Which factors explain the lower prevalence of atopy amongst farmers' children?

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Clinical & Experimental Allergy
Volume 33 Issue 4 Page 427 - April 2003

Which factors explain the lower prevalence of atopy amongst farmers' children?

S. T. Remes*

, K. Iivanainen, H. Koskela and J. Pekkanen

Background The inverse association between farming and atopy in children has been attributed to microbial exposure, especially through livestock. Very little is known about other potential explanatory factors.

Objective To explore potential differences in lifestyle and environmental factors between farmer and non-farmer families, and whether these factors could explain the association between farming and childhood atopy.

Methods A cross-sectional study, including 366 farmers' and 344 non-farmers' children in eastern Finland. Information regarding exposure and background characteristics was gathered by a written questionnaire. Atopy was defined as having one or more positive skin prick test reactions (> 3 mm) against the six common aeroallergens.

Results Regardless of the current farming type, atopy was less frequent among the farmers' children than the non-farmers' children (aOR 0.56, 95% CI 0.40-0.78). Remarkable differences were seen in many lifestyle factors (including diet) between the farmer and non-farmer families, but only a few of the explored factors were associated with atopy. The frequency of current livestock contacts seemed to have an inverse, dose-dependent association with atopy (aOR 0.46, 95% CI 0.22-0.97 for daily vs. no contact). Having lived on a dairy farm in infancy (aOR 0.51, 95% CI 0.28-0.93), or having had cats or dogs in infancy (aOR 0.60, 95% CI 0.42-0.85), decreased the risk of atopy at school age. The inverse association between farming and atopy was not explained by the sociodemographic factors, or by differences in conventional risk factors of atopy. Animal contacts explained partially, but not completely, the association.

Conclusion Higher frequency of animal contacts is one factor, but probably not the only one, explaining the inverse association of farming and atopy in children. The importance of early life exposures may have recently been over-emphasized, and current exposures discounted, when studying the risk factors of childhood atopy.

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Authors:

S. T. Remes

K. Iivanainen

H. Koskela

J. Pekkanen

Keywords

atopy

children

epidemiology

farm

risk factors

skin prick test

Submitted 14 May 2002; revised 16 September 2002; accepted 25 September 2002

Affiliations

*Department of Pediatrics, Kuopio University Hospital,Unit of Environmental Epidemiology, National Public Health Institute andDepartment of Respiratory Medicine, Kuopio University Hospital, Kuopio, Finland

Correspondence

Correspondence: Sami T. Remes, Unit of Environmental Epidemiology, National Public Health Institute, PO Box 95, 70701 Kuopio, Finland. E-mail: Sami.Remes@ktl.fi

To cite this article
Remes, S. T., Iivanainen, K., Koskela, H. & Pekkanen, J.
Which factors explain the lower prevalence of atopy amongst farmers' children?.
Clinical & Experimental Allergy 33 (4), 427-434.
doi: 10.1046/
j.1365-2222.2003.01566.x

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