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Characterisation of asthma among adults with and without childhood farm contact

¹ Institute for Occupational and Environmental Medicine, Unit for Occupational and Environmental Epidemiology and Net Teaching, Ludwig-Maximilians-University, Munich, ² GSF-National Research Centre for Environment and Health, Institute of Epidemiology, Neuherberg, Germany. ³ Dept of Environmental Medicine, Municipal Health Service Amsterdam, Amsterdam, The Netherlands.

CORRESPONDENCE: K. Radon, Institute and Outpatient Clinic for Occupational and Environmental Medicine, Ziemssenstr. 1, D-80336 Munich, Germany. Fax: 49 8951604954. E-mail: Katja.Radon{at}med.uni-muenchen.de

Keywords: Bronchial provocation, farming, hygiene hypothesis, inhalant allergens, lung function tests

Received: October 2, 2006
Accepted January 24, 2007

Childhood farm contact is associated with a lower prevalence of sensitisation and allergic rhinitis. Findings have been contradictory for asthma. The aim of the present study was to investigate the differences between farm and nonfarm subjects using objective measurements.

A cross-sectional questionnaire study was performed among rural adults aged 18–44 yrs, of which 37% lived on a farm during the first 3 yrs of life and were thus referred to as "farm subjects". Lung function, bronchial hyperresponsiveness (BHR) to methacholine and sensitisation were measured in a random sample. A total of 1,595 subjects were included in the analyses.

Among farm subjects, sensitisation against inhalant allergens (odds ratio (OR) 0.7; 95% confidence interval 0.6–0.9), allergic rhinitis (0.5 (0.4–0.8)) and asthma diagnosis (0.7(0.4–1.1)) were less common than among nonfarm subjects. For BHR and lung function, no statistically significant differences were found between the two groups. Stratifying for sensitisation, farm subjects had a lower OR of asthma diagnosis (0.5 (0.3–1.0)) and a nonsignificantly reduced OR of BHR with sensitisation (0.8 (0.5–1.1)).

The present study confirmed, using objective measurements, that farm subjects have a lower prevalence of symptoms and asthma diagnosis, while the prevalence of bronchial hyperresponsiveness does not differ.