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

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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, Almqvist, Catarina·2015·JAMA Pediatrics

DOI 10.1001/jamapediatrics.2015.3219

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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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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
ORCID: Fall, Tove
Lundholm, Cecilia
Örtqvist, Anne K
Fall, Katja
Fang, Fang
Hedhammar, Åke
Kämpe, Olle
Ingelsson, Erik
Almqvist, Catarina
Venue: JAMA Pediatrics
Publisher: American Medical Association (AMA)
Published: 2015-11-02
Volume: 169
Issue: 11
Pages: e153219
ISSN: 1072-4710 (ISSN-L)
2168-6203
DOI: 10.1001/jamapediatrics.2015.3219
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: bronze
doi.org
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 › Pulmonary and Respiratory Medicine › 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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Early Exposure to Dogs and Farm Animals and the Risk of Childhood Asthma

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