Luftschadstoffbelastung und Asthma bronchiale bei Schulkindern

Zusammenfassung In einer Querschnitts-Studie wurde untersucht, ob die Innenraumbelastung—Art der heizung und Ausmass der Ventilation—sowie die Aussenluftbelastung—Stickstoffdioxid-Konzentration und Russpartikeldeposition—unter Kontrolle von Störfaktoren einen Einfluss auf das Vorkommen von Asthma bronchiale im Kindesalter haben. Die Untersuchungsgruppe bestand aus 704 Kindern im Alter von 7 bis 16 Jahren aus Freiburg und zwei Gemeinden im Hochschwarzwald. Das Vorkommen von Bronchialasthma wurde mittels einer standardisierten Befragung der Eltern aufgrund einer vorangehenden ärztlichen Diagnose festgestellt. Die Innenraumbelastungen wurden standardisiert erfragt; die Aussenluftbelastungen wurden aufgrund wöchentlicher Messungen bestimmt. Unter den Störvariablen ist das Vorliegen einer kutanen Sensibilisierung gegenüber Aeroallergenen mittels eines Haut-Prick-Testes ermittelt worden. Die genetische Disposition und andere potentielle Störvariablen ergaben sich aufgrund der Angaben der Eltern. Die Hypothesen sind mittels logistischer Regression und der Schätzung von Odds-Ratios getestet worden. Dabei zeigt sich nur für den Heizungs-Index ein signifikanter Zusammenhang mit Bronchialasthma. Im Falle von Einzelraumheizungen besteht gegenüber anderen Heizungsarten ein etwa 4,8-fach erhöhtes Relatives Risiko an Asthma erkrankt zu sein. Unter den Störvariablen wurde für die kutane Sensibilisierung ein achtfaches relatives Asthmarisiko identifiziert.

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Summary To examine the possibility of an effect of indoor and outdoor exposures on the prevalence of asthma in childhood we conducted a cross-sectional study in the area of Freiburg city and two communities in the Black Forest. The study group consists of 704 children aged 7 to 16 years. The children and their mothers took part in a standardized interview and a medical examination. Indoor exposures were assessed from information gathered in the interview by two different indices: (a) heating system and single room heating, and (b) the amount of indoor ventilation. The measurement of outdoor pollutants took into account weekly estimations of NO₂ and combustion particles. The presence of asthma was recorded according to a previous medical diagnosis. Confounders were assessed during the interview (passive smoking, genetic predisposition to asthma etc.) or during the medical examination (cutaneous sensitization with a skin prick test). For the analysis of the data we applied logistic regression models and estimated odds-ratios. Only one of the four hypothesis variables displays a significant effect on the prevalence of asthma: Stoves as heating device carry a 4,8-fold relative risk for asthma compared to other types of heating. Among the confounding variables controlled for in the explanatory model, cutaneous reactions showed a relative risk of eight.

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Résumé L'effet de la pollution de l'air intérieur et extérieur sur la prévalence de l'asthme chez l'enfant a été étudié dans la région de Freiburg, RFA et dans deux communes voisinantes de la Forêt Noire. Le collectif de sujets était composé de 704 enfants âgés de 7 à 16 ans. Les mères de famille et leur(s) enfant(s) participaient à un interview standardisé et à un examen clinique. L'évaluation de l'exposition aux polluants intérieurs a été basée sur l'information recueillie lors de l'interview et sur deux index différents: 1) type et nombre de sources de chauffage. 2) la qualité de la ventilation de l'air intérieur. La concentration de dioxide d'azote et la quantité de particules de suie ont été mesurées dans l'air extérieur. La détermination de la prévalence d'asthme a été basée sur les diagnostics antérieurs des médecins traitants et les résultats de l'interview standardisé. D'autres facteurs prédisposant à l'asthme ont été déterminés lors de l'interview (exposition à la fumée de cigarette, prédisposition génétique à l'asthme) et lors de l'examen clinique (présence d'allergie évaluée par test cutané). Les données ont été analysées par une régression logistique et une estimation de «odds ratios». Une corrélation significative a pu être démontrée entre la prévalence d'asthme et l'index de chauffage. Le risque relatif était 4,8 fois plus élevé dans les ménages à source de chauffage multiple comparés à d'autres types de chauffage. Parmi les facteurs prédisposant à l'asthme la sensibilisation dans les tests cutanés augmentait le risque relatif de l'asthme d'un facteur huit.

