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Mikkelsen S, Dinh KM, Boldsen JK, Pedersen OB, Holst GJ, Petersen MS, Kaspersen KA, Møller BK, Nielsen KR, Paarup HM, Rostgaard K, Hjalgrim H, Sørensen E, Handgaard LJ, Hansen TF, Banasik K, Burgdorf KS, Ullum H, Sigsgaard T, Erikstrup C. Combinations of self-reported rhinitis, conjunctivitis, and asthma predicts IgE sensitization in more than 25,000 Danes. Clin Transl Allergy 2021; 11:e12013. [PMID: 33900050 PMCID: PMC8099331 DOI: 10.1002/clt2.12013] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 02/12/2021] [Accepted: 02/17/2021] [Indexed: 12/01/2022] Open
Abstract
Background Allergic rhinitis (AR), allergic conjunctivitis (AC), and asthma composing multiple phenotypes and improved understanding of these phenotypes and their respective risk factors are needed. Objectives The objective of this study was to define the prevalence of AR, AC, and asthma and their association with allergen‐specific immunoglobulin E (sIgE) sensitization in a large cohort of blood donors and identify risk factors. Methods From the nationwide population‐based Danish Blood Donor Study, 52,976 participants completed an electronic questionnaire including AR, AC, asthma, allergic predisposition, and childhood residence. Of these, 25,257 were additionally tested for sIgE to inhalation allergens (Phadiatop). Results The prevalence of sIgE sensitization, AR, AC, and asthma was 30%, 19%, 15%, and 9%, respectively. The youngest birth cohorts had the highest prevalence of sIgE sensitization and symptoms of asthma, AR, and AC, and for asthma, they apparently experienced symptoms at an earlier age. The sIgE sensitization was positively associated with male sex. The sIgE seroprevalence was higher in participants with both AR and AC (ARC) than in participants with either AR or AC. Allergic predisposition and sIgE sensitization increased the risk of the diseases, while farm upbringing was associated with reduced prevalence of ARC, however, only in sIgE sensitized participants. Conclusion Birth year, childhood residence, sIgE sensitization, and allergic predisposition were associated with asthma, AR, and AC prevalence. Individuals with self‐reported ARC represent a primarily sIgE‐positive phenotype, while those with either AR or AC represent more diverse phenotypes.
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Affiliation(s)
- Susan Mikkelsen
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
| | - Khoa Manh Dinh
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
| | - Jens Kjaergaard Boldsen
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark.,Danish Big Data Centre for Environment and Health (BERTHA), Aarhus University, Roskilde, Denmark
| | - Ole Birger Pedersen
- Department of Clinical Immunology, Zealand University Hospital, Køge, Denmark
| | - Gitte Juel Holst
- The Danish Clinical Quality Program-National Clinical Registries (RKKP), Central Denmark Region, Aarhus, Denmark
| | | | - Kathrine Agergård Kaspersen
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark.,Danish Big Data Centre for Environment and Health (BERTHA), Aarhus University, Roskilde, Denmark
| | - Bjarne Kuno Møller
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
| | - Kaspar Rene Nielsen
- Department of Clinical Immunology, Aalborg University Hospital, Aalborg, Denmark
| | | | - Klaus Rostgaard
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
| | - Henrik Hjalgrim
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
| | - Erik Sørensen
- Department of Clinical Immunology, Copenhagen University Hospital, Copenhagen, Denmark
| | - Linda Jenny Handgaard
- Department of Clinical Immunology, Copenhagen University Hospital, Copenhagen, Denmark
| | - Thomas Folkmann Hansen
- Department of Neurology, Danish Headache Center, Copenhagen University Hospital, Glostrup, Denmark.,Faculty of Health and Medical Sciences, Novo Nordisk Foundation Center for Protein Research, University of Copenhagen, Copenhagen, Denmark
| | - Karina Banasik
- Faculty of Health and Medical Sciences, Novo Nordisk Foundation Center for Protein Research, University of Copenhagen, Copenhagen, Denmark
| | | | - Henrik Ullum
- Department of Clinical Immunology, Copenhagen University Hospital, Copenhagen, Denmark.,Statens Serum Institut, Copenhagen, Denmark
| | - Torben Sigsgaard
- Danish Big Data Centre for Environment and Health (BERTHA), Aarhus University, Roskilde, Denmark.,Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Christian Erikstrup
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark.,Danish Big Data Centre for Environment and Health (BERTHA), Aarhus University, Roskilde, Denmark
