Prevalence of rhinitis, pillow type and past and present ownership of furred pets

BACKGROUND: There has been no previous work investigating the effects of furred pet ownership and pillow type on the risk of developing rhinitis. Recently, unexpected and unexplained associations of asthma with nonfeather pillows have been reported. OBJECTIVE: We developed a questionnaire-based cross-sectional survey to determine whether the past or present ownership of cats or dogs, or the use of nonfeather pillows contributes to the development of seasonal or perennial rhinitis. METHODS: We surveyed 2555 accompanying friends and relatives of patients attending the outpatients departments at one London hospital in 1996. Individuals with rhinitis were defined as those suffering with three or more symptoms of rhinitis either throughout the year (perennial) or for part of the year (seasonal). Present or childhood ownership of cats or dogs was recorded. RESULTS: A strong association was seen with nonfeather pillow use and both seasonal [odds ratio (OR) 1.85; 95% confidence interval (CI) 1.43-2.5] and perennial (OR 2.63; CI 1.67-5. 0) rhinitis. However, more than one-third of rhinitics had changed their pillow type. After restricting the data to exclude subjects who changed their pillow to avoid allergies, the strong association of nonfeather pillow use with perennial rhinitis remained (OR 2.44; CI 1.25-5.0). Adjusting the data to the extreme situation where all former pillow type was feather changes the apparent risk to 0.99 (CI 0.67-1.43). No associations for either seasonal or perennial rhinitis were seen for feather pillows. A weak association of current dog ownership is demonstrated for seasonal rhinitis (OR 1. 47; CI 1.01-2.14). No associations were seen for childhood dog ownership or cat ownership at any time with either type of rhinitis. CONCLUSIONS: Feather pillow use and the ownership of furred pets appears unlikely to increase the risk of developing perennial or seasonal rhinitis. In fact, in contrast with currently held views, there is evidence that the use of nonfeather pillows may increase the risk.     

Do asthma and allergy influence subsequent pet keeping? An analysis of childhood and adulthood

BACKGROUND: Asthma and allergy might influence the choice of keeping pets, leading to apparent protective effects of pets on allergic disease. OBJECTIVE: We investigated the effects of asthma and allergy on subsequent pet keeping in childhood and adulthood. METHODS: Information about asthma and pet keeping at ages 0 to 4, 5 to 15, 20 to 44, and 26 to 56 years was provided by 9812 subjects participating in the 9-year follow-up of the European Community Respiratory Health Survey. RESULTS: In childhood asthma debut at younger than 5 years was associated with less cat keeping at 5 to 15 years (odds ratio [OR], 0.60; 95% CI, 0.44-0.82), an effect only observed when the parents did not have asthma or allergy (P(interaction) = .045). Childhood asthma did not influence adult pet ownership, unless there were adult symptoms. Adults less often acquired cats at follow-up if they had 3 or more asthma symptoms (OR, 0.78; 95% CI, 0.64-0.95), were taking asthma medication (OR, 0.48; 95% CI, 0.31-0.74), had hay fever (OR, 0.75; 95% CI, 0.62-0.91), had atopy (OR, 0.75; 95% CI, 0.61-0.91), or had specific IgE to cat (OR, 0.57; 95% CI, 0.39-0.82) at baseline. Adults who already had pets usually continued keeping the same type of pet, except that the presence of 3 or more asthma symptoms was associated with less subsequent dog keeping (OR, 0.69; 95% CI, 0.53-0.89). Pet removal between surveys to reduce allergen was reported by 4.7%. CONCLUSION: Selective avoidance subsequent to asthma or allergy was observed for childhood cat keeping and adult cat acquisition. Avoidance would produce an apparent protective effect of cats on childhood asthma (large OR, 0.83). Avoidance was generally not observed for dogs or birds. CLINICAL IMPLICATIONS: A part of the protective effects of childhood cats on asthma and allergy can be attributed to selective avoidance.     