     

Die Rolle von Zytokinen bei Allergien und Asthma

Allergic reactions are characterized by inappropriate immune responses to antigens which are tolerated by most people.After the initial demonstration of different subpopulations of T-helper cells characterized by their cytokine expression profile it has been recognized that T_H2 cells and their cytokines (IL-4, IL-5, IL-9 and IL-13) are strongly associated with allergic responses.T_H2 cytokines have crucial functions in the development of allergic hyperreactivity and during initiation and progression of allergic responses.Therapeutic approaches for the selective inhibition of T_H2 cytokines are already in clinical trials.Further subpopulations of T cells (T_H1,T_H3,T_R1) mediate allergic responses through the secretion of cytokines which suppress T_H2 cells and their effector functions.Allergysuppressing cytokines like IFN-γ, IL-10 and TGF-β can be considered as further targets for manipulating the immune system in allergic diseases.These cytokines as well as agents modulating their specific expression are currently under intensive investigation.     

Durchimpfung bei Kleinkindern und Schulkindern im Kanton Bern

Zusammenfassung Bei einer repräsentativen Stichprobe von 840 Kindern der Jahrgänge 1986–1988 und 1991 wurde im Jahre 1995 der Durchimpfungsgrad bei 24monatigen Kindern und nach Abschluss des ersten Schuljahres im Kanton Bern abgeschätzt sowie der zeitliche Verlauf der Durchimpfung analysiert. Die Rückantwortquote betrug 96%. Die Impfprävalenzen lagen im Alter von 24 Monaten für Masern (74%), Mumps und Röteln (MMR) (72%) höher als für Diphtherie (D) und Tetanus (T) (62%) sowie Poliomyelitis (Polio) (60%) (4 Dosen) (p<0,0001). Immer noch wurden 32% der Schweizer Kinder des Jahrgangs 1991 gegen Tuberkulose geimpft. Die 24monatigen Kinder der vier Jahrgänge zeigten generell eine ähnliche Durchimpfung. Die 101 ausländischen Kinder wiesen vereinzelte Impflücken auf. Über die Jahre stieg die Impfdichte aller Jahrgänge für MMR, DT und Polio (4 Dosen), so dass die 8,5jährigen Kinder des Jahrganges 1986 die Quoten (>95%) aufwiesen, die am Ende des zweiten Lebensjahres zu erreichen gewesen wären. Nach Abschluss des ersten Schuljahres wiesen 88% der 8,5jährigen Kinder eine MMR-Impfung und 91% eine Masern-Impfung auf. Vermehrte Anstrengungen sind angezeigt, um den Durchimpfungsgrad der 24monatigen, insbesondere der ausländischen Kinder zu erhöhen, um die Impfungen gemäss Schweizer Impfplan zeitgerecht durchzuführen und die BCG-Impfung auf Kinder mit erhöhtem Tuberkuloserisiko zu beschränken.

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Summary In 1995 immunization coverage at 24 months of age and after the first school year was estimated according to the method recommended by the WHO. Vaccination booklets of 840 children born in 1986, 1987, 1988 or 1991 in the Canton of Berne were reviewed. The response rate was high (96%). The immunization coverage at 24 months of age were for measles 74%, for mumps and rubella (MMR) 72% higher than for diphteria (D), tetanus (T) (62%) and poliomyelitis (polio) (60%) (4 doses) (p<0.0001). Of the Swiss children born in 1991 32% were vaccinated against tuberculosis. Children 24 months of age of all years had generally a similar immunization coverage. The 101 children of foreign nationalities showed somewhat lower vaccination rates. Immunization uptake for MMR, DT and polio (4 doses) increased over time, so that children born in 1986 at 8,5 years of age had the rate (>95%) to be reached at the end of the second year of life. After the first school year 88% of the 8,5 years old children presented a vaccination against MMR and 91% a vaccination against measles. Intensified efforts are necessary to achieve a higher immunization coverage at 24 months of age especially among children of foreign nationality, a timely administration of vaccines according to recommended immunization schedule and to restrict BCG vaccine to children at increased risk of tuberculosis.