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Wjst M. Allergy protection at farms-just a myth? IMMUNITY INFLAMMATION AND DISEASE 2020; 9:74-75. [PMID: 33200546 PMCID: PMC7860597 DOI: 10.1002/iid3.378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 10/01/2020] [Accepted: 10/15/2020] [Indexed: 12/01/2022]
Affiliation(s)
- Matthias Wjst
- Institute of Lung Biology and Disease, Helmholtz Zentrum Muenchen, German Research Center for Environmental Health (GmbH), München, Germany.,Institut für Medizinische Informatik, Statistik und Epidemiologie, Technische Universität München, München, Germany
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3
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Asthma and selective migration from farming environments in a three-generation cohort study. Eur J Epidemiol 2019; 34:601-609. [PMID: 30729356 DOI: 10.1007/s10654-019-00491-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Accepted: 01/29/2019] [Indexed: 10/27/2022]
Abstract
Individuals raised on a farm appear to have less asthma than individual raised elsewhere. However, selective migration might contribute to this as may also the suggested protection from farm environment. This study investigated if parents with asthma are less likely to raise their children on a farm. This study involved three generations: 6045 participants in ECRHS/RHINE cohorts (born 1945-1973, denoted G1), their 10,121 parents (denoted G0) and their 8260 offspring participating in RHINESSA (born 1963-1998, denoted G2). G2-offspring provided information on parents not participating in ECRHS/RHINE. Asthma status and place of upbringing for all three generations were reported in questionnaires by G1 in 2010-2012 and by G2 in 2013-2016. Binary regressions with farm upbringing as outcome were performed to explore associations between parental asthma and offspring farm upbringing in G0-G1 and G1-G2. Having at least one parent with asthma was not associated with offspring farm upbringing, either in G1-G2 (RR 1.11, 95% CI 0.81-1.52) or in G0-G1 (RR 0.99, 0.85-1.15). G1 parents with asthma born in a city tended to move and raise their G2 offspring on a farm (RR 2.00, 1.12-3.55), while G1 parents with asthma born on a farm were less likely to raise their G2 offspring on a farm (RR 0.34, 0.11-1.06). This pattern was not observed in analyses of G0-G1. This study suggests that the protective effect from farm upbringing on subsequent asthma development could not be explained by selective migration. Intriguingly, asthmatic parents appeared to change environment when having children.
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Christensen SH, Timm S, Janson C, Benediktsdóttir B, Forsberg B, Holm M, Jogi R, Johannessen A, Omenaas E, Sigsgaard T, Svanes C, Schlünssen V. A clear urban-rural gradient of allergic rhinitis in a population-based study in Northern Europe. Eur Clin Respir J 2016; 3:33463. [PMID: 27890047 PMCID: PMC5124633 DOI: 10.3402/ecrj.v3.33463] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Accepted: 11/01/2016] [Indexed: 01/08/2023] Open
Abstract
Background The protective effect of farm upbringing on allergic rhinitis is well known, but how upbringing in other environments influences the development of allergic rhinitis is scarcely investigated. The aim of this study was to investigate the association between place of upbringing and pet keeping in childhood and allergic rhinitis and nasal symptoms in adulthood. Methods The population-based Respiratory Health in Northern Europe study includes subjects from Denmark, Norway, Sweden, Iceland, and Estonia born in 1945–1973. This paper analyses 13,376 participants of the third study wave. Six categories of place of upbringing were defined: farm with livestock, farm without livestock, village in rural area, small town, city suburb, and inner city. Pets in the home at birth and during childhood were recorded. Data were analysed using adjusted logistic regression models. Results Livestock farm upbringing predicted less adult allergic rhinitis [odds ratio (OR) 0.68, 0.54–0.85] and nasal symptoms (OR 0.82, 0.68–0.99) than city upbringing, and an urban–rural gradient with decreasing risk per level of urbanisation was observed (OR 0.92, 0.88–0.94). Pets in the home at birth (OR 0.78, 0.68–0.88) and during childhood (OR 0.83, 0.74–0.93) were associated with less subsequent allergic rhinitis. Pet keeping did not explain the protective effect of place of upbringing. Conclusion Risk of allergic rhinitis and nasal symptoms in adulthood was inversely associated with the level of urbanisation during upbringing. Pets at birth decreased the risk further, but did not explain the urban–rural gradient. Persistent beneficial effects of microbial diversity in early life might be an explanation for the findings.
