Farm exposure in early childhood is associated with a lower risk of severe respiratory illnesses
In multivariable analyses controlling for age, sex, family size, household smoking, daycare, breast-feeding, and family history, early farm exposure remained a statistically significant protective factor for respiratory illness (OR, 0.44; 95% CI, 0.21-0.91) and allergic rhinitis based on medical rec...
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description | In multivariable analyses controlling for age, sex, family size, household smoking, daycare, breast-feeding, and family history, early farm exposure remained a statistically significant protective factor for respiratory illness (OR, 0.44; 95% CI, 0.21-0.91) and allergic rhinitis based on medical record (OR, 0.33; 95% CI, 0.12-0.89; Fig 1, D). Methods Study design This cross-sectional cohort study comprised children between the ages of 5 and 17 years born within MESA between 1986 and 1999.E1 Informed consent was obtained from the parents of the children involved in the study and the study was reviewed and approved by the Marshfield Clinic Research Foundation Institutional Review Board. Asthma Interview Wheezing in past, wheezing in last 12 mo, wheezing after exercise in last 12 mo, parent has been told child has asthma, or child has taken medications for asthma Chart review Health care provider diagnosis of asthma, reactive airway disease, or wheezing and wheezing sign appears in record on more than 1 occasion separated by at least 60 d Allergic rhinitis Interview Runny nose ever without a cold, sneezing last 12 mo, or itchy red eyes Chart review Health care provider diagnosis of allergic or seasonal rhinitis for more than 12 mo or if child's parent reported hay fever on 2 separate occasions Chronic skin rash or eczema/atopic dermatitis Interview Rash ever for >6 mo, rash in last 12 mo, or has been told by health care provider that child has eczema or atopic dermatitis Chart review Health care provider diagnosis of eczema or atopic dermatitis on 2 or more separate occasions Severe respiratory illness Interview First 2 y of life ever had chest infection such as pneumonia, bronchiolitis, RSV infection, or bronchitis Chart review Pneumonia or emergency room visit for respiratory symptoms or hospitalized for serious respiratory infection (bronchiolitis, RSV, pneumonia/pneumonitis, croup) in the first 2 y of life Table E2 Demographic and early exposure characteristics Characteristic Early farm exposure(n = 268) No farm exposure(n = 247) P value Sex: male (%) 52.6 58.4 .46 White (%) 97.5 97.0 .94 Age (y) (mean, SD) 12.7 (3.7) 11.4 (3.5) |
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Methods Study design This cross-sectional cohort study comprised children between the ages of 5 and 17 years born within MESA between 1986 and 1999.E1 Informed consent was obtained from the parents of the children involved in the study and the study was reviewed and approved by the Marshfield Clinic Research Foundation Institutional Review Board. Asthma Interview Wheezing in past, wheezing in last 12 mo, wheezing after exercise in last 12 mo, parent has been told child has asthma, or child has taken medications for asthma Chart review Health care provider diagnosis of asthma, reactive airway disease, or wheezing and wheezing sign appears in record on more than 1 occasion separated by at least 60 d Allergic rhinitis Interview Runny nose ever without a cold, sneezing last 12 mo, or itchy red eyes Chart review Health care provider diagnosis of allergic or seasonal rhinitis for more than 12 mo or if child's parent reported hay fever on 2 separate occasions Chronic skin rash or eczema/atopic dermatitis Interview Rash ever for >6 mo, rash in last 12 mo, or has been told by health care provider that child has eczema or atopic dermatitis Chart review Health care provider diagnosis of eczema or atopic dermatitis on 2 or more separate occasions Severe respiratory illness Interview First 2 y of life ever had chest infection such as pneumonia, bronchiolitis, RSV