EDITORIAL
Childhood allergies, birth order and family size
Childhood allergies, birth order and family size
Correspondence to:
Correspondence to:
Dr P Cullinan
Department of Occupational and Environmental Medicine, Imperial College School of Medicine at the National Heart and Lung Institute, London SW3 6LR, UK; p.cullinan@imperial.ac.uk
Further debate on the explanation for the association between sibship size/birth order and childhood allergic disease
Keywords: hygiene hypothesis; sibship size; birth order; allergic diseases; children
| The first 150 words of the full text of this article appear below. |
Of the 10 plagues visited on the biblical Egyptians, the last was the most terrible; after the rain of frogs, the plague of boils, and the hailstorms came the indiscriminate slaughter of all firstborn animals including children. Infanticide of this degree is thankfully rare—but is it possible that the author(s) of Exodus were expressing a subtler truth?
Studies of birth order—or sibship size—as a risk factor have a long history and have examined a wide variety of diseases. Thus, for example, the rates of Hodgkin’s lymphoma in young adults,1,2 HBsAg+ hepatocellular cancer,3 acute lymphoblastic leukaemia,4 and type I diabetes mellitus5,6 all appear to fall with increasing birth order. In each case the pattern has been assumed to reflect the relatively late age at which children of low birth order (or their mothers during pregnancy) acquire common infections. A similar (but opposite) reasoning has
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