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Affiliation(s)
- Stine Holmegaard Christensen
- Department of Public Health, Section for Environment, Occupation and Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark
| | - Signe Timm
- Department of Public Health, Section for Environment, Occupation and Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark
| | - Christer Janson
- Department of Medical Sciences: Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
| | | | - Bertil Forsberg
- Division of Occupational and Environmental Medicine, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Mathias Holm
- Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Rain Jogi
- Lung Clinic, Tartu University Hospital, Tartu, Estonia
| | - Ane Johannessen
- Centre for Clinical Research, Haukeland University Hospital, Bergen, Norway
| | - Ernst Omenaas
- Centre for Clinical Research, Haukeland University Hospital, Bergen, Norway
| | - Torben Sigsgaard
- Department of Public Health, Section for Environment, Occupation and Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark
| | - Cecilie Svanes
- Centre for Clinical Research, Haukeland University Hospital, Bergen, Norway.,Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway
| | - Vivi Schlünssen
- Department of Public Health, Section for Environment, Occupation and Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark.,National Research Centre for the Working Environment, Copenhagen, Denmark;
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Rennie DC, Karunanayake CP, Chen Y, Lawson JA, Hagel L, Senthilselvan A, Pahwa P, Dosman JA. Early farm residency and prevalence of asthma and hay fever in adults. J Asthma 2015; 53:2-10. [PMID: 26377166 DOI: 10.3109/02770903.2015.1058394] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Asthma and hay fever have been found to be both positively and negatively associated with farming lifestyles in adulthood. Lack of congruency may depend upon early life exposure. OBJECTIVE To assess the importance of different periods of farm residency for asthma and hay fever in an adult Canadian population. METHODS We conducted a questionnaire survey in rural Saskatchewan, Canada. We assessed a history of asthma and hay fever with five categories of farm residency that were mutually exclusive: first year of life only, currently living on a farm, both first year of life and currently living on a farm, other farm living, and no farm living. Generalized estimating equations were used to adjust for clustering effects of adults within households. RESULTS Of the 7148 responding, 30.6% had an early farm living experience only, 34.4% had both early and current farm living experiences, while 17.4% had never lived on a farm. The overall prevalence of ever asthma and hay fever was 8.6% and 12.3%, respectively, and was higher in women. Sex modified the associations between ever asthma and hay fever with farm residency variables whereby women had a decreased risk for both asthma [adjusted odds ratio (ORadj): 0.67, 95% confidence interval (CI):0.47-0.96] and hay fever (ORadj: 0.60, 95% CI: 0.44-0.83) with an early farm exposure only. Men currently living on a farm without an early farm exposure had an increased risk for ever asthma (ORadj: 1.82, 95% CI: 1.02-3.24). CONCLUSION Farm residency in the first year of life shows a protective effect for adult asthma and hay fever that appears to differ by sex.