Early childhood environment related to microbial exposure and the occurrence of atopic disease at school age

BACKGROUND: There is a growing body of evidence that the early childhood environment with respect to day care attendance, older siblings, pet ownership, and early life airway infections may protect from developing atopic disease. Few studies have distinguished between atopic sensitization and symptoms, and none have evaluated independent contributions for all of these different environmental conditions. OBJECTIVE: Examine independent effects on atopic sensitization and symptoms of day care attendance, older siblings, pet ownership, and early infancy's airway disease. METHODS: A cross-sectional survey among 8-13-year-old school children with complete data for 1555 children. RESULTS: After adjustment for confounders, atopic sensitization occurred less frequently in children that had attended a day care centre (OR: 0.73, 95% CI: 0.55-0.98) or had a cat or dog before 2 years of age (OR: 0.78, 95% CI: 0.61-0.99). Having older siblings yielded a nonsignificant trend towards protection (OR: 0.88, 95% CI: 0.70-1.11). For symptoms, there was no relation with having older sibs, day care attendance and pet ownership, although there was a trend towards protection for the combination of atopy and symptoms. In contrast, children with doctors' treated airway disease before age 2, more frequently reported recent symptoms of wheeze, asthma, rhinitis, or dermatitis (all P < 0.05). CONCLUSION: Early life environmental exposure to day care, or pets may protect against atopic sensitization. Protection against symptoms only occurred if atopic sensitization was present as well.     

Farm environment in childhood prevents the development of allergies

BACKGROUND: A protective effect of infections in early life might explain the firmly reported finding of an inverse association between atopic disorders and large sibships. OBJECTIVE: To study the effect of childhood farm, rural non-farm and urban environment, as well as family size and other factors on the occurrence of asthma, wheezing and atopic disorders up to young adulthood. METHODS: Data on lifetime prevalence of physician-diagnosed asthma, allergic rhinitis and/or allergic conjunctivitis, atopic dermatitis, as well as self-reported episodic wheezing from 10 667 Finnish first-year university students aged 18-24 years were collected by a postal questionnaire. Associations of lifetime prevalence of the diseases with living on a farm, in a rural non-farm and urban environment during childhood were estimated by logistic regression analysis. Adjustment was made for potential confounding by gender, parental atopy, parental education, number of older siblings, day care outside the home and passive smoking. RESULTS: The childhood farm environment independently reduced the risk for physician-diagnosed allergic rhinitis and/or allergic conjunctivitis (adjusted odds ratio 0.63, 95% CI 0.50-0.79, P < 0.001), and for diagnosed asthma and episodic wheezing analysed together (OR 0.71, 95% CI 0.54-0.93, P < 0.05), but not for atopic dermatitis during lifetime. Urban childhood environment did not show independent increased risk when compared with rural non-farm residence. The inverse association of sibship size with the occurrence of allergic rhinitis and/or allergic conjunctivitis was found among subjects with one (OR 0.86, 95% CI 0.77-0.96, P < 0.01) or at least four older siblings (OR 0.47, 95% CI 0.26-0.84, P < 0.05). CONCLUSION: Childhood farm environment seems to have a protective effect against allergic rhinitis and/or conjunctivitis, and more weakly against asthma and wheezing irrespective of family size. Environmental exposure to immune modulating agents, such as environmental mycobacteria and actinomycetes, favouring manifestation of a nonatopic phenotype could explain the finding.     

Pet-keeping in childhood and adult asthma and hay fever: European community respiratory health survey

BACKGROUND: Whether pet-keeping early in life protects against or promotes allergy remains unclear. OBJECTIVE: Our aim was to examine the effects of childhood pet-keeping on adult allergic disease in a large international population-based study, including information on sensitization, adult pet-keeping, and pet prevalence in the populations. METHODS: We used information from structured interviews (n = 18,530) and specific IgE to common aeroallergens in blood samples (n = 13,932) from participants in the European Community Respiratory Health Survey (ECRHS) to analyze the associations between keeping pets and adult asthma and hay fever. RESULTS: Keeping cats in childhood was associated with asthma only among atopic subjects, an association that varied between centers (P =.002) and was stronger where cats where less common (< 40% cats: odds ratio(wheeze) [OR(wheeze)] = 1.84, 95% CI = 1.31-2.57; 40%-60% cats: OR(wheeze) = 1.33, 95% CI = 1.10-1.61; > or =60% cats: OR(wheeze) = 0.98, 95% CI = 0.73-1.33). Dogs owned in childhood or adulthood were associated with asthma among nonatopic subjects (childhood: OR(wheeze) = 1.28, 95% CI = 1.13-1.46; adulthood: OR(wheeze) = 1.31, 95% CI = 1.14-1.51; both: OR(wheeze) = 1.69, 95% CI = 1.40-2.04). In atopic subjects, those who had owned dogs in childhood had less hay fever (OR = 0.85; 95% CI = 0.73-0.98) and no increased risk of asthma (OR(wheeze) = 1.01, 95% CI = 0.87-1.17). Respiratory symptoms were more common in subjects who had owned birds during childhood (OR(wheeze) = 1.12; 95% CI = 1.02-1.23) independent of sensitization. CONCLUSIONS: The effects of pet-keeping in childhood varied according to the type of pet, the allergic sensitization of the individual, and the wider environmental exposure to allergen. Cats owned in childhood were associated with more asthma in sensitized adults who grew up in areas with a low community prevalence of cats. Dogs owned in childhood seemed to protect against adult allergic disease but promote nonallergic asthma.     