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Résumé En 1995 la couverture vaccinale à 24 mois et après la première année scolaire, ainsi que son évolution au cours du temps, a été estimée par l'analyse des carnets de vaccination d'un échantillon de 840 enfants, nés en 1986, 1987, 1988, 1991, choisis au hasard selon la méthode de sondage par grappe de l'OMS. Avec un taux de réponse de 96% la couverture vaccinale à 24 mois pour la rougeole (74%), les oreillons et la rubéole (ROR) (72%) était supérieure à celle pour la diphtérie (D), le tétanos (T) (62%) et la poliomyélite (polio) (60%) (4 doses) (p<0.0001). Des enfants suisses de 1991 32% avaient reçu le vaccin BCG. A 24 mois les enfants des 4 groupes d'âge présentaient une couverture vaccinale en général similaire. Les 101 enfants d'origine étrangère montraient quelques lacunes dans leurs vaccinations. Au fil du temps la couverture vaccinale des enfants des 4 années pour ROR, DT et polio (4 doses) augmentait, de telle sorte qu'à 8,5 ans les enfants de 1986 présentaient les taux (>95%) à ateindre à la fin de la deuxième année de vie. Après la première année scolaire la couverture vaccinale des enfants de 8,5 ans pour ROR était de 88%, pour la rougeole de 91%. Des efforts supplémentaires sont nécessaires afin d'augmenter la couverture vaccinale à 24 mois spécialement de la population étrangère, d'administrer les vaccinations selon le calendrier du plan suisse de vaccination et de ne vacciner par le BCG que les enfants ayant un risque accru de tuberculose.

     

Aktuelle Entwicklung von Impfquoten und Impflücken bei Kindern und Jugendlichen in Deutschland

Available data show increasing vaccination coverage of children and adolescents in recent years in Germany. Vaccination coverage of children against diphtheria, tetanus, polio and haemophilus influenzae Type b is high. Vaccination gaps exist for pertussis, hepatitis B and for the second measles, mumps and rubella doses. Coverage is still insufficient to achieve effective herd immunity and measles elimination. Data from the representative German Health Interview and Examination Survey for Children and Adolescents reveal that vaccination of infants is markedly delayed compared to recommendations of the German Standing Committee on Vaccination (STIKO). Particularly older children and adolescents are often not fully vaccinated or are even unvaccinated. A high proportion is missing the recommended booster doses against diphtheria, tetanus, pertussis and polio. Vaccination compliance especially regarding completeness and timeliness is lower in western than eastern Germany, as well as in children of vaccine sceptics and foreign-born children. More comprehensive surveillance of vaccination coverage and adverse events following immunization as well as the implementation of a national immunization plan focussing on closure of immunization gaps could lead to improved vaccination coverage.     

Inzidenz von Schenkelhalsfrakturen in der Bundesrepublik Deutschland im internationalen Vergleich

Zusammenfassung Zuverlässige Daten über die Frakturinzidenz für die Bundesrepublik Deutschland liegen bisher nicht vor. Die Inzidenz von Schenkelhalsfrakturen ist in den Ländern Europas und in den USA sehr unterschiedlich, und ein Transfer von Inzidenzraten aus anderen Regionen ist nicht ohne weiteres möglich. Ziel dieser Studie ist es, diese Lücke zu schließen und die Hüftfrakturinzidenz zwischen der Bundesrepublik Deutschland und anderen Ländern zu vergleichen. Zu diesem Zweck wurden in Düren (82 251 Einwohner) alle Schenkelhalsfrakturen in den Jahren 1987 bis 1989 untersucht. Die Stadt Düren liegt in ländlicher Umgebung und verfügt über 3 Krankenhäuser, die die stationäre Versorgung der Bevölkerung gewährleisten und deren Unterlagen umfassend analysiert werden konnten. Aufgrund der Altersstruktur und der sozialen Schichtung kann die Stadt als repräsentativ für die Bundesrepublik angesehen werden. Ausgeschlossen wurden Frakturen bei adäquatem Trauma und pathologische Frakturen. Es wurden insgesamt 276 hüftnahe Femurfrakturen ohne adäquates Trauma erfaßt. Dabei zeigte sich eine deutliche Alters- und Geschlechtsabhängigkeit mit einem Überwiegen des weiblichen Geschlechts (jährliche Inzidenzrate pro 100 000 Einwohner: Frauen 291,3, Männer 110,2). Die alterskorrigierte Inzidenz ergibt für die Bundesrepublik Deutschland im internationalen Vergleich die dritthöchste Inzidenz von Schenkelhalsfrakturen nach Norwegen und den USA. Die jährliche Inzidenz von 70 000 Schenkelhalsfrakturen in der Bundesrepublik Deutschland (nur alte Bundesländer) liegt deutlich höher als bisher angenommen.