infection, or bronchitis Chart review Pneumonia or emergency room visit for respiratory symptoms or hospitalized for serious respiratory infection (bronchiolitis, RSV, pneumonia/pneumonitis, croup) in the first 2 y of life Table E2 Demographic and early exposure characteristics Characteristic Early farm exposure(n = 268) No farm exposure(n = 247) P value Sex: male (%) 52.6 58.4 .46 White (%) 97.5 97.0 .94 Age (y) (mean, SD) 12.7 (3.7) 11.4 (3.5) <.001 Breast-fed (%) 57.1 52.6 .56 Early indoor pets (%) 82.1 62.3 .003 Day care (%) 38.6 63.1 .002 Household smoking (%) 18.6 23.2 .48 Family history of asthma/atopy (%) 70.6 76.3 .42 No. of siblings (mean, SD) 2.7 (5.7) 1.7 (7.3) .005 Table E3 Early farm exposure and atopic diseases and severe respiratory illnesses frequency in children with early farm exposure compared with no farm exposure Characteristic Early farm exposure(n = 268) No farm exposure(n = 247) P value Asthma (%) Interview 27.4 31.1 .58 Medical record 9.7 10.7 .73 Allergic rhinitis (%) Interview 17.4 28.0 .06 Medical record 5.2 12.4 .02 Eczema or chronic skin rash (%) Interview 6.8 19.5 <.001 Medical record 4.8 4.6 .92 Severe respiratory illnesses (%) Interview 15.7 31.4 .006 Medical record 6.8 17.6 <.001 1 E. von Mutius, D. Vercelli, Farm living: effects on childhood asthma and allergy, Nat Rev Immunol, Vol. 10, 2010, 861-868 2 B. Schaub, J. Liu, S. Hoppler, I. Schleich, J. Huehn, S. Olek, Maternal farm exposure modulates neonatal immune mechanisms through regulatory T cells, J Allergy Clin Immunol, Vol. 123, 2009, 774-782.e5 3 M.J. Ege, M. Mayer, A.-C. Normand, J. Genuneit, W.O. Cookson, C. Braun-Fahrlander, Exposure to environmental microorganisms and childhood asthma, N Engl J Med, Vol. 364, 2011, 701-709 4 J.E. Gern, G.D. Brooks, P. Meyer, A. Chang, K. Shen, M.D. Evans, Bidirectional interactions between viral respiratory illnesses and cytokine responses in the first year of life, J Allergy Clin Immunol, Vol. 117, 2006, 72-78 5 C.C. Copenhaver, J.E. Gern, Z. Li, P.A. Shult, L.A. Rosenthal, L.D. Mikus, Cytokine response patterns, exposure to viruses, and respiratory infections in the first year of life, Am J Respir Crit Care Med, Vol. 170, 2004, 175-180 6 F. DeStefano, E.D. Eaker, S.K. Broste, D.L. Nordstrom, P.L. Peissig, R.A. Vierkant, Epidemiologic research in an integrated regional medical care system: the Marshfield Epidemiologic Study Area, J Clin Epidemiol, Vol. 49, 1996, 643-652 7 O. Fuchs, J. Genuneit, P. Latzin, G. Buchele, E. Horak, G. Loss, Farming environments and childhood atopy, wheeze, lung function, and exhaled nitric oxide, J Allergy Clin Immunol, Vol. 130, 2012, 382-388.e6 8 G. Loss, M. Depner, L.H. Ulfman, R.J. van Neerven, A.J. Hose, J. Genuneit, J Allergy Clin Immunol, Vol. 135, 2015, 56-62 9 G.J. Loss, M. Depner, A.J. Hose, J. Genuneit, A.M. Karvonen, A. Hyvarinen, The early development of wheeze: environmental determinants and genetic susceptibility at 17q21, Am J Respir Crit Care Med, Vol. 193, 2016, 889-897</description><identifier>ISSN: 0091-6749</identifier><identifier>EISSN: 1097-6825</identifier><identifier>DOI: 10.1016/j.jaci.2017.07.032</identifier><identifier>PMID: 28870458</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Age Factors ; Allergies ; Asthma ; Child, Preschool ; Children ; Clinical outcomes ; Cytokines ; Disease Susceptibility ; Eczema ; Emergency medical care ; Environmental Exposure ; Family medical history ; Farms ; Households ; Humans ; Illnesses ; Infections ; Medical records ; Pneumonia ; Public Health Surveillance ; Respiratory diseases ; Respiratory Tract Diseases - diagnosis ; Respiratory Tract Diseases - epidemiology ; Respiratory Tract Diseases - etiology ; Risk Assessment ; Risk Factors ; Rural areas ; Severity of Illness Index ; Studies ; Viral infections ; Wisconsin - epidemiology</subject><ispartof>Journal of allergy and clinical immunology, 2018-01, Vol.141 (1), p.454-456.e4</ispartof><rights>2017 American Academy of Allergy, Asthma & Immunology</rights><rights>Copyright Elsevier Science Ltd. Jan 1, 