A causal association between socioeconomic status and the prevalence of atopic diseases has been reported.26 Similar studies performed in different countries around the world demonstrate that, in poor countries or poor regions within countries, the incidences of atopic dermatitis and other allergic diseases are lower than the numbers of cases reported in affluent societies.27,28 The observation that migrant populations, moving from rural or undeveloped environments to towns and cities, exhibit increased frequencies of atopic symptoms lends additional support to this theory.2 Research has demonstrated that alterations to the types and circulating levels of environmental allergens can increase the risk of developing atopic dermatitis and other atopic diseases. Exposure to industrial pollutants not found in undeveloped nations is now a recognised risk factor contributing to the increased prevalence of atopic dermatitis.29
26. Stewart AW, Mitchell EA, Pearce N, et al. The relationship of per capita gross national product to the prevalence of symptoms of asthma and other atopic diseases in children(ISAAC).Int J Epidemiol 2001;30:173-9
27. Zeyrek CD, Zeyrek F, Sevinc E, et al. Prevalence of asthma and allergic diseases in Sanliurfa, Turkey, and the relation to environmental and socioeconomic factors: is the hygiene hypothesis enough? J Investig Allergol Clin Immunol 2006; 16: 290-5
28. Sole D, Camelo-Nunes IC, Wandalsen GF, et al. Prevalence of symptoms of asthma, rhinitis, and atopic eczema in Brazilian adolescents related to exposure to gaseous air pollutants and socioeconomic status. J Investig Allergol Clin Immunol 2007; 17: 6-13
2. Williams HC. Clinical practice. Atopic dermatitis. N Engl J Med 2005; 352: 2314-24
29. Torres-Borrego J, Molina-Teran AB, Montes-Mendoza C. Prevalence and associated factors of allergic rhinitis and atopic dermatitis in children. Allergol Immunopathol (Madr) 2008; 36: 90-100
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