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Affiliation(s)
- Donna C Rennie
- a Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan , Saskatoon , Saskatchewan , Canada .,b College of Nursing, University of Saskatchewan , Saskatoon , Saskatchewan , Canada
| | - Chandima P Karunanayake
- a Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan , Saskatoon , Saskatchewan , Canada
| | - Yue Chen
- c Department of Epidemiology and Community Medicine, Faculty of Medicine , University of Ottawa , Ottawa , Ontario , Canada
| | - Joshua A Lawson
- a Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan , Saskatoon , Saskatchewan , Canada .,d Department of Medicine , University of Saskatchewan , Saskatoon , Saskatchewan , Canada
| | - Louise Hagel
- a Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan , Saskatoon , Saskatchewan , Canada
| | | | - Punam Pahwa
- a Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan , Saskatoon , Saskatchewan , Canada .,f Department of Community Health and Epidemiology , University of Saskatchewan , Saskatoon , Saskatchewan , Canada
| | - James A Dosman
- a Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan , Saskatoon , Saskatchewan , Canada .,d Department of Medicine , University of Saskatchewan , Saskatoon , Saskatchewan , Canada
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Spierenburg EAJ, Smit LAM, Heederik D, Robbe P, Hylkema MN, Wouters IM. Healthy worker survivor analysis in an occupational cohort study of Dutch agricultural workers. Int Arch Occup Environ Health 2015; 88:1165-73. [PMID: 25795169 PMCID: PMC4608974 DOI: 10.1007/s00420-015-1047-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Accepted: 03/05/2015] [Indexed: 12/04/2022]
Abstract
Objectives
High microbial exposures in farmers and agricultural workers are associated with less atopy. Although it has been speculated that healthy worker survival could be an explanation, this has not been studied so far. Therefore, we investigated the presence of healthy worker survival in a five-year follow-up study of an occupational cohort of Dutch farmers and agricultural industry (company) workers. Methods We compared baseline demographic characteristics, respiratory health, atopy and endotoxin exposure of 259 workers followed up with 124 workers lost to follow-up. Additionally, baseline health status of 31 participants who had changed to lower exposure jobs at follow-up was compared to those with similar or higher exposure jobs at follow-up. Results In general, no major healthy worker survival effect was found. Nonetheless, small differences were observed between subjects included in follow-up and those lost to follow-up. Those lost to follow-up were older, had a lower peak expiratory flow, and were less often raised on a farm. Company workers lost to follow-up with a farm childhood had more often self-reported allergy, but this was not observed for subjects with atopic sensitization or other respiratory symptoms. No differences were found for any of the studied characteristics in participants with lower exposure at follow-up compared to participants with similar or higher exposure at follow-up. Conclusions No major healthy worker survival is present in this organic dust exposed cohort. Differences between participants lost to follow-up and participants included in follow-up with regard to health characteristics are small and unlikely to explain the previously reported inverse associations between endotoxin exposure and atopy. Electronic supplementary material The online version of this article (doi:10.1007/s00420-015-1047-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- E A J Spierenburg
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands.
| | - L A M Smit
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - D Heederik
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - P Robbe
- Department of Pathology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,Groningen Research Institute for Asthma and COPD (GRIAC), University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - M N Hylkema
- Department of Pathology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,Groningen Research Institute for Asthma and COPD (GRIAC), University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - I M Wouters
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
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7
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Rodriquez EJ, Stoecklin-Marois MT, Bennett DH, Tancredi DJ, Schenker MB. Agricultural work exposures and pulmonary function among hired farm workers in California (the MICASA study). J Agromedicine 2014; 19:427-36. [PMID: 25275408 PMCID: PMC11024960 DOI: 10.1080/1059924x.2014.945709] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Despite California's dependence on hired farm labor, scarce research has been conducted on the respiratory health of hired farm workers. Agricultural exposures to inorganic and organic dusts can adversely affect an individual's respiratory health and differ by farm type and job task. The purpose of the present analysis was to examine associations between agricultural work exposures and pulmonary function among 450 California farm workers. Data were collected as part of the Mexican Immigration to California: Agricultural Safety and Acculturation (MICASA) study, a prospective cohort study examining occupational risk factors and health of hired farm worker families in Mendota, California. Time-weighted self-reported average (TWSRA) dust scores were calculated from assessments of past-12-month agricultural work history. Other dust exposure indicator variables included months worked in agriculture in the past 12 months and years worked in agriculture. Multiple linear regression modeled FEV1 (forced expiratory volume in 1 second), FEF(25-75%) (forced midexpiratory flow rate), FVC (forced vital capacity), FEV6, FEV1/FVC, and FEV1/FEV6 separately. Seventy-six percent of participants had worked in agriculture in the past year. In models conducted for crops and tasks separately, high TWSRA dust score was associated with better FEV6. Crop and task models showed associations between greater months worked in agriculture in the past year and better FEV1, FEF(25-75%), and FEV6. Both models also found greater years worked in agriculture to be associated with worse FEV1/FEV6. Results were generally in the opposite direction as expected given past research but not uncommon. Future research should investigate relationships between pulmonary function and agricultural dust exposure over a lifetime and changes in pulmonary function over time.
