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Notes: Within an environmental health study, dermatologic examination of 1273 pre-school-age children (5–7 years old) was carried out in selected areas of East (n= 287) and West (n= 987) Germany in spring 1991. On the basis of comparable genetic background, the influence of a different exposure to air pollutants on the manifestation of atopic diseases was investigated. Halle an der Saale (East Germany) and Duisburg (North/South) as well as Essen (West Germany) were chosen as polluted study areas, whereas the countryside town of Borken (West Germany) served as a control region. Outdoor pollution with particles and SO2 was significantly higher in Halle an der Saale. Of the total study group. 12.9% suffered from atopic eczema at the time of examination. The prevalence was highest in East Germany (17.5%; adjusted odds ratio [OR] 1.39, confidence intervals [CI] 0.77–2.52, compared to Borken). The reported frequencies of hay fever and asthma in the total study population were 2% and 1.3%, respectively, without significant differences between study sites. Some 34.7% of the children showed at least one positive skin prick test reaction; significantly (P〈 0.001) higher sensitization rates were obtained in western regions (Essen, Duisburg-South) than in the control region (Borken) and East Germany. Multivariate analysis of the prevalence of atopic eczema showed associations with parental predisposition (OR 1.52, CI 1.03–2.25), sex (for boys, OR 0.63, CI 0.43–0.92), location (Duisburg-South vs Borken OR 0.52, CI 0.30–0.96). month of investigation (May vs April, and March vs February OR 0.55, CI 0.37–0.81), contact with rabbits (for girls, OR 2.90, CI 1.36–6.19), animal fur in bedrooms (2.17, 1.01–4.67), indoor use of gas without hood (1.68, 1.11–2.56), and distance of homes from a busy road (〈50 m 1.71, 1.07–2.73). Nonsignificant associations were observed for history of helminthic infections (OR 1.61, CI 0.98–2.64) and high parental education level (OR 1.83, CI 0.83–4.02). In East and West Germany, atopic eczema seems to follow a course different from that of respiratory allergic diseases and specific sensitization, a fact which underlines the need for a differentiated analysis.