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Hip fractures incidence rates in Germany compared to other countries

Summary Reported age-adjusted incidence rates vary markedly in Europe and the US, making the transposition of results from elsewhere questionable. The aim of this study is to fill this gap and to compare the hip fracture incidence between Germany and other countries. Population-based epidemiologic research was conducted in Düren (84 251 residents), because its population is representative for West Germany as far as age and social structure are concerned, and because medical care is virtually self-contained within the community. Patient files and discharge statistics of the three local hospitals were thoroughly reviewed. Hip fractures after adequate trauma and pathological fractures were excluded. Between 1987 and 1989 276 inadequate hip fractures were identified among the resident population. There was a highly significant increase in the age specific incidence of hip fractures in both sexes, but females were more frequently affected (crude average annual incidence rate per 100 000: females 291,3, males 110,2). The age-adjusted incidence rates for Germany in comparison to published international data follow on third position after the high rates reported for Norway and the US. The annual incidence of 70 000 hip fractures for the former Federal Republic of Germany is sighificantly higher than expected.

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Les complications les plus sérieuses de l'osteoporose sont les fractures de hanche qui impliquent, en outre, une grande importance socio-économique

Resumé Jusqu'à présent, il manque des donées fiables sur lìncidence des fractures pour l'Allemagne Fédérale. Les incidences de la fracture de hanche des pays d'Europe divergent fortement de ceux des Etats-Unis ce qui met en question le transfert simple des taux d'incidence d'autres régions. La présente étude vise à combler cette lacune en permettant une comparaison entre l'incidence de la fracture de hanche observée en l'Allemagne Fédérale et celle observée en d'autres pays. A cette fin, on a examiné à Düren (ville de 82 251 habitants), entre 1987 et 1989, l'ensemble des fractures de hanche. La ville de Düren, située dans un environnement campagnard, dispose de 3 hôpitaux assurant les soins médicaux stationnaires de la population dont les dossiers ont été analysés retrospectivement et en détail. Grâce à la structure d'âge et à la répartition des couches sociales, cette ville peut être considérée comme représentative pour l'Allemagne Fédérale. Les fractures pathologiques ainsi que celles en provenence d'un traumatisme adéquat ont été excluses de l'analyse. Un total de 276 fractures de fémur à proximité des hanches sans traumatisme adéquat ont été examinées. Les résultats obtenus ont manifesté une dépendance considérable par rapport à l'âge et au sexe, le sexe féminin constituant la partie prédominante (taux d'incidence annuelle moyenne brute: sur 100 000 habitants les femmes occupent 291,3 et les hommes 110,2). En ce qui concerne l'incidence des fractures de hanche, le taux d'incidence rectifié de l'âge situe l'Allemagne Fédérale au troisième rang à l'échelle internationale, après la Norvège et les Etats-Unis. L'incidence de 70 000 fractures de hanche par an en Allemagne Fédérale est largement supérieur par rapport aux estimations.

     

Prävalenz von depressiver Symptomatik und diagnostizierter Depression bei Erwachsenen in Deutschland

In the German Health Interview and Examination Survey (DEGS1), current depressive symptoms were assessed with the “Patient Health Questionnaire” (PHQ-9) in a representative population-based sample of 7,988 adults 18–79 years old. In addition, previously diagnosed depression was assessed by physician interview. The prevalence of current depressive symptoms (PHQ-9 ≥?10 points) is 8.1?% (women: 10.2?%; men: 6.1?%). For both sexes, the prevalence is highest among 18- to 29-year-olds and decreases with age. Persons with higher socioeconomic status (SES) are less likely to have current depressive symptoms. The lifetime prevalence of diagnosed depression is 11.6?% (women: 15.4?%; men: 7.8?%) and is highest among persons 60–69 years old. The 12 month prevalence is 6.0?% (women: 8.1?%; men: 3.8?%) and is highest among 50- to 59-year-olds. In women, but not in men, prevalences decrease with increasing SES. The results describe the distribution of two important aspects of depression among the adult population in Germany and confirm previously observed associations with age, gender and SES. An English full-text version of this article is available at SpringerLink as supplemental.     