Pets, parental atopy, and asthma in adults

BACKGROUND: Studies of exposure to pets and the risk of asthma have provided conflicting results. OBJECTIVE: We conducted a population-based incident case-control study to assess the relationship of current and previous pet keeping with the risk of adult-onset asthma. We also investigated whether genetic propensity as a result of parental atopy modifies these relations. METHODS: From the source population of 441,000 inhabitants of a geographically defined area in South Finland, we systematically recruited, during a 2.5-year period, all new cases of asthma in 21- to 63-year-old adults and randomly selected control subjects. The clinically diagnosed case series consisted of 521 adults with newly diagnosed asthma and a control series of 932 control subjects. Information on current and past exposure to hairy pets was collected by using a self-administered questionnaire. RESULTS: In logistic regression analysis the risk of asthma was lower among subjects with pets during the past 12 months (adjusted odds ratio [OR], 0.74; 95% confidence interval [CI], 0.57-0.96) but higher among subjects with pets more than 12 months previously (adjusted OR, 1.39; 95% CI, 1.05-1.84). Parental atopy increased the risk of asthma (OR, 1.88; 95% CI, 1.47-2.41), but there was no interaction between parental atopy and pet exposure. CONCLUSIONS: The present results are consistent with the hypothesis that both keeping furry pets and parental atopy increase the risk of asthma development in adulthood. Parental atopy does not modify the effects of pet exposure. The negative association between current pets and the risk of asthma is consistent with selective avoidance of these pets by symptomatic individuals.     

Asthma and sensitization in a community with low indoor allergen levels and low pet-keeping frequency

BACKGROUND: Little is known about causes of asthma and sensitization in desert countries. OBJECTIVE: To investigate risk factors associated with asthma and sensitization in Kuwait. METHODS: One hundred sixty children (9-16 years) with physician-diagnosed asthma were recruited and matched (age, sex) with 303 healthy controls. Risk factors were assessed by questionnaires, determination of sensitization status (skin tests and IgE), and home allergen exposure (mite, cat, dog, cockroach; ELISA). RESULTS: Home allergen levels and frequency of pet ownership were very low (cat, 4.1%; dog, 1.5%). The risk of cat sensitization increased significantly among cat owners (odds ratio [OR], 3.53; 95% CI, 1.33-9.41; P = .01), and in children with reported contact with cats during the first year of life (OR, 2.60; 95% CI, 1.17-5.80; P = .019). In the multivariate analysis, maternal atopy (OR, 1.77; 95% CI, 1.13-2.75; P = .01) and cat ownership (OR, 3.32; 95% CI, 1.19-9.25; P = .02) remained significant associates of cat sensitization. Current dog ownership significantly increased the risk of sensitization to dog (OR, 6.05; 95% CI, 1.33-27.54; P = .02). In the multivariate analysis, dog ownership remained the only significant associate of dog sensitization (OR, 6.02; 95% CI, 1.30-27.96; P = .02). Sensitization to Alternaria was the strongest independent associate of the asthma group. Family history of asthma, history of whooping cough, current cat ownership, and breast-feeding <2 months were other significant and independent risk factors for asthma. CONCLUSIONS: Pet ownership markedly increased the risk of sensitization to pets. Despite low allergen exposure, the pattern of childhood asthma in Kuwait follows that described in Western communities (strong association with sensitization).     

Role of current and childhood exposure to cat and atopic sensitization. European Community Respiratory Health Survey.

