Not all farming environments protect against the development of asthma and wheeze in children
Abstract
Background In recent years, studies have shown a protective effect of being raised in a farm environment on the development of hay fever and atopic sensitization. Inconsistent data on the relation of farming to asthma and wheeze have raised some doubt about a true protective effect. Objective We sought to study the differential effects of farm-associated exposures on specific asthma-related health outcomes. Methods The cross-sectional Prevention of Allergy Risk Factors for Sensitization in Children Related to Farming and Anthroposophic Lifestyle study included 8263 school-age children from rural areas in 5 European countries. Information on farm-related exposures and health outcomes was obtained by using questionnaires. In subsamples allergen-specific IgE and RNA expression of CD14 and Toll-like receptor genes were measured, and dust from children's mattresses was evaluated for microbial components. Results Inverse relations with a diagnosis of asthma were found for pig keeping (odds ratio [OR], 0.57; 95% CI, 0.38-0.86), farm milk consumption (OR, 0.77; 95% CI, 0.60-0.99), frequent stay in animal sheds (OR, 0.71; 95% CI, 0.54-0.95), child's involvement in haying (OR, 0.56; 95% CI, 0.38-0.81), and use of silage (OR, 0.55; 95% CI, 0.31-0.98; for nonatopic asthma) and in Germany for agriculture (OR, 0.34; 95% CI, 0.22-0.53). Protective factors were related with higher expression levels of genes of the innate immunity. Potential risk factors for asthma and wheeze were also identified in the farm milieu. Levels of endotoxin and extracellular polysaccharides were related to the health outcomes independently of the farm exposures. Conclusions The protective effect of being raised in a farm environment was ascribed to distinct exposures. Clinical implications The development of atopic sensitization and atopic and nonatopic asthma is most likely determined by different environmental factors, possibly reflecting distinct pathomechanisms.
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Exposure to agricultural dust, which contains fungi, bacteria, microbial toxins and allergens, and hay handling could be important contributors for increased respiratory symptoms.
“Exposure to agricultural dust, which contains fungi, bacteria, microbial toxins and allergens, and hay handling could be some of the important contributors for these increased respiratory symptoms [9,10].”
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Self-citationHaving lived on a farm and protection against allergic diseases in Australia
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Farm dust and endotoxin protect against allergy through A20 induction in lung epithelial cells
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Self-citationNew insights into the epidemiology of childhood atopic dermatitis
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“Exposure to agricultural dust, which contains fungi, bacteria, microbial toxins and allergens, and hay handling could be some of the important contributors for these increased respiratory symptoms [9,10].”
Background
- Authors
- Ege, M. J., Frei, R., Bieli, C., Schram-Bijkerk, D., Waser, M., Benz, M. R., Weiss, G., Nyberg, F., van Hage, M., Pershagen, G., Brunekreef, B., Riedler, J., Lauener, R., Braun-Fahrländer, C., & von Mutius, E.
- Affiliations
- München Klinik (DE)
- University Children's Hospital Zurich (CH)
- University of Basel (CH)
- University Medical Center Utrecht (NL)
- Karolinska Institutet (SE)
- Corresponding author
- Ege, Markus Johannes
- ORCID
- Venue
- Journal of Allergy and Clinical Immunology
- Publisher
- Elsevier BV
- Published
- 2007-05
- Volume
- 119
- Issue
- 5
- Pages
- 1140-1147
- ISSN
- 0091-6749 (ISSN-L)
- OpenAlex
- W2103517048
- Cited by
- 294
- References
- 2
- Citations by year
- 2026: 2 · 2025: 6 · 2024: 2 · 2023: 8 · 2022: 11 · 2021: 15 · 2020: 17 · 2019: 22 · 2018: 14 · 2017: 18 · 2016: 16 · 2015: 16 · 2014: 19 · 2013: 16 · 2012: 27
- FWCI
- 14.98
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Allergy and Clinical Immunology (publishedVersion)
- PubMed (publishedVersion)
- 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
- farm environment, childhood asthma, wheezing, atopic sensitization, non-allergic asthma, pig farming, haying, silage, endotoxin, exopolysaccharides, innate immunity, Toll-like receptor genes, CD14, specific IgE, mattress dust, rural children
- MeSH terms
- Adolescent, Agriculture, Animals, Animals, Domestic, Asthma, Child, Child, Preschool, Cross-Sectional Studies, Environmental Exposure, Female, Humans, Hypersensitivity, Immunoglobulin E, Male, Respiratory Sounds, Gene Expression, Lipopolysaccharide Receptors, Toll-Like Receptors
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