Atopy and asthma result from the effects of environmental factors on genetically susceptible persons, and different prevalence rates have been documented worldwide. In developed and industrialized countries a higher prevalence of atopy and asthma is observed as compared with undeveloped and less affluent countries. Migration involves exposure to a new set of pollutants and allergens. In addition, it involves several socioeconomic and cultural issues such as housing conditions, diet and accessibility to medical services, all of which are likely to affect migrants’ health. Migration studies provide information on the role of environmental factors in the development of atopy and asthma. Immigration to allergy-prevalent countries causes more allergies and asthma in immigrants as compared to the prevalence of atopy in their countries of origin. The increase in allergy and asthma is usually not related to ethnicity, but in certain populations may play an important role. Studies on migrants support the notion that lifestyle and environmental factors in western industrialized countries facilitate atopy and asthma. The effect is time-dependent. Acquiring allergy is influenced by the age at the time of immigration. Migrants, in general, are more prone to the development of allergies than the local population. Low hygiene prior to immigration does not seem to protect against the development of atopy or asthma. Vaccinations do not affect the development of atopy or asthma in the general population and in migrants. Migrants should be aware of the potential of developing allergies and/or asthma. Strategies for primary prevention in high-risk atopic individuals and secondary prevention guidelines should be developed both for populations in developing countries as well as for immigrants from such countries to atopy-prevalent developed countries.

1.
Tang EA, Wiesch DG, Samet JM: Epidemiology of asthma and allergic disease; in Adkinson NK, Yunginger JW, Busse WW, Bochner BS, Holgate ST, Simmons ER (eds): Middleton’s Allergy: Principles and Practice, ed 6. St Louis, Mosby, 2003, pp 1127–1168.
2.
Coultas DB, Gong H Jr, Grad R, et al: Respiratory diseases in minorities of the United States. Am J Respir Crit Care Med 1993;149:S93.
3.
Peat JK, Woolcock AJ, Leeder SR, Blackburn CR: Asthma and bronchitis in Sydney schoolchildren. II. The effect of social factors and smoking on prevalence. Am J Epidemiol 1980;111:728–735.
4.
Gibson PG, Henry RL, Shah S, Powell H, Wang H: Migration to a western country increases asthma symptoms but not eosinophilic airway inflammation. Pediatr Pulmonol 2003;36:209–215.
5.
Powell CV, Nolan TM, Carlin JB, Bennett CM, Johnson PD: Respiratory symptoms and duration of residence in immigrant teenagers living in Melbourne, Australia. Arch Dis Child 1999;81:159–162.
6.
Leung RC, Carlin JB, Burdon JG, Czarny D: Asthma, allergy and atopy in Asian immigrants in Melbourne. Med J Aust 1994;161:418–425.
7.
Leung R: Asthma, allergy and atopy in South-east Asian immigrants in Australia. Aust NZ J Med 1994;24:255–257.
8.
Leung R: Asthma and migration. Respirology 1996;1:123–126.
9.
Tedeschi A, Barcella M, Bo GA, Miadonna A: Onset of allergy and asthma symptoms in extra-European immigrants to Milan, Italy: Possible role of environmental factors. Clin Exp Allergy 2003;33:449–454.
10.
Tobias A, Soriano JB, Chinn S, Anto JM, Sunyer J, Burney P; European Community Respiratory Health Survey: Symptoms of asthma, bronchial responsiveness and atopy in immigrants and emigrants in Europe. European Community Respiratory Health Survey. Eur Respir J 2001;18:459–465.
11.
Rosenberg R, Vinker S, Zakut H, Kizner F, Nakar S, Kitai E: An unusually high prevalence of asthma in Ethiopian immigrants to Israel. Fam Med 1999;31:276–279.
12.
Ballin A, Somekh E, Geva D, Meytes D: High rate of asthma among immigrants. Med Hypotheses 1998;51:281–284.
13.
Kalyoncu AF, Stalenheim G: Survey on the allergic status in a Turkish population in Sweden. Allergol Immunopathol (Madr) 1993;21:11–14.
14.
Kalyoncu AF, Stalenheim G: Serum IgE levels and allergic spectra in immigrants to Sweden. Allergy 1992;47/4:277–280.
15.
Asseyr AF, Businco L: Atopic sensitization in children of Somali immigrants in Italy. J Investig Allergol Clin Immunol 1994;4/4:192–196.
16.
Dervaderics M, Fust G, Otos M, Barok J, Pataky G: Differences in the sensitization to ragweed pollen and occurrence of late summer allergic symptoms between native and immigrant workers of the nuclear power plant of Hungary. Immunol Invest 2002;31:29–40.
17.
Geller-Bernstein C: Genetic and environmental determinants in the pathogenesis of allergic diseases. Pediatr Pulmonol 1997;16:S13–S14.
18.
Goren AI, Bruderman I: Pulmonary functions and respiratory symptoms and diseases among adult Israelis. Variations by country of origin. Isr J Med Sci 1986;22:761–765.
19.
Hjern A, Rasmussen F, Hedlin G: Age at adoption, ethnicity and atopic disorder: A study of internationally adopted young men in Sweden. Pediatr Allergy Immunol 1999;10:101–106.
20.
Leung R, Ho P: Asthma, allergy, and atopy in three shouth-east Asian populations. Thorax 1994;49:1205–1210.
21.
Waite DA, Eyles EF, Tonkin SL, O’Donnell TV: Asthma prevalence in Tokelauan children in their environments. Clin Allergy 1980;10:71–75.
22.
Williams HC, Pembroke AC, Forsdyke H, Boodoo G, Hay RJ, Burney PGJ: London-born black Caribbean children are at high risk of atopic dermatitis. J Am Acad Dermatol 1995;32:212–217.
23.
Diepgen TL: Atopic dermatitis: The role of environmental and social factors, the European experience. J Am Acad Dermatol 2001;45(1 suppl):S44–S48.
24.
Hjern A, Haglund B, Bremberg S, Ringback-Weitoft G: Social adversity, migration and hospital admissions for childhood asthma in Sweden. Acta Paediatr 1999;88:1107–1112.
25.
Kabesch M, Schaal W, Nicolai T, von Mutius E: Lower prevalence of asthma and atopy in Turkish children living in Germany. Eur Respir J 1999;13:577–582.
26.
Eder W, Von Mutius E: Hygiene hypothesis and endotoxin: What is the evidence? Curr Opin Allergy Clin Immunol 2004;4:113–117.
27.
Rottem M, Shoenfeld Y: Vaccination and allergy. Curr Opin Otolaryngol Head Neck Surg 2004;12:223–231.
28.
Gruber C, Illi S, Lau S, Nickel R, Forster J, Kamin W, Bauer CP, Wahn V, Wahn U; MAS-90 Study Group: Transient suppression of atopy in early childhood is associated with high vaccination coverage. Pediatrics 2003;111/3:e282–e288.
29.
Gruber C, Meinlschmidt G, Bergmann R, Wahn U, Stark K: Is early BCG vaccination associated with less atopic disease? An epidemiological study in German preschool children with different ethnic backgrounds. Pediatr Allergy Immunol 2002;13:177–181.
30.
Strannegard IL, Larsson LO, Wennergren G, Strannegard O: Prevalence of allergy in children in relation to prior BCG vaccination and infection with atypical mycobacteria. Allergy 1998;53:249–254.
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