Abstract
Introduction: The Barker hypothesis on early life programming implies that childhood disadvantages may have long-term health consequences; increasing the subject's susceptibility to harmful adult exposures might be one plausible pathway.
Aim and objectives: To investigate if susceptibility to harmful adult exposures such as cleaning agents could also be influenced by early life factors.
Methods: Respiratory Health In Northern Europe (RHINE) is a postal questionnaire follow-up study of the ECRHS I stage I. In RHINE III, 13283 subjects responded to the question “have you ever worked as a cleaner” (“Yes” n=2138) and reported the duration of working as a cleaner.
Early life disadvantage was defined by factors predicting enhanced susceptibility to smoking in a previous analysis (born during winter months, maternal age >35 years, severe respiratory infection <5 years, maternal smoking). Associations of respiratory health with cleaning and interaction with early life disadvantages were analysed with multiple logistic regression adjusting for potential confounders.
Results: Cleaning was more strongly associated with wheeze and asthma symptoms among those with early life disadvantage (ORwheeze=1.8 [95%CI = 1.5-2.3]; ORasthma symptoms=2.2 [1.8-2.8]) than among those without (ORwheeze=1.3[95%CI = 0.9-1.8]; ORasthma symptoms=1.6 [1.1-2.3]). The observed difference was significant for wheeze (pinteraction=0.044), and did not reach significant for asthma symptoms (pinteraction=0.078).
Conclusion: Early life disadvantage appears to modify the impact of working as a cleaner on respiratory health. We hypothesize that early life disadvantage might act by increasing the lungs' vulnerability to cleaning agents.
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