2018</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c483t-26a3f02c0444768df5daf388945ef37cf0277f478943cc181e52ddbb04401c2d3</citedby><cites>FETCH-LOGICAL-c483t-26a3f02c0444768df5daf388945ef37cf0277f478943cc181e52ddbb04401c2d3</cites><orcidid>0000-0002-0532-3701</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jaci.2017.07.032$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,314,780,784,885,3548,27923,27924,45994</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28870458$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ludka-Gaulke, Tiffany</creatorcontrib><creatorcontrib>Ghera, Princy</creatorcontrib><creatorcontrib>Waring, Stephen C.</creatorcontrib><creatorcontrib>Keifer, Matthew</creatorcontrib><creatorcontrib>Seroogy, Christine</creatorcontrib><creatorcontrib>Gern, James E.</creatorcontrib><creatorcontrib>Kirkhorn, Steven</creatorcontrib><title>Farm exposure in early childhood is associated with a lower risk of severe respiratory illnesses</title><title>Journal of allergy and clinical immunology</title><addtitle>J Allergy Clin Immunol</addtitle><description>In multivariable analyses controlling for age, sex, family size, household smoking, daycare, breast-feeding, and family history, early farm exposure remained a statistically significant protective factor for respiratory illness (OR, 0.44; 95% CI, 0.21-0.91) and allergic rhinitis based on medical record (OR, 0.33; 95% CI, 0.12-0.89; Fig 1, D). Methods Study design This cross-sectional cohort study comprised children between the ages of 5 and 17 years born within MESA between 1986 and 1999.E1 Informed consent was obtained from the parents of the children involved in the study and the study was reviewed and approved by the Marshfield Clinic Research Foundation Institutional Review Board. Asthma Interview Wheezing in past, wheezing in last 12 mo, wheezing after exercise in last 12 mo, parent has been told child has asthma, or child has taken medications for asthma Chart review Health care provider diagnosis of asthma, reactive airway disease, or wheezing and wheezing sign appears in record on more than 1 occasion separated by at least 60 d Allergic rhinitis Interview Runny nose ever without a cold, sneezing last 12 mo, or itchy red eyes Chart review Health care provider diagnosis of allergic or seasonal rhinitis for more than 12 mo or if child's parent reported hay fever on 2 separate occasions Chronic skin rash or eczema/atopic dermatitis Interview Rash ever for >6 mo, rash in last 12 mo, or has been told by health care provider that child has eczema or atopic dermatitis Chart review Health care provider diagnosis of eczema or atopic dermatitis on 2 or more separate occasions Severe respiratory illness Interview First 2 y of life ever had chest infection such as pneumonia, bronchiolitis, RSV infection, or bronchitis Chart review Pneumonia or emergency room visit for respiratory symptoms or hospitalized for serious respiratory infection (bronchiolitis, RSV, pneumonia/pneumonitis, croup) in the first 2 y of life Table E2 Demographic and early exposure characteristics Characteristic Early farm exposure(n = 268) No farm exposure(n = 247) P value Sex: male (%) 52.6 58.4 .46 White (%) 97.5 97.0 .94 Age (y) (mean, SD) 12.7 (3.7) 11.4 (3.5) <.001 Breast-fed (%) 57.1 52.6 .56 Early indoor pets (%) 82.1 62.3 .003 Day care (%) 38.6 63.1 .002 Household smoking (%) 18.6 23.2 .48 Family history of asthma/atopy (%) 70.6 76.3 .42 No. of siblings (mean, SD) 2.7 (5.7) 1.7 (7.3) .005 Table E3 Early farm exposure and atopic diseases and severe respiratory illnesses frequency in children with early farm exposure compared with no farm exposure Characteristic Early farm exposure(n = 268) No farm exposure(n = 247) P value Asthma (%) Interview 27.4 31.1 .58 Medical record 9.7 10.7 .73 Allergic rhinitis (%) Interview 17.4 28.0 .06 Medical record 5.2 12.4 .02 Eczema or chronic skin rash (%) Interview 6.8 19.5 <.001 Medical record 4.8 4.6 .92 Severe respiratory illnesses (%) Interview 15.7 31.4 .006 Medical record 6.8 17.6 <.001 1 E. von Mutius, D. Vercelli, Farm living: effects on childhood asthma and allergy, Nat Rev Immunol, Vol. 10, 2010, 861-868 2 B. Schaub, J. Liu, S. Hoppler, I. Schleich, J. Huehn, S. Olek, Maternal farm exposure modulates neonatal immune mechanisms through regulatory T cells, J Allergy Clin Immunol, Vol. 123, 2009, 774-782.e5 3 M.J. Ege, M. Mayer, A.