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Not all farming environments protect against the development of asthma and wheeze in children.
J Allergy Clin Immunol. 2007 May; 119(5):1140-7.JA

Abstract

BACKGROUND

In recent years, studies have shown a protective effect of being raised in a farm environment on the development of hay fever and atopic sensitization. Inconsistent data on the relation of farming to asthma and wheeze have raised some doubt about a true protective effect.

OBJECTIVE

We sought to study the differential effects of farm-associated exposures on specific asthma-related health outcomes.

METHODS

The cross-sectional Prevention of Allergy Risk Factors for Sensitization in Children Related to Farming and Anthroposophic Lifestyle study included 8263 school-age children from rural areas in 5 European countries. Information on farm-related exposures and health outcomes was obtained by using questionnaires. In subsamples allergen-specific IgE and RNA expression of CD14 and Toll-like receptor genes were measured, and dust from children's mattresses was evaluated for microbial components.

RESULTS

Inverse relations with a diagnosis of asthma were found for pig keeping (odds ratio [OR], 0.57; 95% CI, 0.38-0.86), farm milk consumption (OR, 0.77; 95% CI, 0.60-0.99), frequent stay in animal sheds (OR, 0.71; 95% CI, 0.54-0.95), child's involvement in haying (OR, 0.56; 95% CI, 0.38-0.81), and use of silage (OR, 0.55; 95% CI, 0.31-0.98; for nonatopic asthma) and in Germany for agriculture (OR, 0.34; 95% CI, 0.22-0.53). Protective factors were related with higher expression levels of genes of the innate immunity. Potential risk factors for asthma and wheeze were also identified in the farm milieu. Levels of endotoxin and extracellular polysaccharides were related to the health outcomes independently of the farm exposures.

CONCLUSIONS

The protective effect of being raised in a farm environment was ascribed to distinct exposures.

CLINICAL IMPLICATIONS

The development of atopic sensitization and atopic and nonatopic asthma is most likely determined by different environmental factors, possibly reflecting distinct pathomechanisms.

Authors+Show Affiliations

University Children's Hospital Munich, Germany.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17349684

Citation

Ege, Markus Johannes, et al. "Not All Farming Environments Protect Against the Development of Asthma and Wheeze in Children." The Journal of Allergy and Clinical Immunology, vol. 119, no. 5, 2007, pp. 1140-7.
Ege MJ, Frei R, Bieli C, et al. Not all farming environments protect against the development of asthma and wheeze in children. J Allergy Clin Immunol. 2007;119(5):1140-7.
Ege, M. J., Frei, R., Bieli, C., Schram-Bijkerk, D., Waser, M., Benz, M. R., Weiss, G., Nyberg, F., van Hage, M., Pershagen, G., Brunekreef, B., Riedler, J., Lauener, R., Braun-Fahrländer, C., & von Mutius, E. (2007). Not all farming environments protect against the development of asthma and wheeze in children. The Journal of Allergy and Clinical Immunology, 119(5), 1140-7.
Ege MJ, et al. Not All Farming Environments Protect Against the Development of Asthma and Wheeze in Children. J Allergy Clin Immunol. 2007;119(5):1140-7. PubMed PMID: 17349684.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Not all farming environments protect against the development of asthma and wheeze in children. AU - Ege,Markus Johannes, AU - Frei,Remo, AU - Bieli,Christian, AU - Schram-Bijkerk,Dieneke, AU - Waser,Marco, AU - Benz,Marcus R, AU - Weiss,Gertraud, AU - Nyberg,Fredrik, AU - van Hage,Marianne, AU - Pershagen,Göran, AU - Brunekreef,Bert, AU - Riedler,Josef, AU - Lauener,Roger, AU - Braun-Fahrländer,Charlotte, AU - von Mutius,Erika, AU - ,, Y1 - 2007/03/08/ PY - 2006/08/07/received PY - 2006/12/15/revised PY - 2007/01/19/accepted PY - 2007/3/14/pubmed PY - 2007/7/7/medline PY - 2007/3/14/entrez SP - 1140 EP - 7 JF - The Journal of allergy and clinical immunology JO - J Allergy Clin Immunol VL - 119 IS - 5 N2 - BACKGROUND: In recent years, studies have shown a protective effect of being raised in a farm environment on the development of hay fever and atopic sensitization. Inconsistent data on the relation of farming to asthma and wheeze have raised some doubt about a true protective effect. OBJECTIVE: We sought to study the differential effects of farm-associated exposures on specific asthma-related health outcomes. METHODS: The cross-sectional Prevention of Allergy Risk Factors for Sensitization in Children Related to Farming and Anthroposophic Lifestyle study included 8263 school-age children from rural areas in 5 European countries. Information on farm-related exposures and health outcomes was obtained by using questionnaires. In subsamples allergen-specific IgE and RNA expression of CD14 and Toll-like receptor genes were measured, and dust from children's mattresses was evaluated for microbial components. RESULTS: Inverse relations with a diagnosis of asthma were found for pig keeping (odds ratio [OR], 0.57; 95% CI, 0.38-0.86), farm milk consumption (OR, 0.77; 95% CI, 0.60-0.99), frequent stay in animal sheds (OR, 0.71; 95% CI, 0.54-0.95), child's involvement in haying (OR, 0.56; 95% CI, 0.38-0.81), and use of silage (OR, 0.55; 95% CI, 0.31-0.98; for nonatopic asthma) and in Germany for agriculture (OR, 0.34; 95% CI, 0.22-0.53). Protective factors were related with higher expression levels of genes of the innate immunity. Potential risk factors for asthma and wheeze were also identified in the farm milieu. Levels of endotoxin and extracellular polysaccharides were related to the health outcomes independently of the farm exposures. CONCLUSIONS: The protective effect of being raised in a farm environment was ascribed to distinct exposures. CLINICAL IMPLICATIONS: The development of atopic sensitization and atopic and nonatopic asthma is most likely determined by different environmental factors, possibly reflecting distinct pathomechanisms. SN - 0091-6749 UR - https://www.unboundmedicine.com/medline/citation/17349684/Not_all_farming_environments_protect_against_the_development_of_asthma_and_wheeze_in_children_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0091-6749(07)00347-8 DB - PRIME DP - Unbound Medicine ER -