Cited by 157Asthma and respiratory diseasesOccupational exposure and asthmaIndoor Air Quality and Microbial Exposure

Early Exposure to Dogs and Farm Animals and the Risk of Childhood Asthma

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Fall, Tove, Lundholm, Cecilia, Örtqvist, Anne K, Fall, Katja, Fang, Fang, Hedhammar, Åke, Kämpe, Olle, Ingelsson, Erik +1 more·2015·JAMA Pediatrics

Abstract

IMPORTANCE: The association between early exposure to animals and childhood asthma is not clear, and previous studies have yielded contradictory results. OBJECTIVE: To determine whether exposure to dogs and farm animals confers a risk of asthma. DESIGN, SETTING AND PARTICIPANTS: In a nationwide cohort study, the association between early exposure to dogs and farm animals and the risk of asthma was evaluated and included all children born in Sweden from January 1, 2001, to December 31, 2010 (N = 1,011,051), using registry data on dog and farm registration, asthma medication, diagnosis, and confounders for parents and their children. The association was assessed as the odds ratio (OR) for a current diagnosis of asthma at age 6 years for school-aged children and as the hazard ratio (HR) for incident asthma at ages 1 to 5 years for preschool-aged children. Data were analyzed from January 1, 2007, to September 30, 2012. EXPOSURES: Living with a dog or farm animal. MAIN OUTCOMES AND MEASURES: Childhood asthma diagnosis and medication used. RESULTS: Of the 1,011,051 children born during the study period, 376,638 preschool-aged (53,460 [14.2%] exposed to dogs and 1729 [0.5%] exposed to farm animals) and 276,298 school-aged children (22,629 [8.2%] exposed to dogs and 958 [0.3%] exposed to farm animals) were included in the analyses. Of these, 18,799 children (5.0%) in the preschool-aged children's cohort experienced an asthmatic event before baseline, and 28,511 cases of asthma and 906,071 years at risk were recorded during follow-up (incidence rate, 3.1 cases per 1000 years at risk). In the school-aged children's cohort, 11,585 children (4.2%) experienced an asthmatic event during the seventh year of life. Dog exposure during the first year of life was associated with a decreased risk of asthma in school-aged children (OR, 0.87; 95% CI, 0.81-0.93) and in preschool-aged children 3 years or older (HR, 0.90; 95% CI, 0.83-0.99) but not in children younger than 3 years (HR, 1.03; 95% CI, 1.00-1.07). Results were comparable when analyzing only first-born children. Farm animal exposure was associated with a reduced risk of asthma in both school-aged children and preschool-aged children (OR, 0.48; 95% CI, 0.31-0.76, and HR, 0.69; 95% CI, 0.56-0.84), respectively. CONCLUSIONS AND RELEVANCE: In this study, the data support the hypothesis that exposure to dogs and farm animals during the first year of life reduces the risk of asthma in children at age 6 years. This information might be helpful in decision making for families and physicians on the appropriateness and timing of early animal exposure.

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Crossref · 10.1001/jamapediatrics.2015.3219

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Authors
Fall, T., Lundholm, C., Örtqvist, A. K., Fall, K., Fang, F., Hedhammar, Å., Kämpe, O., Ingelsson, E., & Almqvist, C.
Affiliations
  • Uppsala University (SE)
  • Karolinska Institutet (SE)
  • Örebro University (SE)
  • Swedish University of Agricultural Sciences (SE)
  • Karolinska University Hospital (SE)
Corresponding author
Fall, Tove
Venue
JAMA Pediatrics
Published
2015-11-02
Volume
169
Issue
11
Pages
e153219
ISSN
  • 1072-4710 (ISSN-L)
  • 2168-6203
OpenAlex
W2105608108
Cited by
157
References
35
Citations by year
2026: 4 · 2025: 13 · 2024: 6 · 2023: 11 · 2022: 21 · 2021: 17 · 2020: 15 · 2019: 21 · 2018: 18 · 2017: 16 · 2016: 12 · 2015: 3
FWCI
12.03
Type
journal article
Language
en
Open access
Locations
  • Archives of Pediatrics and Adolescent Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • Figshare (submittedVersion)
  • Open Archive (Karolinska Institutet) (submittedVersion)
Funders
  • Svenska Forskningsrådet Formas (340-2013-5867)
  • Karolinska Institutet (2011-3060)
  • Stockholms Läns Landsting (2011-3060, 340‐2013‐5867)
  • Vetenskapsrådet (340–2013-5867, 2011-03060, 80748301)
  • Novo Nordisk Fonden (NNF14OC0011003)
Topics
  • Health Sciences › Medicine › Physiology › Asthma and respiratory diseases
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Occupational exposure and asthma
  • Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Indoor Air Quality and Microbial Exposure
Keywords
childhood asthma, dog exposure, farm animal exposure, early life exposure, asthma risk, preschool children, school-aged children, asthma treatment, pediatric atopic dermatitis
MeSH terms
Animals, Animals, Domestic, Asthma, Child, Child, Preschool, Dogs, Environmental Exposure, Female, Humans, Male, Registries, Risk Factors, Sweden, Cohort Studies, Incidence, Odds Ratio

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