-C. Normand, J. Genuneit, W.O. Cookson, C. Braun-Fahrlander, Exposure to environmental microorganisms and childhood asthma, N Engl J Med, Vol. 364, 2011, 701-709 4 J.E. Gern, G.D. Brooks, P. Meyer, A. Chang, K. Shen, M.D. Evans, Bidirectional interactions between viral respiratory illnesses and cytokine responses in the first year of life, J Allergy Clin Immunol, Vol. 117, 2006, 72-78 5 C.C. Copenhaver, J.E. Gern, Z. Li, P.A. Shult, L.A. Rosenthal, L.D. Mikus, Cytokine response patterns, exposure to viruses, and respiratory infections in the first year of life, Am J Respir Crit Care Med, Vol. 170, 2004, 175-180 6 F. DeStefano, E.D. Eaker, S.K. Broste, D.L. Nordstrom, P.L. Peissig, R.A. Vierkant, Epidemiologic research in an integrated regional medical care system: the Marshfield Epidemiologic Study Area, J Clin Epidemiol, Vol. 49, 1996, 643-652 7 O. Fuchs, J. Genuneit, P. Latzin, G. Buchele, E. Horak, G. Loss, Farming environments and childhood atopy, wheeze, lung function, and exhaled nitric oxide, J Allergy Clin Immunol, Vol. 130, 2012, 382-388.e6 8 G. Loss, M. Depner, L.H. Ulfman, R.J. van Neerven, A.J. Hose, J. Genuneit, J Allergy Clin Immunol, Vol. 135, 2015, 56-62 9 G.J. Loss, M. Depner, A.J. Hose, J. Genuneit, A.M. Karvonen, A. Hyvarinen, The early development of wheeze: environmental determinants and genetic susceptibility at 17q21, Am J Respir Crit Care Med, Vol. 193, 2016, 889-897</description><subject>Age Factors</subject><subject>Allergies</subject><subject>Asthma</subject><subject>Child, Preschool</subject><subject>Children</subject><subject>Clinical outcomes</subject><subject>Cytokines</subject><subject>Disease Susceptibility</subject><subject>Eczema</subject><subject>Emergency medical care</subject><subject>Environmental Exposure</subject><subject>Family medical history</subject><subject>Farms</subject><subject>Households</subject><subject>Humans</subject><subject>Illnesses</subject><subject>Infections</subject><subject>Medical records</subject><subject>Pneumonia</subject><subject>Public Health Surveillance</subject><subject>Respiratory diseases</subject><subject>Respiratory Tract Diseases - diagnosis</subject><subject>Respiratory Tract Diseases - epidemiology</subject><subject>Respiratory Tract Diseases - etiology</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Rural areas</subject><subject>Severity of Illness Index</subject><subject>Studies</subject><subject>Viral infections</subject><subject>Wisconsin - epidemiology</subject><issn>0091-6749</issn><issn>1097-6825</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kV-LEzEUxYMobq1-AR8k4IsvU_N3kgERlsVVYcEXfY5pcsemTic1d6Zrv70pXRf1QXIhJPd3Drk5hDznbMUZb19vV1sf0kowblaslhQPyIKzzjStFfohWTDW8aY1qrsgTxC3rJ6l7R6TC2GtYUrbBfl67cuOws99xrkATSMFX4YjDZs0xE3OkSakHjGH5CeI9DZNG-rpkG-h0JLwO809RThAFRfAfSp-yuVI0zCMgAj4lDzq_YDw7G5fki_X7z5ffWhuPr3_eHV50wRl5dSI1sueicCUUqa1sdfR99LaTmnopQm1Z0yvTL2QIXDLQYsY1-vKMx5ElEvy9uy7n9c7iAHGqfjB7Uva-XJ02Sf3d2dMG_ctH5w22ipuq8GrO4OSf8yAk9slDDAMfoQ8o-Od1JYrZXVFX_6DbvNcxjpepaxutWzrWhJxpkLJiAX6-8dw5k4Buq07BehOATpWS4oqevHnGPeS34lV4M0ZgPqZhwTFYUgwBoipQJhczOl__r8A-DCtyA</recordid><startdate>20180101</startdate><enddate>20180101</enddate><creator>Ludka-Gaulke, Tiffany</creator><creator>Ghera, Princy</creator><creator>Waring, Stephen C.</creator><creator>Keifer, Matthew</creator><creator>Seroogy, Christine</creator><creator>Gern, James E.