Environmental and occupational respiratory disordersWhich aspects of the farming lifestyle explain the inverse association with childhood allergy?
Section snippets
Study participants
The Study of Asthma and Allergy in Shropshire took place in 2 stages. Shropshire was chosen because it was believed to have a mix of farming types. An initial questionnaire was sent to all the children in rural primary schools with significant numbers of farming children attending. The aim was to identify parent-reported symptoms of asthma, eczema, and allergic rhinitis by using questions from the International Study of Asthma and Allergy in Childhood.14 A food-frequency questionnaire that
Results
A response rate of 66.0% (4767/7226) was achieved from the primary survey. This was less than had been anticipated; however, distribution of the questionnaires coincided with the worst flooding in Shropshire since 1947. Invitations to participate in the second stage of the study were sent to 1458 children, of whom 1073 (73.6%) replied and 944 (64.7%) consented to participate in one or more parts of the second stage. The actual number participating in the allergy tests was 879 (60.3%), with the
Discussion
Our study found a significantly lower prevalence among farmers' children of current asthma and seasonal allergic rhinitis symptoms but not current eczema symptoms. A nonsignificant reduced rate of atopy among farming children was also observed. However, the effect estimate for atopy was consistent with a meta-analysis of the published farming studies to date (our effect, 0.68; fixed effects pooled estimate, 0.59; 95% CI, 0.52-0.68; P < .001).2, 4, 5, 7, 10, 11, 12, 13 Similar consistency was
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Supported through a Wellcome Research Training Fellowship in Clinical Epidemiology (grant no. 056906/Z/99/Z) held by Dr Perkin.
Disclosure of potential conflict of interest: The authors have declared that they have no conflict of interest.