BACKGROUND: Clinical and population studies have shown that exposure and sensitization to allergens derived from furred pets, particularly cats, represent an important risk factor of allergic respiratory disease and also a significant risk factor for asthma. OBJECTIVE: In the framework of the multicenter European Community Respiratory Health Survey an analysis of the association of current and childhood exposure to cat with atopic sensitization to cat was conducted. METHODS: This study included cross-sectional data from 35 centers representing 16 countries. Altogether, 18,097 subjects were included, of whom 13,509 (75%) provided a blood sample for the measurement of specific IgE. Exposure data and data for potential confounders were extracted from an interviewer-led questionnaire. RESULTS: The prevalence of sensitization to cat (serum specific IgE >0.35 kU/L) was 9%. Among those who did not report allergic symptoms in the presence of pets or house dust, those who owned cats were significantly more likely to be sensitized to cats than were those who did not (odds ratio [95% confidence interval] 1.57 [1.20-2.06]. Childhood exposure to pets including cats was associated with lower sensitization to cats in adulthood, particularly among those with a positive family history of atopy (odds ratio [95% confidence interval] 0.68 [0.51-0.93]. Positive correlations were found between the community prevalence of cat and the prevalences of sensitization to cat, respiratory symptoms, physician-diagnosed asthma, and current asthma medication. CONCLUSIONS: Current cat ownership represents a significant risk for sensitization to cat if cats are allowed indoors. Our results support the hypothesis that childhood exposure to pets, including cats, might modulate immunologic mechanisms and reduce sensitization to cat in adulthood. The significant correlation found between the community prevalence of cat ownership and community prevalence of specific sensitization to cat represents the first documentation of such a relationship.     

Allergy markers in adults in relation to the timing of pet exposure: the EGEA study

BACKGROUND: Studies suggest that early childhood exposure to pets may protect from the development of atopy, but limited information is available on adults. The association of allergy markers in adulthood with current and childhood exposure to pets was studied considering retrospectively the window of exposure. METHODS: Immunoglobulin E (IgE), skin prick tests (SPT), eosinophils were related to exposure to pets in 187 adult asthmatic cases and 243 controls from the Epidemiological Study on the Genetics and Environment of Asthma, bronchial hyperresponsiveness and atopy (EGEA) study. Analyses were redone after exclusion of subjects who removed pets or experienced symptoms to animals to take into account selection in that retrospective study. RESULTS: In asthmatic cases, current exposure to pets was unrelated to SPT positivity (+), whereas childhood exposure was significantly related to less SPT+ to any allergen, and to cat in particular, with an association restricted to those exposed before 2 years of age [OR = 0.30 (CI 0.12-0.76)]. Considering the relative timing of exposure in relation to asthma onset showed that the protective effect of exposure to pets occurs for pet exposure starting before asthma onset [OR for SPT+ = 0.19 (CI 0.08-0.48)]. CONCLUSION: Results support the hypothesis that exposure to pets in early life, and in particular before asthma onset, may protect against allergen sensitization in adulthood.     

Prevalence and predictors of atopy among young Danish adults

BACKGROUND: The prevalence of atopic diseases is increasing in western countries, and environmental exposures in childhood may influence development of atopic sensitization. OBJECTIVE: To investigate the prevalence and predictors of atopy among young Danish adults. METHODS: Of 940 invited subjects, aged 19-29 years, complete data were obtained from 525 (56%) subjects. All completed a questionnaire concerning asthma, rhinitis, preschool nursery care, smoking habits, family size, education and employment. A skin prick test was performed, and pulmonary function was measured using standard techniques. Atopy was defined as a positive skin prick test. RESULTS: The frequency of atopy was 32% (males 43% vs. females 23%, P < 0.001). We found a positive association between atopy and atopic dermatitis (P < 0.05), rhinitis (P < 0.001), itching when eating nuts (P < 0.001) and current asthma (P < 0.001). There was an inverse relation between atopy and having furred pets in childhood (P < 0.05), passive smoking in childhood (P < 0.01) and current passive smoking (P < 0.05). An increasing number of siblings was inversely related to atopy to grass (P < 0.05); however, only an increasing number of older siblings seemed to protect from atopy to grass (P < 0.05). Subjects who had never attended a day-care centre had significantly more atopy to grass (P < 0.05). No significant association was found between atopy and airway infections requiring hospitalization before the age of 5 years, or between atopy and bedroom sharing in childhood. CONCLUSION: Atopy is common among young Danish adults, especially in males. Participants were less likely to be atopic, especially to grass allergen, if they came from large families, had kept furred pets as children, and had been exposed to tobacco smoke.     

