RT Journal Article
SR Electronic
T1 The effects of growing up on a farm on adult lung function and allergic phenotypes: an international population-based study
JF Thorax
JO Thorax
FD BMJ Publishing Group Ltd and British Thoracic Society
SP 236
OP 244
DO 10.1136/thoraxjnl-2015-208154
VO 72
IS 3
A1 B Campbell
A1 C Raherison
A1 C J Lodge
A1 A J Lowe
A1 T Gislason
A1 J Heinrich
A1 J Sunyer
A1 F Gómez Real
A1 D Norbäck
A1 M C Matheson
A1 M Wjst
A1 J Dratva
A1 R de Marco
A1 D Jarvis
A1 V Schlünssen
A1 C Janson
A1 B Leynaert
A1 C Svanes
A1 S C Dharmage
YR 2017
UL http://thorax.bmj.com/content/72/3/236.abstract
AB Rationale Evidence has suggested that exposure to environmental or microbial biodiversity in early life may impact subsequent lung function and allergic disease risk.Objectives To investigate the influence of childhood living environment and biodiversity indicators on atopy, asthma and lung function in adulthood.Methods and measurements The European Community Respiratory Health Survey II investigated ∼10 201 participants aged 26–54 years from 14 countries, including participants' place of upbringing (farm, rural environment or inner city) before age 5 years. A ‘biodiversity score’ was created based on childhood exposure to cats, dogs, day care, bedroom sharing and older siblings. Associations with lung function, bronchial hyper-responsiveness (BHR), allergic sensitisation, asthma and rhinitis were analysed.Main results As compared with a city upbringing, those with early-life farm exposure had less atopic sensitisation (adjusted OR 0.46, 95% CI 0.37 to 0.58), atopic BHR (0.54 (0.35 to 0.83)), atopic asthma (0.47 (0.28 to 0.81)) and atopic rhinitis (0.43 (0.32 to 0.57)), but not non-atopic outcomes. Less pronounced protective effects were observed for rural environment exposures. Women with a farm upbringing had higher FEV1 (adjusted difference 110 mL (64 to 157)), independent of sensitisation and asthma. In an inner city environment, a higher biodiversity score was related to less allergic sensitisation.Conclusions This is the first study to report beneficial effects of growing up on a farm on adult FEV1. Our study confirmed the beneficial effects of early farm life on sensitisation, asthma and rhinitis, and found a similar association for BHR. In persons with an urban upbringing, a higher biodiversity score predicted less allergic sensitisation, but to a lesser magnitude than a childhood farm environment.