</creator><creator>Kirkhorn, Steven</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7SS</scope><scope>7T5</scope><scope>H94</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-0532-3701</orcidid></search><sort><creationdate>20180101</creationdate><title>Farm exposure in early childhood is associated with a lower risk of severe respiratory illnesses</title><author>Ludka-Gaulke, Tiffany ; Ghera, Princy ; Waring, Stephen C. ; Keifer, Matthew ; Seroogy, Christine ; Gern, James E. ; Kirkhorn, Steven</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c483t-26a3f02c0444768df5daf388945ef37cf0277f478943cc181e52ddbb04401c2d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Age Factors</topic><topic>Allergies</topic><topic>Asthma</topic><topic>Child, Preschool</topic><topic>Children</topic><topic>Clinical outcomes</topic><topic>Cytokines</topic><topic>Disease Susceptibility</topic><topic>Eczema</topic><topic>Emergency medical care</topic><topic>Environmental Exposure</topic><topic>Family medical history</topic><topic>Farms</topic><topic>Households</topic><topic>Humans</topic><topic>Illnesses</topic><topic>Infections</topic><topic>Medical records</topic><topic>Pneumonia</topic><topic>Public Health Surveillance</topic><topic>Respiratory diseases</topic><topic>Respiratory Tract Diseases - diagnosis</topic><topic>Respiratory Tract Diseases - epidemiology</topic><topic>Respiratory Tract Diseases - etiology</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>Rural areas</topic><topic>Severity of Illness Index</topic><topic>Studies</topic><topic>Viral infections</topic><topic>Wisconsin - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ludka-Gaulke, Tiffany</creatorcontrib><creatorcontrib>Ghera, Princy</creatorcontrib><creatorcontrib>Waring, Stephen C.</creatorcontrib><creatorcontrib>Keifer, Matthew</creatorcontrib><creatorcontrib>Seroogy, Christine</creatorcontrib><creatorcontrib>Gern, James E.</creatorcontrib><creatorcontrib>Kirkhorn, Steven</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Entomology Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of allergy and clinical immunology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ludka-Gaulke, Tiffany</au><au>Ghera, Princy</au><au>Waring, Stephen C.</au><au>Keifer, Matthew</au><au>Seroogy, Christine</au><au>Gern, James E.</au><au>Kirkhorn, Steven</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Farm exposure in early childhood is associated with a lower risk of severe respiratory illnesses</atitle><jtitle>Journal of allergy and clinical immunology</jtitle><addtitle>J Allergy Clin Immunol</addtitle><date>2018-01-01</date><risdate>2018</risdate><volume>141</volume><issue>1</issue><spage>454</spage><epage>456.e4</epage><pages>454-456.e4</pages><issn>0091-6749</issn><eissn>1097-6825</eissn><abstract>In multivariable analyses controlling for age, sex, family size, household smoking, daycare, breast-feeding, and family history, early farm exposure remained a statistically significant protective factor for respiratory illness (OR, 0.44; 95% CI, 0.21-0.91) and allergic rhinitis based on medical record (OR, 0.33; 95% CI, 0.12-0.89; Fig 1, D). Methods Study design This cross-sectional cohort study comprised children between the ages of 5 and 17 years born within MESA between 1986 and 1999.E1 Informed consent was obtained from the parents of the children involved in the study and the study was reviewed and approved by the Marshfield Clinic Research Foundation Institutional Review Board. Asthma Interview Wheezing in past, wheezing in last 12 mo, wheezing after exercise in last 12 mo, parent has been told child has asthma, or child has taken medications for asthma Chart review Health care provider diagnosis of asthma, reactive airway disease, or wheezing and wheezing sign appears in record on more than 1 occasion separated by at least 60 d Allergic rhinitis Interview Runny nose ever without a cold, sneezing last 12 mo, or itchy red eyes Chart review Health care provider diagnosis of allergic or seasonal rhinitis for more than 12 mo or if child's parent reported hay fever on 2 separate occasions Chronic skin rash or eczema/atopic dermatitis Interview Rash ever for >6 mo, rash in last 12 mo, or has been told by health care provider that child has eczema or atopic dermatitis Chart review Health care provider diagnosis of eczema or atopic dermatitis on 2 or more separate occasions Severe respiratory