Environmental and occupational respiratory disordersPrenatal farm exposure is related to the expression of receptors of the innate immunity and to atopic sensitization in school-age children
Section snippets
Population and study areas
The cross-sectional Prevention of Allergy Risk Factors for Sensitization in Children Related to Farming and Anthroposophic Life Style (PARSIFAL) study aimed at studying the determinants of childhood asthma and allergies in farming and anthroposophic populations, as described previously.12 A child who lived on a farm and whose family ran the farm was considered a farm child. Other children were termed farm reference children. The present analyses focus on 2823 farm and 5440 farm reference
Results
Of the 11,969 invited farm and farm reference children, 8402 (70%) returned the questionnaires. A total of 139 children were excluded because of missing values for sex and age or because they did not meet the age criteria of 5 to 13 years.
The prevalence of all outcomes (atopic sensitization, rhinoconjunctivitis symptoms and physician's diagnosis of seasonal rhinoconjunctivitis, and current wheezing and physician's diagnosis of asthma) was significantly lower in farm children compared with in
Discussion
The present study showed a clear inverse association of a farming environment (farm milk consumption, stable/barn visits, and contact with farm animals) with the prevalence of seasonal rhinoconjunctivitis, symptoms of seasonal rhinoconjunctivitis, and asthma. Maternal exposure to stables in pregnancy was associated with atopic sensitization and the expression of genes for receptors of the innate immune system (ie, TLR2, TLR4, and CD14). A dose-response relation was found between the extent of
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Supported by a research grant from the European Union (QLRT 1999-01391) and by funding from the Swedish Foundation for Health Care Science and Allergy Research, the Swiss National Foundation (grant no. 32-100324), and the Kühne-Foundation.
Disclosure of potential conflict of interest: D. Schram-Bijkerek has received grants from Parsifal EU projects. E. von Mutius has consultant arrangements with UCB and GlaxoSmithKline. All other authors—none disclosed.
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Both authors contributed equally to this work.
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The PARSIFAL study group: Tobias Alfvén, Johan Alm, Anna Bergström, Lars Engstrand, Helen Flöistrup, Niclas Håkansson, Gunnar Lilja, Fredrik Nyberg, Jackie Swartz, Magnus Wickman (Sweden); Marco Waser, Felix Sennhauser, Johannes Wildhaber, Alex Möller (Switzerland); Gert Doekes, Mirian Boeve, Jeroen Douwes, Machteld Huber, Mirjam Matze (the Netherlands); Waltraud Eder, Gertraud Weiss, Mynda Schreuer (Austria); and Karin B. Michels (United States).