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Exposure to microbial agents in house dust and wheezing, atopic dermatitis and atopic sensitization in early childhood: a birth cohort study in rural areas.
Clin Exp Allergy. 2012 Aug; 42(8):1246-56.CE

Abstract

BACKGROUND

Early-life exposure to environmental microbial agents may be associated with development of wheezing and allergic diseases.

OBJECTIVE

To assess the association of microbial exposure in rural homes with the risk of asthma, wheezing, atopic dermatitis and sensitization.

METHODS

Birth cohorts of rural children (n = 1133), half from farmer families, were followed up from birth to 2 years of age by questionnaires in five European centres. Endotoxin and extracellular polysaccharides (EPS) of Penicillium and Aspergillus spp. were determined from living room floor and mother's mattress dust samples collected at 2 months of age. Specific IgE against 19 allergens was measured at 1 year of age. Discrete-time hazard models, generalized estimations equations (GEE) and logistic regression were used for statistical analyses.

RESULTS

The incidence of asthma was inversely associated with the amount of dust (adjusted odds ratio (aOR) 0.73, 95% CI 0.58-0.93) and the loads (units/m(2)) of EPS (aOR 0.75, 95% CI 0.55-1.04) and endotoxin (aOR 0.79, 95% CI 0.60-1.05) in the mother's mattress. Similar associations were seen with wheezing and with living room floor dust. The microbial markers were highly correlated and their effects could not be clearly separated. The inverse associations were seen especially among non-farmers. The risk of sensitization to inhalant allergens increased with increasing endotoxin exposure from mattress dust. No associations were observed with concentrations (units/g) or with atopic dermatitis.

CONCLUSION AND CLINICAL RELEVANCE

The amount and microbial content of house dust were inversely associated with asthma and wheezing, but due to high correlations between microbial agents and amount of dust, it was not possible to disentangle their individual effects. New ways to better measure and represent exposure to environmental microbes, including indexes of biodiversity, are needed especially among farmers.

Authors+Show Affiliations

Department of Environmental Health, National Institute for Health and Welfare, Kuopio, Finland. anne.karvonen@thl.fiNo 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 availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

22805472

Citation

Karvonen, A M., et al. "Exposure to Microbial Agents in House Dust and Wheezing, Atopic Dermatitis and Atopic Sensitization in Early Childhood: a Birth Cohort Study in Rural Areas." Clinical and Experimental Allergy : Journal of the British Society for Allergy and Clinical Immunology, vol. 42, no. 8, 2012, pp. 1246-56.
Karvonen AM, Hyvärinen A, Gehring U, et al. Exposure to microbial agents in house dust and wheezing, atopic dermatitis and atopic sensitization in early childhood: a birth cohort study in rural areas. Clin Exp Allergy. 2012;42(8):1246-56.
Karvonen, A. M., Hyvärinen, A., Gehring, U., Korppi, M., Doekes, G., Riedler, J., Braun-Fahrländer, C., Bitter, S., Schmid, S., Keski-Nisula, L., Roponen, M., Kaulek, V., Dalphin, J. C., Pfefferle, P. I., Renz, H., Büchele, G., von Mutius, E., & Pekkanen, J. (2012). Exposure to microbial agents in house dust and wheezing, atopic dermatitis and atopic sensitization in early childhood: a birth cohort study in rural areas. Clinical and Experimental Allergy : Journal of the British Society for Allergy and Clinical Immunology, 42(8), 1246-56. https://doi.org/10.1111/j.1365-2222.2012.04002.x
Karvonen AM, et al. Exposure to Microbial Agents in House Dust and Wheezing, Atopic Dermatitis and Atopic Sensitization in Early Childhood: a Birth Cohort Study in Rural Areas. Clin Exp Allergy. 2012;42(8):1246-56. PubMed PMID: 22805472.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Exposure to microbial agents in house dust and wheezing, atopic dermatitis and atopic sensitization in early childhood: a birth cohort study in rural areas. AU - Karvonen,A M, AU - Hyvärinen,A, AU - Gehring,U, AU - Korppi,M, AU - Doekes,G, AU - Riedler,J, AU - Braun-Fahrländer,C, AU - Bitter,S, AU - Schmid,S, AU - Keski-Nisula,L, AU - Roponen,M, AU - Kaulek,V, AU - Dalphin,J-C, AU - Pfefferle,P I, AU - Renz,H, AU - Büchele,G, AU - von Mutius,E, AU - Pekkanen,J, AU - ,, PY - 2012/7/19/entrez PY - 2012/7/19/pubmed PY - 2012/12/12/medline SP - 1246 EP - 56 JF - Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology JO - Clin Exp Allergy VL - 42 IS - 8 N2 - BACKGROUND: Early-life exposure to environmental microbial agents may be associated with development of wheezing and allergic diseases. OBJECTIVE: To assess the association of microbial exposure in rural homes with the risk of asthma, wheezing, atopic dermatitis and sensitization. METHODS: Birth cohorts of rural children (n = 1133), half from farmer families, were followed up from birth to 2 years of age by questionnaires in five European centres. Endotoxin and extracellular polysaccharides (EPS) of Penicillium and Aspergillus spp. were determined from living room floor and mother's mattress dust samples collected at 2 months of age. Specific IgE against 19 allergens was measured at 1 year of age. Discrete-time hazard models, generalized estimations equations (GEE) and logistic regression were used for statistical analyses. RESULTS: The incidence of asthma was inversely associated with the amount of dust (adjusted odds ratio (aOR) 0.73, 95% CI 0.58-0.93) and the loads (units/m(2)) of EPS (aOR 0.75, 95% CI 0.55-1.04) and endotoxin (aOR 0.79, 95% CI 0.60-1.05) in the mother's mattress. Similar associations were seen with wheezing and with living room floor dust. The microbial markers were highly correlated and their effects could not be clearly separated. The inverse associations were seen especially among non-farmers. The risk of sensitization to inhalant allergens increased with increasing endotoxin exposure from mattress dust. No associations were observed with concentrations (units/g) or with atopic dermatitis. CONCLUSION AND CLINICAL RELEVANCE: The amount and microbial content of house dust were inversely associated with asthma and wheezing, but due to high correlations between microbial agents and amount of dust, it was not possible to disentangle their individual effects. New ways to better measure and represent exposure to environmental microbes, including indexes of biodiversity, are needed especially among farmers. SN - 1365-2222 UR - https://www.unboundmedicine.com/medline/citation/22805472/Exposure_to_microbial_agents_in_house_dust_and_wheezing_atopic_dermatitis_and_atopic_sensitization_in_early_childhood:_a_birth_cohort_study_in_rural_areas_ L2 - https://doi.org/10.1111/j.1365-2222.2012.04002.x DB - PRIME DP - Unbound Medicine ER -