illness Interview First 2 y of life ever had chest infection such as pneumonia, bronchiolitis, RSV infection, or bronchitis Chart review Pneumonia or emergency room visit for respiratory symptoms or hospitalized for serious respiratory infection (bronchiolitis, RSV, pneumonia/pneumonitis, croup) in the first 2 y of life Table E2 Demographic and early exposure characteristics Characteristic Early farm exposure(n = 268) No farm exposure(n = 247) P value Sex: male (%) 52.6 58.4 .46 White (%) 97.5 97.0 .94 Age (y) (mean, SD) 12.7 (3.7) 11.4 (3.5) <.001 Breast-fed (%) 57.1 52.6 .56 Early indoor pets (%) 82.1 62.3 .003 Day care (%) 38.6 63.1 .002 Household smoking (%) 18.6 23.2 .48 Family history of asthma/atopy (%) 70.6 76.3 .42 No. of siblings (mean, SD) 2.7 (5.7) 1.7 (7.3) .005 Table E3 Early farm exposure and atopic diseases and severe respiratory illnesses frequency in children with early farm exposure compared with no farm exposure Characteristic Early farm exposure(n = 268) No farm exposure(n = 247) P value Asthma (%) Interview 27.4 31.1 .58 Medical record 9.7 10.7 .73 Allergic rhinitis (%) Interview 17.4 28.0 .06 Medical record 5.2 12.4 .02 Eczema or chronic skin rash (%) Interview 6.8 19.5 <.001 Medical record 4.8 4.6 .92 Severe respiratory illnesses (%) Interview 15.7 31.4 .006 Medical record 6.8 17.6 <.001 1 E. von Mutius, D. Vercelli, Farm living: effects on childhood asthma and allergy, Nat Rev Immunol, Vol. 10, 2010, 861-868 2 B. Schaub, J. Liu, S. Hoppler, I. Schleich, J. Huehn, S. Olek, Maternal farm exposure modulates neonatal immune mechanisms through regulatory T cells, J Allergy Clin Immunol, Vol. 123, 2009, 774-782.e5 3 M.J. Ege, M. Mayer, A.-C. Normand, J. Genuneit, W.O. Cookson, C. Braun-Fahrlander, Exposure to environmental microorganisms and childhood asthma, N Engl J Med, Vol. 364, 2011, 701-709 4 J.E. Gern, G.D. Brooks, P. Meyer, A. Chang, K. Shen, M.D. Evans, Bidirectional interactions between viral respiratory illnesses and cytokine responses in the first year of life, J Allergy Clin Immunol, Vol. 117, 2006, 72-78 5 C.C. Copenhaver, J.E. Gern, Z. Li, P.A. Shult, L.A. Rosenthal, L.D. Mikus, Cytokine response patterns, exposure to viruses, and respiratory infections in the first year of life, Am J Respir Crit Care Med, Vol. 170, 2004, 175-180 6 F. DeStefano, E.D. Eaker, S.K. Broste, D.L. Nordstrom, P.L. Peissig, R.A. Vierkant, Epidemiologic research in an integrated regional medical care system: the Marshfield Epidemiologic Study Area, J Clin Epidemiol, Vol. 49, 1996, 643-652 7 O. Fuchs, J. Genuneit, P. Latzin, G. Buchele, E. Horak, G. Loss, Farming environments and childhood atopy, wheeze, lung function, and exhaled nitric oxide, J Allergy Clin Immunol, Vol. 130, 2012, 382-388.e6 8 G. Loss, M. Depner, L.H. Ulfman, R.J. van Neerven, A.J. Hose, J. Genuneit, J Allergy Clin Immunol, Vol. 135, 2015, 56-62 9 G.J. Loss, M. Depner, A.J. Hose, J. Genuneit, A.M. Karvonen, A. Hyvarinen, The early development of wheeze: environmental determinants and genetic susceptibility at 17q21, Am J Respir Crit Care Med, Vol. 193, 2016, 889-897</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>28870458</pmid><doi>10.1016/j.jaci.2017.07.032</doi><orcidid>https://orcid.org/0000-0002-0532-3701</orcidid><oa>free_for_read</oa></addata></record> |
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subjects | Age Factors Allergies Asthma Child, Preschool Children Clinical outcomes Cytokines Disease Susceptibility Eczema Emergency medical care Environmental Exposure Family medical history Farms Households Humans Illnesses Infections Medical records Pneumonia Public Health Surveillance Respiratory diseases Respiratory Tract Diseases - diagnosis Respiratory Tract Diseases - epidemiology Respiratory Tract Diseases - etiology Risk Assessment Risk Factors Rural areas Severity of Illness Index Studies Viral infections Wisconsin - epidemiology |
title | Farm exposure in early childhood is associated with a lower risk of severe respiratory illnesses |
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