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<article article-type="editorial" dtd-version="1.0" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id journal-id-type="publisher-id">CEP</journal-id>
<journal-title-group>
<journal-title>Clinical and Experimental Pediatrics</journal-title><abbrev-journal-title>Clin Exp Pediatr</abbrev-journal-title></journal-title-group>
<issn pub-type="epub">2713-4148</issn>
<publisher>
<publisher-name>Korean Pediatric Society</publisher-name></publisher></journal-meta>
<article-meta>
<article-id pub-id-type="doi">10.3345/cep.2020.00213</article-id>
<article-id pub-id-type="publisher-id">cep-2020-00213</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Editorial</subject>
<subj-group subj-group-type="heading">
<subject>Allergy</subject>
</subj-group></subj-group></article-categories>
<title-group>
<article-title>Trends in prevalence of allergic diseases in Korean children: how and why?</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<contrib-id contrib-id-type="orcid">http://orcid.org/0000-0002-6300-1348</contrib-id>
<name><surname>Lee</surname><given-names>Kyung Suk</given-names></name>
<degrees>MD</degrees>
<degrees>PhD</degrees>
<xref ref-type="corresp" rid="c1-cep-2020-00213"/>
<xref ref-type="aff" rid="af1-cep-2020-00213"/>
</contrib>
<aff id="af1-cep-2020-00213">Department of Pediatrics, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, <country>Korea</country></aff>
</contrib-group>
<author-notes>
<corresp id="c1-cep-2020-00213">Corresponding author: Kyung Suk Lee, MD, PhD. Department of Pediatrics, Hanyang University Guri Hospital, Hanyang University College of Medicine, 153 Gyeongchun-ro, Guri 11923, Korea E-mail: <email>lksallergy@gmail.com</email></corresp>
</author-notes>
<pub-date pub-type="collection">
<month>7</month>
<year>2020</year></pub-date>
<pub-date pub-type="epub">
<day>13</day>
<month>4</month>
<year>2020</year></pub-date>
<volume>63</volume>
<issue>7</issue>
<fpage>263</fpage>
<lpage>264</lpage>
<history>
<date date-type="received">
<day>13</day>
<month>02</month>
<year>2020</year></date>
<date date-type="rev-recd">
<day>31</day>
<month>03</month>
<year>2020</year></date>
<date date-type="accepted">
<day>13</day>
<month>04</month>
<year>2020</year></date>
</history>
<permissions>
<copyright-statement>Copyright &#x000a9; 2020 by The Korean Pediatric Society</copyright-statement>
<copyright-year>2020</copyright-year>
<license>
<license-p>This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by-nc/4.0/">http://creativecommons.org/licenses/by-nc/4.0/</ext-link>) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p></license></permissions>
<related-article related-article-type="commentary-article" id="cep-2020-00213" vol="63" page="278" ext-link-type="pmc"/>
</article-meta></front>
<body>
<p>The prevalence of allergic diseases is an important issue in the medical field &#x0005b;<xref ref-type="bibr" rid="b1-cep-2020-00213">1</xref>&#x0005d;. Asthma, allergic rhinitis, and atopic dermatitis influence children&#x02019;s health and quality of life and increase their socioeconomic burden &#x0005b;<xref ref-type="bibr" rid="b1-cep-2020-00213">1</xref>&#x0005d;. Previous studies have analyzed the prevalence of these allergic diseases to institute prevention and treatment protocols. The International Study of Asthma and Allergies in Childhood (ISAAC), the representative global study of the prevalence of allergic diseases, conducted phases I&#x02013;IV in 1991&#x02013;2012 &#x0005b;<xref ref-type="bibr" rid="b2-cep-2020-00213">2</xref>&#x0005d;. Prototypal questionnaires in this study are utilized to define allergic diseases in prevalence studies &#x0005b;<xref ref-type="bibr" rid="b2-cep-2020-00213">2</xref>&#x0005d;. In Korea, the ISAAC has been ongoing since the 1990s, and the data were published in a report by the ISAAC Steering Committee in 1998 &#x0005b;<xref ref-type="bibr" rid="b3-cep-2020-00213">3</xref>&#x0005d;. National health surveys such as the Korea National Health and Nutrition Examination Survey and Korea Youth Risk Behavior Web-based Survey have also investigated the prevalence of allergic diseases &#x0005b;<xref ref-type="bibr" rid="b4-cep-2020-00213">4</xref>&#x0005d;.</p>