Breastfeeding and prevalence of allergic diseases in Japanese university students

BACKGROUND: Although historical support exists for the concept that breastfeeding might be protective against allergic diseases, contradictory findings have been observed recently. OBJECTIVE: To investigate the cumulative prevalence of allergic diseases in Japanese university students and to identify explanatory variables including breastfeeding. METHODS: From March 18, 2003, through March 29, 2005, a total of 9,615 students newly enrolled at the University of Tokyo responded to a written questionnaire on allergic diseases. RESULTS: Cumulative prevalence of allergic rhinitis, atopic dermatitis, and asthma was 47.2%, 17.4%, and 9.3%, respectively. These data were closely correlated, and prevalence of any 1 of the 3 diseases significantly increased the odds for historical prevalence of the other 2 (P < .001). Male sex (odds ratio [OR], 1.5; 95% confidence interval [CI], 1.4-1.7) and maternal (OR, 2.2; 95% CI, 2.0-2.5) or paternal (OR, 1.6; 95% CI, 1.4-1.8) history of allergic rhinitis were significant correlates of increased odds for allergic rhinitis. Maternal (OR, 2.7; 95% CI, 1.6-4.5), paternal (OR, 3.8; 95% CI, 2.2-6.6), or sibling (OR, 1.9; 95% CI, 1.5-2.4) history of atopic dermatitis was a significant correlate of increased odds for atopic dermatitis. As for asthma, maternal (OR, 4.9; 95% CI, 3.0-7.9), paternal (OR, 4.0; 95% CI, 2.3-7.0), or sibling (OR, 3.3; 95% CI, 2.4-4.5) history of asthma was a significant correlate of increased odds. Logistic regression analysis showed no consistent evidence of the effects of breastfeeding on the cumulative prevalence. CONCLUSION: The cumulative prevalence of these diseases among young adults revealed that the effect of breastfeeding is negligible when compared with genetic factors.     

Childhood asthma and continuous exposure to cats since the first year of life with cats allowed in the child's bedroom

Background: There are controversial data as to interdependencies of exposure to furred pets in infancy and the prevalence of asthma and hay fever in children. Does the timing, intensity and type of pet exposure matter? Methods: Cross‐sectional questionnaire data on 8216 German schoolchildren aged 5–7 years not living on a farm in ten rural districts in Bavaria in 1997 were analysed. The diagnosis of asthma and hay fever was ascertained with the International Study of Asthma and Allergies in Childhood (ISAAC) core questions. Wheeze and asthma were classified as ‘atopic’ in children who also had hay fever or atopic dermatitis. Prevalence and intensity of exposure to pets in the first year of life and at present were assessed via questionnaire. Results: Although the study was of considerable size we found no convincing association between atopic disease and pet exposure in general. Exposure to cats from the first year of life to school entry, however, was associated with a reduced prevalence of atopic asthma, if cats were allowed to be in the child's bedroom: no case of atopic asthma in 296 children exposed and an aOR 0.11 (95% CI:0.01–0.52) for atopic wheeze in the last 12 months. Conclusions: Allowing cats to be in the child's bedroom from the first year of life onwards may be an indicator of intensive exposure to cats and appears to prevent the development of childhood asthma.     

Risk factors for atopic dermatitis in infants at high risk of allergy: the PIAMA study

BACKGROUND: It has been suggested that the period immediately after birth is a sensitive period for the development of atopic disease. OBJECTIVE: We investigated whether birth characteristics and environmental factors are associated with the development of atopic dermatitis in the first year of life. METHODS: Seventy-six children with and 228 without atopic dermatitis, all children of mothers with respiratory allergy or asthma (PIAMA birth cohort study) were included in the study. Atopic dermatitis was defined as a positive history of an itchy skin condition with at least two of the following characteristics: visible dermatitis, history of outer arms/leg involvement, or general dry skin. Multiple logistic regression analysis was performed to study the independent effects of various risk factors. RESULTS: A birth weight >/=4000 g compared to 3000-4000 g was a significant risk factor for atopic dermatitis (odds ratio (OR)=2.4; 95% CI: 1.1-5.1) as was day care attendance (OR=2.9; 95% CI: 1.5-5.9). Exclusive breastfeeding in the first 3 months was negatively associated with atopic dermatitis (OR=0.6; 95% CI: 0.3-1.2), especially with visible dermatitis (OR=0.4; 95% CI: 0.2-1.0). Gender, gestational age, the presence of siblings or pets, and parental smoking were not significantly associated with atopic dermatitis. CONCLUSION: This study shows that a high birth weight and day care attendance increase the risk of atopic dermatitis in the first year of life, while exclusive breastfeeding is a protective factor when dermatitis is found on inspection.     

