarrey Varela A.f · García Hernández G.g · Guillén-Grima F.h · González Díaz C.i · Huerta González I.j · Arnedo Pena A.k · Busquets Monge R.l
aCartagena Clinical and Research Unit and Department of Pediatrics, University of Murcia, Murcia, bPublic and Environmental Health Unit, Department of Preventive Medicine, University of Valencia, Valencia, cDepartment of Pediatrics, Donostia Hospital, San Sebastián, dDepartment of Pediatrics, Torrecárdenas Hospital, Almería, eDepartment of Pediatrics, University of Valladolid, Valladolid, fMaría José Jove Foundation, La Coruña, gPediatric Allergy and Pneumology Unit, 12 de Octubre Children’s Hospital, Madrid, hDepartment of Health Sciences, Public University of Navarra, Navarra, iDepartment of Pediatrics, Basurto Hospital, Bilbao, jDepartment of Public Health, Regional Health Authority, Asturias, kDepartment of Epidemiology, Regional Health Authority, Castellón, and lDepartment of Pediatrics, Hospital del Mar UAB, Barcelona, Spain Int Arch Allergy Immunol 2005;137:303–309 (DOI:10.1159/000086461)


Background: The role of immunization with bacillus Calmette-Guérin (BCG) in the prevalence of asthma, hay fever and atopic dermatitis is not definitely established and seems to be influenced by ethnic background. The aim of this study was to analyze the relationship between this immunization and the prevalence of those diseases in a homogeneous population of Spanish schoolchildren. Methods: The International Study of Asthma and Allergies in Childhood (ISAAC) core and environmental questionnaires were used in four different centers of the Spanish North Atlantic coast. Bilbao, San Sebastián and Asturias have a universal BCG immunization policy during the first days of life, whereas La Coruña discontinued this practice in 1989. Except for this center, immunization coverage was above 90%. A random sample of schools of Asturias or all schools in the city district (rest of centers) with children 6 and 7 years old was surveyed. Results: The participation rate was above 70%. After excluding those children born outside Spain, the numbers were 6,762 immunized and 2,828 nonimmunized. After adjusting for gender, age, smoking habits of the father and mother, truck traffic near the household, older and younger siblings and having a cat or a dog during the first year of the child’s life, the adjusted ORs of the BCG-immunized children suffering from asthma, hay fever and atopic dermatitis were respectively 0.87 (95% CI 0.76–1.00), 0.87 (0.75–1.01) and 0.89 (0.76–1.05). Conclusions: BCG immunization offers a weak but significant protection against asthma and hay fever in Spanish schoolchildren.


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