1. The PIAMA research project
The PIAMA-study is a large ongoing population-based cohort study with prenatal inclusion and follow-up until the current age of 18 years. The study was designed to investigate the influence of lifestyle and environment on the development of asthma, allergy and lung function. It therefore contains a detailed characterization of lifestyle and environmental exposures in all stages of childhood.
The population consists of 3,963 children who were born in 1996/97 after prenatal recruitment through prenatal clinics in the northern, middle and southwestern part of the Netherlands.
After inclusion, allergic and non-allergic mothers were identified through a 'screening questionnaire'. Children of allergic mothers were labeled 'high-risk' children for asthma, children of non-allergic mothers were labeled 'low-risk' children. The children were allocated to an intervention study or to a natural history study. The intervention measure consisted of mite-impermeable mattress covers on the children's and the parents' beds. High risk children were allocated either to the Intervention Study (one third in the intervention group, one third in the placebo group) or to the Natural History Study (one third of the high-risk children as a control group without mattress covers). Low-risk children were allocated to the Natural History Study only.
The evaluation of effectiveness of the mattress covers to reduce allergen exposure, demonstrated that there was no effect of the intervention on asthma and allergy outcomes up to age 8 years. The PIAMA study thus contributed as one of the first studies, to new insights that allergen reduction is not the effective preventive strategy that was hoped for in the early nineties.
The first phase of the PIAMA-study lasted until the children reached the age of 8 years, being the age at which a reliable diagnosis of asthma and allergy can be made. In this phase data was collected through 10 rounds of questionnaires (on personal characteristics, respiratory symptoms, lifestyle and evironmental exposures) and 3 rounds of medical examinations. At age 8 years, 92% of the baseline PIAMA population was still in the study.
It was decided to continue the PIAMA study after the age of 8 years through adolescence and preferably even longer, into adulthood. In the light of the increasing awareness of the effects of lifestyle and environment on childhood asthma and lung function, and the availability of detailed information on these topics in the PIAMA study, the study is in an excellent position to contribute to new insights on these aspects. Also, the renewed awareness that childhood asthma is a risk factor for adult-onset COPD adds to the relevance of prolonged follow-up.
At the age of 11 years a questionnaire was filled out by 75% of the study population. A medical examination was successfully completed in 1500 12-year-olds. At the age of 14 years questionnaires were completed by 2200 children and around 2000 parents.
In 2012 and 2013, a medical examination was successfully completed in a little over 800 16-year-olds, in which anthropometric measures were taken, lung function was assessed and a blood sample was drawn for determination of total and specific IgE and HbA1C and cholesterol levels. Part of the protocol was designed in collaboration with the MeDALL project (http://medall-fp7.eu/).
At the age of 17 / 18 years old, 2100 participants filled out extensive questionnaires covering health, lifestyle and environmental aspects.
Successful (international) research collaboration confers clear benefits to the collaborating parties and to scientific progress in general. Data from the PIAMA study has been used in international collaborations over the years to study asthma and allergy, resulting in many scientific papers, as can be seen in "publicaties".
The PIAMA study group welcomes initiatives from external researchers or research groups who want to make use of the PIAMA data for specific research questions in collaboration with the PIAMA group, or members thereof. An overview of the data available in the PIAMA study can be found at http://www.birthcohorts.net/
Interested researchers can contact one of the PIAMA Principal Investigators with their questions or proposals.
Prof. dr. Bert Brunekreef B.Brunekreef@uu.nl Dr. Ulrike Gehring firstname.lastname@example.org Prof. dr. Gerard Koppelman email@example.com Prof. dr. Jet Smit H.A.Smit@umcutrecht.nl Dr. Alet Wijga Alet.Wijga@rivm.nl
In the interest of transparancy and quality control, the data underlying the findings presented in published papers will be made available upon request. Requests can be submitted to the PIAMA Principal Investigators.
The PIAMA data are not freely accessible in the public domain, because this would be in conflict with the agreement between the study team and the PIAMA participants.
If you wish to receive a reprint of one of the listed publications, please contact Eef van Otterloo (E.firstname.lastname@example.org).