Childhood farm environment and asthma and sensitization in young adulthood

BACKGROUND: Farm environment in childhood may protect against sensitization, allergic rhinitis, and asthma. METHODS: Subjects were obtained from 10 667 Finnish first-year university students who responded to a questionnaire survey on IgE-mediated diseases. Two random samples were selected from 1631 respondents in Turku: subjects with asthma or wheezing, and subjects without asthmatic symptoms. A total of 296 subjects (72%) participated. Skin prick tests (SPT), measurements of IgE-antibodies, methacholine challenge, and bronchodilation tests were performed. Weighted occurrence of current asthma and sensitization among students from "childhood farm" and "childhood nonfarm" environments were analyzed. RESULTS: Current asthma was found in 3.1% of subjects with childhood farm environment, and in 12.4% with nonfarm environment (odds ratio (OR) 0.22; 95% confidence interval (CI) 0.07-0.70). There were fewer positive SPT to birch (8.3 vs. 24.2%, OR 0.28, 95% CI 0.07-1.15) and timothy pollen (12.6 vs. 30.3%, OR 0.33, 95% CI 0.09-1.20) among subjects with childhood farm environment, but more sensitization to house-dust mite (22.0 vs. 4.9%, OR 5.43, 95% CI 1.60-18.46). Sensitization to cat (RAST class >/= 3) was less common in subjects with farm compared to nonfarm environments in childhood (1.5 vs. 13.1%; OR 0.10, 95% CI 0.02-0.47). CONCLUSIONS: Farm environment in childhood protects against adult asthma and sensitization-especially to cat-the most important asthma related allergen. In contrast, sensitization to house-dust mite was more common in farming subjects.     

Polymorphisms of histamine-metabolizing enzymes and clinical manifestations of asthma and allergic rhinitis

BACKGROUND: Polymorphisms of enzymes involved in histamine biodisposition may affect clinical symptoms in diseases related to histamine, such as asthma or allergic rhinitis (AR). OBJECTIVE: This study aims to analyse two common polymorphisms in genes coding for histamine-metabolizing enzymes in patients with allergic diseases. METHODS: Five-hundred and sixty-five individuals participated in the study, including 270 unrelated patients with asthma and/or AR recruited from a single centre and 295 healthy volunteers. Participants were analysed for the presence of Thr105Ile and His645Asp amino acid substitutions at histamine N-methyltransferase (HNMT) and diamine oxidase (amiloride binding protein 1) enzymes, respectively, by amplification-restriction procedures. RESULTS: The variant HNMT allele frequencies were slightly higher among patients with asthma [16.0%, 95% confidence interval (CI) 12.0-20.0] and among patients with rhinitis (13.2, 95% CI 10.3-16.1) as compared with healthy subjects (11.5 95% CI 8.9-14.1). The variant ABP1 allele frequencies were similar among patients with asthma (30.8%, 95% CI 25.7-35.9), rhinitis (28.7, 95% CI 24.8-32.6) and healthy subjects (26.8 95% CI 23.2-30.3). Individuals carrying mutated ABP1 alleles presented allergy symptoms with significantly lower IgE levels as compared with individuals without mutated genes, with a significant gene-dose effect (P<0.001). In addition, the percentage of individuals presenting symptoms without eosinophilia was significantly higher among homozygous carriers of ABP1 variant alleles (P<0.020) as compared with the rest of the atopic patients. CONCLUSION: There is a lack of association between the allelic variants studied and the risk of developing allergic asthma and rhinitis. However, patients carrying the His645Asp polymorphism of ABP1 are more prone to developing symptoms with lower IgE levels.     