Lebensmittelverzehr bei Kindern und Jugendlichen in Deutschland

Since dietary behaviour has an essential impact on health, information on food consumption was obtained in the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). The average food frequency and portion size "in recent weeks" was assessed with a food frequency questionnaire. Two versions of the questionnaire, identical in content, exist: one aimed at parents of 1-10-year-olds and the other directly at 11-17-year-olds. The results include data on 7,186 boys and 6,919 girls, aged 3-17. About half of the participants each consume bread, milk and fresh fruits every day. The majority (about three quarter) eat fast food only once a month or less. However, 16 % of the participants eat chocolate, and almost 20 % other sweets every day. More boys than girls individually consume soft drinks, milk, dairy products, meat, sausage, cereals and white bread every day. More girls consume fresh fruits and raw vegetables each day. With increasing age the proportion of daily consumers of soft drinks, cheese (and among boys also meat and sausage) increases, but the proportion of daily consumers of juices, tap water, milk, dairy products, fresh fruits, raw vegetables, cookies, chocolate, sweets (and among girls also breakfast cereals) falls. As expected the consumption of sweets and soft drinks is relatively high. Whereas more than half of the children each consume fruits and vegetables on a daily base, this consumption declines with increasing age.     

Sport und Gesundheit bei Erwachsenen in Deutschland

Regularly participating in sports activities can have a positive effect on people's health and is therefore an important area of health promotion. Data of the Telephone Health Survey 2003 indicate that until now there is an unexploited potential for programmes promoting sports: in total 37.3% of men aged 18 years and above and 38.4% of equally aged women do not participate in sports at all; another 20.9% of men and 28.4% of women only engage in sports activities for up to 2 h/week. The highest prevalence of sports activity is seen among young adults, whereas it is lowest among older people. However, the latter slightly increased their sports activity during the last 10 years, while the trend observed among younger adults seems to point rather in the opposite direction. Also relevant for the planning and implementation of group-specific interventions is the observation that persons with low socioeconomic status tend to engage less often in sports than people with middle or high status do. The present study underlines the health relevance of sports participation by presenting inverse relationships between sports activity and behaviour-related health risks such as smoking and obesity as well as a positive effect of sports on self-assessed health.     

Das Unfallgeschehen bei Kindern und Jugendlichen in Deutschland

Compared to adults, children and adolescents run a considerably higher risk of suffering unintentional injuries (UI). To prevent UI, detailed knowledge of the overall accident occurrence and the determinants of UI is needed. This article gives an overview of the data sources covering the occurrence of UI among children and adolescents in Germany. According to the Robert Koch Institute’s German Health Interview and Examination Survey for Children and Adolescents (KiGGS), approximately 15.3?% of children and adolescents (1–17 years) in Germany suffer at least one UI within 12 months. Most accidents (60.7?%) occur at home or during leisure-time activities. In 2011, the German Statutory Accident Insurance (DGUV) registered more than 1.4 million accidents among children in day-care facilities and students in educational institutions. According to official statistics, in the same year, more than 50,000 children and adolescents were injured in traffic accidents. Moreover, the Federal Statistical Office registered 260,534 hospital admissions due to injuries and poisonings among children and adolescents. All data sources revealed age- and sex-specific differences. Boys suffer UI more frequently than girls do and they show higher injury rates in adolescence than during childhood. While UI among children mostly happen at home, road traffic and leisure-time accidents increase in occurrence during adolescence. In Germany, there are numerous initiatives dedicated to the prevention of UI in children and adolescents. The creation of target group-specific prevention measures is complicated by the fact that the methodological approaches of existing data sources differ considerably.     

