期刊
出版社
MDPI AG
DOI: 10.3390/ijerph13010093
关键词
asthma; early life environment; farming; microbial exposure; urban-rural gradient; hygiene hypothesis; RHINE
资金
- Faculty of Health, Aarhus University, Denmark [240008]
- Wood Dust Foundation [444508795]
- Danish Lung Association
- Swedish Heart and Lung Foundation
- Swedish Association Against Asthma and Allergy
- Swedish Association against Heart and Lung Disease
- Swedish Council for Working Life and Social Research
- Bror Hjerpstedt Foundation
- Vardal Foundation for Health Care and Allergic Researce
- Norwegian Research Council [135773/330]
- Norwegian Asthma and Allergy Association
- Icelandic Research Council
- Estonian Science Foundation [4350]
The early life environment appears to have a persistent impact on asthma risk. We hypothesize that environmental factors related to rural life mediate lower asthma prevalence in rural populations, and aimed to investigate an urban-rural gradient, assessed by place of upbringing, for asthma. The population-based Respiratory Health In Northern Europe (RHINE) study includes subjects from Denmark, Norway, Sweden, Iceland and Estonia born 1945-1973. The present analysis encompasses questionnaire data on 11,123 RHINE subjects. 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. The association of place of upbringing with asthma onset was analysed with Cox regression adjusted for relevant confounders. Subjects growing up on livestock farms had less asthma (8%) than subjects growing up in inner cities (11%) (hazard ratio 0.72 95% CI 0.57-0.91), and a significant urban-rural gradient was observed across six urbanisation levels (p = 0.02). An urban-rural gradient was only evident among women, smokers and for late-onset asthma. Analyses on wheeze and place of upbringing revealed similar results. In conclusion, this study suggests a protective effect of livestock farm upbringing on asthma development and an urban-rural gradient in a Northern European population.
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