<p>The incidence of allergic diseases has been gradually increasing over the past few decades, especially in developing countries &#x0005b;<xref ref-type="bibr" rid="b5-cep-2020-00213">5</xref>&#x0005d;. However, according to the study by Ha et al. &#x0005b;<xref ref-type="bibr" rid="b6-cep-2020-00213">6</xref>&#x0005d;, the trend in recent prevalence is changing. Asthma, a relatively severe respiratory allergic disease, has been decreasing in children and the elderly, whereas allergic rhinitis has been increasing in all age groups above school-age children &#x0005b;<xref ref-type="bibr" rid="b6-cep-2020-00213">6</xref>&#x0005d;. The trend in prevalence of atopic dermatitis varies widely among age groups &#x0005b;<xref ref-type="bibr" rid="b6-cep-2020-00213">6</xref>&#x0005d;. This shift in the trend suggests that, although the treatment of severe allergic diseases such as asthma is important, we should also pay more attention to managing mild allergic diseases such as allergic rhinitis that impact quality of life.</p>
<p>The Korean central and local governments&#x02019; active policy against allergic diseases is one reason for the decrease in asthma &#x0005b;<xref ref-type="bibr" rid="b7-cep-2020-00213">7</xref>&#x0005d;. For example, the Atopic Asthma Education Information Center and Atopy-Asthma-Friendly School Project aims to actively inform Koreans about disease prevention and management &#x0005b;<xref ref-type="bibr" rid="b7-cep-2020-00213">7</xref>&#x0005d;. The most distinctive argument in the study by Ha et al. &#x0005b;<xref ref-type="bibr" rid="b6-cep-2020-00213">6</xref>&#x0005d; is that the withdrawal of humidifier disinfectants had a significant effect on reducing asthma rates. In Korea, from 1994 to 2001, the extensive use of humidifier disinfectants was a serious risk factor that increased the prevalence of respiratory diseases including asthma and lung injury &#x0005b;<xref ref-type="bibr" rid="b8-cep-2020-00213">8</xref>&#x0005d;.</p>
<p>On the contrary, allergic rhinitis has shown interesting increase in prevalence &#x0005b;<xref ref-type="bibr" rid="b6-cep-2020-00213">6</xref>&#x0005d;. Humidifier disinfectant use is also a risk factor for allergic rhinitis; demonstrations in rat experiments showed degeneration of the normal nasal epithelium &#x0005b;<xref ref-type="bibr" rid="b9-cep-2020-00213">9</xref>&#x0005d;. However, with the decreasing use of humidifier disinfectants, the prevalence of allergic rhinitis has increased while that of asthma has decreased, which defies the concept of a one-airway disease &#x0005b;<xref ref-type="bibr" rid="b6-cep-2020-00213">6</xref>&#x0005d;. Further research is needed to ascertain this opposing change in the prevalence of asthma and allergic rhinitis. In addition, the Ha et al. &#x0005b;<xref ref-type="bibr" rid="b6-cep-2020-00213">6</xref>&#x0005d; study indicated that environmental pollution, climate change, and especially the exposure to chemicals such as phthalate are crucial factors in the development of allergic rhinitis. Accordingly, management at the government level is important to control such risk factors of allergic diseases.</p>
<p>The prevalence of atopic dermatitis has decreased in infants and preschool children but increased in the elderly age group &#x0005b;<xref ref-type="bibr" rid="b6-cep-2020-00213">6</xref>&#x0005d;. In Korea, the increase in breast milk feeding, vaginal delivery, and probiotics consumption might have contributed to the decrease in the prevalence of atopic dermatitis in the younger age group &#x0005b;<xref ref-type="bibr" rid="b10-cep-2020-00213">10</xref>&#x0005d;. However, further studies are required to determine the causes of the increasing incidence of atopic dermatitis in elderly individuals.</p>
<p>In conclusion, the trends in the prevalence of allergic diseases vary among diseases and age groups &#x0005b;<xref ref-type="bibr" rid="b6-cep-2020-00213">6</xref>&#x0005d;. An analysis of the underlying causes of allergic diseases is important to formulating countermeasures for such diseases and will provide insight into these trends over the next decade.</p>
</body>
<back>
<fn-group>
<fn fn-type="conflict"><p>No potential conflict of interest relevant to this article was reported.</p></fn>
</fn-group>
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