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Background: In Munich, the first German case of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was detected on 27 January 2020 at the Division of Infectious Diseases and Tropical Medicine of the University Hospital LMU Munich (DIDTM), and consecutively the Covid Testing Unit was established. Germany advocated several public health measures to control the outbreak. This study investigates the effects of measures on health service utilization in the public, which in turn can alter case numbers and test positivity rates., Method: Our retrospective observational study was conducted to determine the effects of public health measures on the utilization of a testing facility and positivity rates from the first operational COVID-19 testing facility in Munich for waves 1 and 2 over a period of 14 months. This was accomplished by comparing trends in client characteristics including age, gender, symptoms, and socio-demographic aspects over time to non-pharmaceutical measures in Germany. To depict trend changes in testing numbers over time, we developed a negative binomial model with multiple breakpoints., Results: In total 9861 tests were conducted on 6989 clients. The clients were mostly young (median age: 34), female (60.58%), and asymptomatic (67.89%). Among those who tested positive for SARS-CoV-2, 67.72% were symptomatic while the percentage was 29.06% among those who tested negative. There are other risk factors, but a SARS-CoV-2-positive colleague at work is the most prominent factor. Trend changes in the clients' testing numbers could be attributed to the implementation of various public health measures, testing strategies, and attitudes of individuals toward the pandemic. However, test positivity rates did not change substantially during the second wave of the pandemic., Conclusion: We could show that implementation or changes in public health measures have a strong effect on the utilization of testing facilities by the general public, which independently of the true epidemiological background situation can result in changing test numbers., (© 2023. The Author(s).)

Although work-related asthma and allergies are a huge burden for society, investigation of occupational exposures in early work life using an unexposed reference group is rare. Thus, the present analyses aimed to assess the potential impact of occupational exposure and other risk factors on the prevalence of work-related sensitisation and incidence of allergic rhinitis/asthma using a population-based approach and taking into account an unexposed reference group. In SOLAR (Study on Occupational Allergy Risks) II, German participants of ISAAC (International Study of Asthma and Allergies in Childhood) phase II were followed from childhood (9-11 years) until early adulthood (19-24 years). Data on 1570 participants were available to fit predictive models. Occupational exposure was not statistically significantly associated with disease prevalence/incidence. Sensitisation in childhood, parental asthma, environmental tobacco smoke exposure during puberty, sex and study location were statistically significant predictors of outcome. Our results indicate that occupational exposure is of little relevance for work-related sensitisation prevalence and allergic rhinitis/asthma incidence in early work life, while other risk factors can be used to improve career guidance for adolescents. Further research on the role of a potential healthy hire effect and the impact of longer exposure duration is needed., (©ERS 2014.)

This study determined the influence of various meteorological variables and air pollutants on airway disorders in general, and asthma and/or chronic obstructive pulmonary disease in particular, in Munich, Bavaria, during 2006 and 2007. This was achieved through an evaluation of the daily frequency of calls to medical and emergency call centres, ambulatory medical care visits at general practitioners, and prescriptions of antibiotics for respiratory diseases. Meteorological parameters were extracted from data supplied by the European Centre for Medium Range Weather Forecast. Data on air pollutant levels were extracted from the air quality database of the European Environmental Agency for different measurement sites. In addition to descriptive analyses, a backward elimination procedure was performed to identify variables associated with medical outcome variables. Afterwards, generalised additive models (GAM) were used to verify whether the selected variables had a linear or nonlinear impact on the medical outcomes. The analyses demonstrated associations between environmental parameters and daily frequencies of different medical outcomes, such as visits at GPs and air pressure (-27 % per 10 hPa change) or ozone (-24 % per 10 μg/m(3) change). The results of the GAM indicated that the effects of some covariates, such as carbon monoxide on consultations at GPs, or humidity on medical calls in general, were nonlinear, while the type of association varied between medical outcomes. These data suggest that the multiple, complex effect of environmental factors on medical outcomes should not be assumed homogeneous or linear a priori and that different settings might be associated with different types of associations.

Background: Predictive models have rarely been used in allergy research and practice. However, they might support physicians in advising patients., Objective: The aim of this study was to create predictive models for the incidence and persistence of allergic rhinitis (AR) during adolescence., Methods: A prospective population-based cohort study was conducted starting at age 9 to 11 years. Potential risk factors for atopic diseases obtained at baseline in 2810 subjects were used to create predictive logistic regression models for the incidence and persistence of physician-diagnosed AR with current symptoms at age 15 to 18 years., Results: Positive skin prick test responses to outdoor allergens at baseline were the most important determinant for both the incidence and persistence of AR until follow-up. For the incidence of AR, positive skin prick test responses to indoor allergens, parental history of asthma, female sex, and not having been breast-fed exclusively for 2 or more months were additional statistically significant independent risk factors. Depending on the number of risk factors present, the probability of the incidence of AR increased from 2% (no risk factors present) to 72% (full model; 95% CI, 58% to 85%). The probability of persistence of AR ranged from 33% (no risk factors present) to 83% (full model; 95% CI, 70% to 97%)., Conclusion: The course of AR over puberty can be predicted using risk factors that are easy to determine in childhood. Sensitization to outdoor allergens seems to play a much greater role for disease development than sensitization to indoor allergens. This might help pediatricians in advising patients., (Copyright © 2011 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.)

Chronic obstructive pulmonary disease (COPD) is one of the most important causes of morbidity and mortality in the world. The disease is often aggravated by periods of increased symptoms requiring medical attention. Among the possible triggers for these exacerbations, meteorological factors are under consideration. The objective of this study was to assess the influence of various meteorological factors on the health status of patients with COPD. For this purpose, the daily number of ambulatory care visits due to COPD was analysed in Bavaria, Germany, for the years 2006 and 2007. The meteorological factors were provided by the model at the European Centre for Medium Range Weather Forecast (ECMWF). For the multivariate analysis, a generalised linear model was used. In Bavaria, an increase of 1% of daily consultations (about 103 visits per day) was found to be associated with a change of 0.72 K temperature, 209.55 of log air surface pressure in Pa, and a decrease of 1% of daily consultations with 1,453,763 Ws m(2) of solar radiation. There also seem to be regional differences between north and south Bavaria; for instance, the effect of wind speed and specific humidity with a lag of 1 day were only significant in the north. This study could contribute to a tool for the prevention of exacerbations. It also serves as a model for the further evaluation of the impact of meteorological factors on health, and could easily be applied to other diseases or other regions.