RT Journal Article SR Electronic T1 Farm exposure in utero may protect against asthma, hay fever and eczema JF European Respiratory Journal JO Eur Respir J FD European Respiratory Society SP 603 OP 611 DO 10.1183/09031936.00033707 VO 32 IS 3 A1 J. Douwes A1 S. Cheng A1 N. Travier A1 C. Cohet A1 A. Niesink A1 J. McKenzie A1 C. Cunningham A1 G. Le Gros A1 E. von Mutius A1 N. Pearce YR 2008 UL http://erj.ersjournals.com/content/32/3/603.abstract AB The aim of the present study was to assess which factors contribute to the lower prevalence of allergic diseases in farmers’ children, and the importance of timing of exposure. In a cross-sectional questionnaire survey, asthma symptoms, hay fever and eczema were assessed, as well as current, early and prenatal farm-related exposures in 1,333 farmers’ children and 566 reference children aged 5–17 yrs. Farmers’ children had a lower incidence of asthma symptoms and eczema. Current and maternal exposure during pregnancy to animals and/or grain and hay reduced the risk of asthma symptoms, hay fever and eczema. The exposure–response association for maternal exposure was nonlinear for most outcomes. After mutual adjustment, the effects of prenatal exposure remained unchanged whereas current exposure remained protective only for asthma medication, asthma ever and hay fever. Exposure during the first 2 yrs was not associated with symptoms, after controlling for prenatal exposure. A combination of prenatal and current exposure was most strongly associated with wheeze (odds ratio (OR) 0.48, 95% confidence interval (CI) 0.28–0.80), asthma medication (OR 0.50, 95% CI 0.30–0.82), asthma ever (OR 0.50, 95% CI 0.33–0.76), hay fever (OR 0.47, 95% CI 0.30–0.73) and eczema (OR 0.46, 95% CI 0.30–0.70). Prenatal exposure may contribute to the low prevalence of asthma, hay fever and eczema in farmers’ children, but continued exposure may be required to maintain optimal protection.