Protection from childhood asthma and allergy in Alpine farm environments鈥攖he GABRIEL Advanced Studies

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• 作者：Sabina Illi ; PhD^a ; ^&lowast ; ; ^{sabina.illi@med.uni-muenchen.de} ; Martin Depner ; PhD^a ; ^&lowast ; ; Jon Genuneit ; MD^b ; Elisabeth Horak ; MD^c ; Georg Loss ; MSc^d ; ^e ; Christine Strunz-Lehner ; MPH^a ; Gisela B&uuml ; chele ; PhD^b ; Andrzej Boznanski ; MD ; PhD^f ; Hanna Danielewicz ; MD^f ; Paul Cullinan ; MD^g ; Dick Heederik ; PhD^h ; Charlotte Braun-Fahrlä ; nder ; MD^d ; ^e ; Erika von Mutius ; MD ; MSc^a ; GABRIELA Study Group^&Dagger ;
• 关键词：Asthma ; hay fever ; atopic dermatitis ; atopic sensitization ; childhood ; farming ; farm milk ; early life
• 刊名：Journal of Allergy and Clinical Immunology
• 出版年：2012
• 期刊代码：158_00916749
• 类别：med
• 出版时间：June, 2012
• 卷：129
• 期：6
• 页码：1470-1477.e6
• 文件大小：679 K

摘要

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Background

Studies on the association of farm environments with asthma and atopy have repeatedly observed a protective effect of farming. However, no single specific farm-related exposure explaining this protective farm effect has consistently been identified.

Objective

We sought to determine distinct farm exposures that account for the protective effect of farming on asthma and atopy.

Methods

In rural regions of Austria, Germany, and Switzerland, 79,888 school-aged children answered a recruiting questionnaire (phase I). In phase II a stratified random subsample of 8,419 children answered a detailed questionnaire on farming environment. Blood samples and specific IgE levels were available for 7,682 of these children. A聽broad asthma definition was used, comprising symptoms, diagnosis, or treatment ever.

Results

Children living on a farm were at significantly reduced risk of asthma (adjusted odds ratio [aOR], 0.68; 95%CI, 0.59-0.78; P聽< .001), hay fever (aOR, 0.43; 95%CI, 0.36-0.52; P聽< .001), atopic dermatitis (aOR, 0.80; 95%CI, 0.69-0.93; P聽= .004), and atopic sensitization (aOR, 0.54; 95%CI, 0.48-0.61; P聽< .001) compared with nonfarm children. Whereas this overall farm effect could be explained by specific exposures to cows, straw, and farm milk for asthma and exposure to fodder storage rooms and manure for atopic dermatitis, the farm effect on hay fever and atopic sensitization could not be completely explained by the questionnaire items themselves or their diversity.

Conclusion

A specific type of farm typical for traditional farming (ie, with cows and cultivation) was protective against asthma, hay fever, and atopy. However, whereas the farm effect on asthma could be explained by specific farm characteristics, there is a link still missing for hay fever and atopy.