"Early" cat ownership and the risk of sensitization and allergic rhinitis in Ligurian children with respiratory symptoms.

BACKGROUND: Studies on the role of cat ownership in the development of allergy have lead to conflicting results, probably owing to heterogeneity of the populations evaluated. OBJECTIVE: To evaluate the possible effect of cat ownership on the frequency of sensitization and asthma or rhinitis in children living in Liguria, Italy, who attended a pediatric clinic for respiratory symptoms. METHODS: We enrolled 269 consecutive school-aged children in 12 months. Sensitization to aeroallergens by skin prick testing and the presence of respiratory symptoms (ie, asthma and rhinitis) were evaluated. To analyze the role of different independent variables in association with respiratory symptoms and sensitization, a multiple logistic regression analysis was performed. RESULTS: Of 269 children, 81 were exposed to cats at home in the first 2 years of life ("early" cat owners), 65 after the first 2 years of life ("late" cat owners), and 123 never ("never" cat owners). Early cat ownership was significantly associated with a lower risk of cat sensitization compared with never cat ownership (adjusted odds ratio [ORadj], 0.32; 95% confidence interval [CI], 0.14-0.74; P = .01). Early cat ownership was also associated with a significantly lower risk of allergic rhinitis than late cat ownership (ORadj, 0.43; 95% CI, 0.22-0.85) or never cat ownership (ORadj, 0.51; 95% CI, 0.28-0.92). No differences in the frequency of asthma were found among the 3 groups (P = .74) CONCLUSIONS: Cat ownership in early childhood can play an important role in preventing sensitization to cat and in lowering the frequency of allergic rhinitis, at least in children with the characteristics of the population studied.     

Negative association of Enterobius infestation with asthma and rhinitis in primary school children in Taipei

BACKGROUND: The relationship between allergy and parasites has been controversial, especially in non-tropical countries. Enterobius vermicularis (human pinworm) is the most prevalent intestinal parasite in industrialized countries. OBJECTIVE: To examine the association between pinworm infestation and allergy in primary school children. METHOD: Peri-anal tape test for pinworm is routinely performed in Taipei primary schools. We collected data from school records and questionnaires distributed to all children in four primary schools grades 1 through 6 (n = 3107). RESULTS: The prevalence of physician-diagnosed asthma (9.3% vs. 14.1%, P = 0.007) and allergic rhinitis (27.4% vs. 38.3%, P = 0.001) was lower in pinworm-positive compared to uninfested children. Pinworm was not correlated with atopic dermatitis or parent allergy. With logistic regression controlling for sex, parent allergy and lower respiratory infection, current asthma (OR = 0.25, 95% CI 0.10-0.63) and rhinitis (OR = 0.61, 95% CI 0.45-0.84) were negatively associated with pinworm. Among children in grades 3-6 who had no asthma or rhinitis before age 7, those with early infestation (pinworm diagnosis at or before grade 1) had a lower risk of having diagnosis of rhinitis during school years, compared to the uninfected group (5.4% vs. 12.3%, P = 0.03; adjusted OR = 0.47, 95% CI 0.21-1.02). CONCLUSIONS: We identified a negative association between pinworm infestation and allergic airway diseases, which could in part be attributed to protective effect of pinworm infestation on development of allergic symptoms. Other mechanisms of association could not be ruled out.     

Small nonspecialized farming as a protective factor against immediate‐type occupational respiratory allergy?