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Affiliation(s)
- Erik J Rodriquez
- a Center for Tobacco Control Research and Education , University of California, San Francisco , San Francisco , California , USA
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Mounchetrou IN, Monnet E, Laplante JJ, Dalphin JC, Thaon I. Predictors of early cessation of dairy farming in the French Doubs province: 12-year follow-up. Am J Ind Med 2012; 55:136-42. [PMID: 22069061 DOI: 10.1002/ajim.21031] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/07/2011] [Indexed: 11/06/2022]
Abstract
BACKGROUND A healthy worker effect due to respiratory disability has been noted in the farming population, but other factors may also interfere. Little has been published about factors influencing the early cessation of work in self-employed dairy farmers. METHODS Two hundred and nineteen dairy farmers were included from a cohort constituted in eastern France in 1993-1994 with a 12-year follow-up. Spirometric data, personal, and farm characteristics were registered. Cox models with delayed entry in which age was the time-scale were applied to identify the baseline predictive factors of the early cessation of dairy farming. RESULTS Working in a modern farm was protective against early cessation of dairy farming (hazard ratio: 0.36 [95% CI: 0.16-0.81]), especially in men. Having asthma was a predictive factor of early cessation, especially in women (hazard ratio: 16.12 [95% CI: 3.28-79.12]). CONCLUSIONS The most predictive factors of early cessation of dairy farming were health related in women and farm related in men.
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Affiliation(s)
- Ibrahim Njoya Mounchetrou
- Service de Maladies Professionnelles, Centre Hospitalier Universitaire de Nancy, rue du Morvan, Vandoeuvre lès Nancy, France
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9
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Smit LAM, Zuurbier M, Doekes G, Wouters IM, Heederik D, Douwes J. Hay fever and asthma symptoms in conventional and organic farmers in The Netherlands. Occup Environ Med 2006; 64:101-7. [PMID: 17018582 PMCID: PMC2078430 DOI: 10.1136/oem.2006.028167] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Farming has been associated with respiratory symptoms and with protection against atopy. To date, effects of organic farming on respiratory health have not been studied. AIMS To (1) compare hay fever and asthma-like symptoms in organic and conventional farmers and (2) assess associations between current and childhood farm exposures and respiratory health effects by conducting a survey. METHODS Questionnaire data from 1205 conventional and 593 organic farmers were evaluated. Associations between health effects and farm exposures were assessed by logistic regression analyses. RESULTS Organic farmers reported less wheezing with shortness of breath and slightly more hay fever than conventional farmers. However, organic farming was not an independent determinant of hay fever when adjusted for farming practices and potential confounders. Livestock farmers who grew up on a farm had a threefold lower prevalence of hay fever than crop farmers without a farm childhood (odds ratio (OR) 0.3, 95% confidence interval (CI) 0.1 to 0.5). Both crop farmers who grew up on a farm and livestock farmers who did not grow up on a farm had a reduced prevalence, although less pronounced and not statistically significant. Use of disinfectants containing quaternary ammonium compounds was positively related to hay fever (OR 2.1, 95% CI 1 to 4.4). No effects of farming practices were found for asthma. CONCLUSIONS Our study adds to the evidence that a farm childhood in combination with current livestock farming protects against allergic disorders. This effect was found for both organic and conventional farmers.
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Affiliation(s)
- Lidwien A M Smit
- Institute for Risk Assessment Sciences, Division of Environmental Epidemiology, Utrecht University, Utrecht, The Netherlands.
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