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The Manchester Asthma and Allergy Study
  The Study  
  The Manchester Asthma and Allergy Study is an unselected, population-based prospective cohort study investigating the risk factors for the development of asthma and other atopic disorders.  
  Recruitment and Screening  
  Study participants were recruited in utero from antenatal clinics at Wythenshawe and Stepping hill hospitals. The study began recruiting in 1995. All pregnant women and their partners were screened for eligibility at antenatal visits (8th-10th week of pregnancy). A full explanation of the proposed future follow-up for the child was given and both parents completed a basic respiratory questionnaire and skin prick testing. Children were assigned to risk groups according to parental atopic status (high risk, both parents atopic; medium risk, one parent atopic; low risk, neither parent atopic). The study covers a 50 square mile area of Cheshire and South Manchester.  
  Clinical Follow-up  
  The children have been followed regularly and were invited to clinic for an assessment around their 1st, 3rd, 5th, 8th, 11th and between 13-16 year birthdays. Our 18+ follow up is currently underway.

Parents and children complete a variety of validated questionnaires regarding symptoms of asthma and allergies, medication use, food intake and allergy, activity, socio economic status, psychological and family relationships. Measurements of environmental exposures include levels of house dust mite and cat and dog allergens during pregnancy and early life; pet ownership and exposure, childcare arrangements, number of siblings, vaccination uptake, and endotoxin exposure.

Blood samples are taken for specific IgE levels and genetics, and urine samples were obtained for urinary EPX. Skin prick testing is performed for a variety of aeroallergens, moulds, and foods.

The children have performed a wide variety of routine and specialised lung function tests, including spirometry, whole body plethysmography, static lung volumes, diffusion studies and FeNO as well as indirect and direct challenge tests to look for airway hyperreactivity. Samples of sputum and airway condensate have also been collected.

A subgroup of those at high risk (with no pets in the home) was randomized to stringent environmental control (allergen impermeable covers for the parental and infant bed, hot washing of bedding weekly, HEPA vacuum cleaner, hard floor for the nursery), and the remainder followed a normal regime.

If participants cannot attend the clinic visits we now offer home, postal and online visits, however most still attend so that more detailed lung function data can be collected.