Occupational Asthma Reference
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Campbell B, Raherison C, Lodge CJ, Lowe AJ, Gislason T, Heinrich J, Sunyer J, Gómez Real F, Norbäck D, Matheson MC, Wjst M, Dratva J, de Marco R, Jarvis D, Schlünssen V, Janson C, Leynaert B, Svanes C, Dharmage SC,
Original article: The effects of growing up on a farm on adult lung function and allergic phenotypes: an international population-based study,
Thorax,
2017;72:236-244,
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(Plain text:
Campbell B, Raherison C, Lodge CJ, Lowe AJ, Gislason T, Heinrich J, Sunyer J, Gomez Real F, Norback D, Matheson MC, Wjst M, Dratva J, de Marco R, Jarvis D, Schlunssen V, Janson C, Leynaert B, Svanes C, Dharmage SC,
Original article: The effects of growing up on a farm on adult lung function and allergic phenotypes: an international population-based study,
Thorax)
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Keywords: Farm, asthma, atopy, ECRHS 2, biodiversity
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Abstract
Rationale
Evidence has suggested that exposure to environmental or microbial biodiversity in early life may impact subsequent lung function and allergic disease risk.
Objectives
To investigate the influence of childhood living environment and biodiversity indicators on atopy, asthma and lung function in adulthood.
Methods and measurements
The European Community Respiratory Health Survey II investigated ~10 201 participants aged 26–54 years from 14 countries, including participants' place of upbringing (farm, rural environment or inner city) before age 5 years. A ‘biodiversity score’ was created based on childhood exposure to cats, dogs, day care, bedroom sharing and older siblings. Associations with lung function, bronchial hyper-responsiveness (BHR), allergic sensitisation, asthma and rhinitis were analysed.
Main results
As compared with a city upbringing, those with early-life farm exposure had less atopic sensitisation (adjusted OR 0.46, 95% CI 0.37 to 0.58), atopic BHR (0.54 (0.35 to 0.83)), atopic asthma (0.47 (0.28 to 0.81)) and atopic rhinitis (0.43 (0.32 to 0.57)), but not non-atopic outcomes. Less pronounced protective effects were observed for rural environment exposures. Women with a farm upbringing had higher FEV1 (adjusted difference 110 mL (64 to 157)), independent of sensitisation and asthma. In an inner city environment, a higher biodiversity score was related to less allergic sensitisation.
Conclusions
This is the first study to report beneficial effects of growing up on a farm on adult FEV1. Our study confirmed the beneficial effects of early farm life on sensitisation, asthma and rhinitis, and found a similar association for BHR. In persons with an urban upbringing, a higher biodiversity score predicted less allergic sensitisation, but to a lesser magnitude than a childhood farm environment.
Full Text
Comments
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This extends the work on early life farm exposure and other measures of microbial biodiversity to adults, showing a continued protective effect on the reduction of atopy. Biodiversity was scored by schooling or play schooling under 5, early life dog in the home, sharing bedrooms and having older sibs. For inner city residents a higher biodiversity score was associated with less atopy.
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