Mundgesundheitsverhalten von Kindern und Jugendlichen in Deutschland

Despite successful prevention and the possibility to directly control oral health by individual behaviour, children are still affected by caries. Aim of this article is to determine the prevalence and the social factors influencing selected aspects of oral health behaviour based on data of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). Over a period of three years, 17,641 children and adolescents aged 0 to 17 years - a representative sample for Germany - were examined in the nationwide KiGGS study. Based on a written survey and a medical interview, data on oral health behaviour were also collected. 29 % of the surveyed children and adolescents brushed their teeth only once daily or less frequently. This type of teeth brushing behaviour shows a social status gradient (low: 39 %, middle: 28 %, high: 22 %) and is more frequently found in children with a migration background (45 %) than in those without a migration background (26 %). Differences were also found between girls and boys (girls: 25 %; boys: 33 %). In only 8 % of cases, parents stated that their children have a dental check-up less than once a year. However, this information substantially differs from the actual visits to dentists. Here again, differences regarding social status (low: 12 %; high: 6 %) and migration status (migrants: 16 %; non-migrants: 6 %) were found. According to the parents, 43 % of the 0-to-2-year-olds and 7 % of the 3-to-6-year-olds use pharmaceutical preparations for caries prevention. Relevant differences were found between migrants (5 %) and non-migrants (8 %). These results show that there is primarily a need for social status-specific and culture-specific prevention. To identify starting points for effectively offering preventative measures, a systematic study into the factors causing these behavioural differences is needed.     

Parasitosen bei Schulkindern in einem Schweizer Juradorf

Summary In a village of the Swiss Jura we examined 134 schoolchildren (7 to 16 years old) clinically, parasitologically and serologically for parasites. Half of the children showed an insufficient hygiene of hands, feet and/or anus. In 7 out of 107 anus-scotch-tests there were eggs ofEnterobius vermicularis. Protozoans could be demonstrated in 8 of 133 MIF-stool-samples (2 cases ofGiardia lamblia, 2Endolimax nana and 4 Jodamoeba bütschlii). Using the procedure of enrichment of Telemann no helminth eggs were detected. Altogether parasites were found in 10% of the children.31 children have antibodies againstToxo-plasma gondii (IF titre140). 5 children showed a positiveToxocara- serology, additional 5 an uncertain positive reaction. The immunodiagnostic ofEchinococcosis (ELISA,IF, IHA, CIE) was doubtfully positive in 4 children.In this study, intestinal protozoans and E. vermicularis were the most commonly occurring parasites followed by asymptomatic toxocariasis.

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Résumé Dans un village du Jura Suisse, 134 enfants scolarisés entre 7 et 16 ans ont été examinés cliniquement, parasitologiquement et sérologiquement à la recherche de parasites. Cette analyse a démontré que la moitié des enfants accusait une insuffisance d'hygiène des mains, pieds et/ou anus. Sur 7 des 107 scotch-tests anaux, nous avons trouvé des oeufs d'Enterobius vermicularis. Dans 8 échantillons de selles sur 133 au total, il y avait des protozoaires (2Giardia lamblia,2 Endolimax nana et 4Jodamoeba bütschlii). Selon la méthode de concentration Telemann, il n'y a jamais eu présence d'oeufs d'helminthes. 10% des examinés présentaient des parasites.31 enfants ont des anticorps contreToxoplasma gondii (IF titre140). Chez 5 enfants on a trouvé une sérologie positive visà-vis detoxocara, chez 5 autres enfants une sérologie positive incertaine. On a également constaté chez 4 enfants un immunodiagnostic d'échinococcose douteux (ELISA, IF, IHA, CIE). Dans notre analyse collective, en dehors des protozoaires intestinaux et d'E. vermicularis, on distingue essentiellement la toxocarose asymptomatique.

     

Die Gesundheit von Kindern und Jugendlichen in Deutschland

The deficits in our knowledge of the health status of infants, children, and adolescents in Germany are large and significant. To close the gaps, the concept for a national, representative health interview and examination survey of the young generation has been developed by the Robert Koch Institute supported by the expertise of German and international specialists. The development of the concept, study design and methodology took several years. After a pilot study, which took place over a period of 12 months and involved 1,630 young people aged between 0 and 17 years, the concept, design and materials were thoroughly revised. The survey will start in 2003, and include about 20,000 individuals in this age range. It will be the most comprehensive health study of young people ever undertaken in Germany. The funding comes from the German Federal Ministries of Health and of Research and Education, as well as from the Robert Koch Institute. Over a period of 3 years, participants, randomly selected from the registries of inhabitants, will be medically examined and their parents interviewed. From the age of 11, the youngsters themselves will also fill in a questionnaire serving as an additional source of information. The data obtained will form the basis for a National Health Report on children and adolescents, open new fields of prevention and intervention, and support the research of the scientific community as a Public Use File which will be available 1 year after the end of data collection.