BACKGROUND: In Poland small, nonspecialized farms, growing different crops and raising usually a few animals of various species constitute the majority. OBJECTIVE: The aim of the case-control study was to evaluate the risk factors of work-related respiratory symptoms and occupational asthma and/or rhinitis in Polish farmers and investigate whether the farming characteristics may have influence on the prevalence of atopy and allergic diseases. METHODS: The study groups comprised 100 cases who were farmers reporting work-related asthmatic and/or rhinitis symptoms from randomly selected family doctors practices (80 of 353) and 102 healthy controls. All subjects were examined by means of a questionnaire, skin prick tests (SPT) to common and occupational allergens, total serum immunoglobulin (Ig)E level and the presence of specific IgE and allergen-specific inhalation challenge tests were performed. The provocation tests were monitored with the spirometry, histamine challenge test and evaluation of nasal symptoms score and nasal washings. RESULTS: Respiratory allergic disease was recognized in 68 symptomatic patients, including 41 cases because of occupational allergens (asthma n=38, rhinitis n=41). Step-wise logistic regression analysis confirmed the protective role of small farms against the development of work-related symptoms (OR 0.23; 95% CI 0.11, 0.47) as well as the significance of positive SPT to cereals (OR 5.55; 95% CI 1.6, 19.21) and storage mites (OR 3.73; 95% CI 1.27, 10.96) as a risk factor of these symptoms. Cereal farming (OR 13.75; 95% CI 2.39, 78.83) and positive SPT to cereals (OR 26.92; 95% CI 5.33, 135.9) and storage mites (OR 44.07; 95% CI 8.40, 231.1) were found to be significant risk factors of occupational asthma and/or rhinitis. CONCLUSIONS: Cereal farming and hypersensitivity to cereals plays the significant role in the development of occupational asthma among Polish farmers. It also seems that working on small farms may protect farmers against work-related respiratory symptoms that are mostly because of allergy.     

Association of active and passive smoking with allergic disorders in pregnant Japanese women: baseline data from the Osaka Maternal and Child Health Study.

BACKGROUND: Evidence remains inconclusive as to whether smoking is a risk factor for allergic disorders in adults. OBJECTIVE: To investigate the relationship between active and passive smoking exposure and allergic disorders in pregnant Japanese women. METHODS: This cross-sectional study included 1,002 pregnant women. Participants were classified as having asthma after the age of 18 years if they had used an asthma medication at any time after reaching the age of 18 years. Current atopic eczema and allergic rhinitis (including cedar pollinosis) were defined as being present if participants had received any drug treatment during the previous 12 months. Adjustment was made for age; gestation; parity; family history of asthma, atopic eczema, and allergic rhinitis; indoor domestic pets; family income; education; and the mite antigen level in house dust. RESULTS: Current smoking, but not environmental tobacco smoke exposure, was independently related to an increased prevalence of asthma after the age of 18 years (adjusted odds ratio [OR], 2.66; 95% confidence interval [CI], 1.30-5.38). A significant positive association of current passive smoking exposure at home (adjusted OR, 1.89; 95% CI, 1.10-3.30) and at work (adjusted OR, 2.50; 95% CI, 1.29-4.76) with the prevalence of current allergic rhinitis was observed, whereas no measurable association with active smoking exposure was found. Neither active nor passive smoking was statistically significantly related to the prevalence of current atopic eczema. CONCLUSIONS: These findings suggest that active smoking and environmental tobacco smoke exposure may increase the likelihood of asthma and allergic rhinitis, respectively, in pregnant Japanese women.     

Respiratory illnesses in early life and asthma and atopy in childhood

BACKGROUND: The relation between respiratory illnesses in early life and the development of asthma and atopy in childhood is incompletely understood. OBJECTIVE: We sought to examine the relationship between respiratory illnesses in early life and atopic diseases at school age. METHODS: We performed a prospective birth cohort study of the relationship between respiratory illnesses in the first year of life and asthma, atopy (sensitization to >or=1 allergen), and allergic rhinitis at school age in 440 children with a parental history of atopy. Logistic regression was used to examine the relationship between respiratory illnesses and asthma, atopy, and allergic rhinitis. The relationship between respiratory illnesses in early life and repeated measures of wheezing between the ages of 1 and 7 years was investigated by using a proportional hazards models. RESULTS: Physician-diagnosed croup (adjusted odds ratio [OR], 0.30; 95% CI, 0.12-0.72) and having 2 or more physician-diagnosed ear infections (adjusted OR, 0.58; 95% CI, 0.35-0.98) in the first year of life were inversely associated with atopy at school age. Physician-diagnosed bronchiolitis before age 1 year was significantly associated with asthma at age 7 years (adjusted OR, 2.77; 95% CI, 1.23-6.22). Recurrent nasal catarrh (>or=3 episodes of a runny nose) in the first year of life was associated with allergic rhinitis at age 7 years (adjusted OR, 2.99; 95% CI, 1.03-8.67). CONCLUSION: The relationship between early-life respiratory illnesses and asthma and atopy is complex and likely dependent on the type of infection and immune response it initiates. CLINICAL IMPLICATIONS: Certain respiratory illnesses in early life modify the risk of atopy and asthma at school age.