Early Exposure to Dogs and Farm Animals and the Risk of Childhood Asthma
Early Exposure to Dogs and Farm Animals and the Risk of Childhood Asthma
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DOI：
10.1001/jamapediatrics.2015.3219
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发表时间：
2015-11-01
期刊：
影响因子：
26.1
通讯作者：
Almqvist, Catarina
中科院分区：
文献类型：
--
作者：
Fall, Tove;Lundholm, Cecilia;Almqvist, Catarina
重要性早期接触动物和儿童哮喘之间的联系尚不清楚，以前的研究已经得出了相互矛盾的结果。目的为了确定接触狗和农场动物是否会导致哮喘的风险。设计，设置和参与者在一项全国性的队列研究中，早期接触狗和农场动物与哮喘风险之间的关系进行了评估，包括自2009年1月以来在瑞典出生的所有儿童。2001年1月1日至2010年12月31日（N = 1 011 051），使用犬和农场登记、哮喘药物、诊断和父母及其子女混杂因素的登记数据。该关联被评估为学龄儿童在6岁时当前诊断为哮喘的比值比（OR）和学龄前儿童在1至5岁时突发哮喘的风险比（HR）。分析了2007年1月1日至2012年9月30日的数据。暴露与狗或农场动物一起生活。主要结果和指标儿童哮喘诊断和使用的药物。结果在研究期间出生的1011051名儿童中，376 638名学龄前儿童（53 460人[14.2%]接触狗，1729人[0.5%]接触农场动物）和276 298名学龄儿童（22 629例[8.2%]暴露于犬，958例[0.3%]暴露于农场动物）被纳入分析。其中，学龄前儿童队列中的18799名儿童（5.0%）在基线前发生哮喘事件，随访期间记录了28511例哮喘病例和906071年的风险（发病率，3.1例/1000年的风险）。在学龄儿童队列中，11585名儿童（4.2%）在生命的第七年经历了哮喘事件。出生后第一年接触狗与学龄儿童哮喘风险降低相关（OR，0.87; 95%CI，0.81-0.93）和3岁或以上学龄前儿童（HR，0.90; 95% CI，0.83-0.99），但3岁以下儿童未发生（HR，1.03; 95% CI，1.00-1.07）。当只分析第一个孩子时，结果是相当的。农场动物暴露与学龄儿童和学龄前儿童哮喘风险降低有关（OR，0.48; 95% CI，0.31-0.76; HR，0.69; 95%CI，0.56-0.84）。结论和相关性在这项研究中，这些数据支持这样一种假设，即在生命的第一年接触狗和农场动物可降低6岁儿童患哮喘的风险。这些信息可能有助于家庭和医生对早期动物暴露的适当性和时间的决策。
IMPORTANCE The association between early exposure to animals and childhood asthma is not clear, and previous studies have yielded contradictory results.OBJECTIVE To determine whether exposure to dogs and farm animals confers a risk of asthma.DESIGN, SETTING AND PARTICIPANTS In a nationwide cohort study, the association between early exposure to dogs and farm animals and the risk of asthma was evaluated and included all children born in Sweden from January 1, 2001, to December 31, 2010 (N = 1 011 051), using registry data on dog and farm registration, asthma medication, diagnosis, and confounders for parents and their children. The association was assessed as the odds ratio (OR) for a current diagnosis of asthma at age 6 years for school-aged children and as the hazard ratio (HR) for incident asthma at ages 1 to 5 years for preschool-aged children. Data were analyzed from January 1, 2007, to September 30, 2012.EXPOSURES Living with a dog or farm animal.MAIN OUTCOMES AND MEASURES Childhood asthma diagnosis and medication used.RESULTS Of the 1 011 051 children born during the study period, 376 638 preschool-aged (53 460 [14.2%] exposed to dogs and 1729 [0.5%] exposed to farm animals) and 276 298 school-aged children (22 629 [8.2%] exposed to dogs and 958 [0.3%] exposed to farm animals) were included in the analyses. Of these, 18 799 children (5.0%) in the preschool-aged children's cohort experienced an asthmatic event before baseline, and 28 511 cases of asthma and 906 071 years at risk were recorded during follow-up (incidence rate, 3.1 cases per 1000 years at risk). In the school-aged children's cohort, 11 585 children (4.2%) experienced an asthmatic event during the seventh year of life. Dog exposure during the first year of life was associated with a decreased risk of asthma in school-aged children (OR, 0.87; 95% CI, 0.81-0.93) and in preschool-aged children 3 years or older (HR, 0.90; 95% CI, 0.83-0.99) but not in children younger than 3 years (HR, 1.03; 95% CI, 1.00-1.07). Results were comparable when analyzing only first-born children. Farm animal exposure was associated with a reduced risk of asthma in both school-aged children and preschool-aged children (OR, 0.48; 95% CI, 0.31-0.76, and HR, 0.69; 95% CI, 0.56-0.84), respectively.CONCLUSIONS AND RELEVANCE In this study, the data support the hypothesis that exposure to dogs and farm animals during the first year of life reduces the risk of asthma in children at age 6 years. This information might be helpful in decision making for families and physicians on the appropriateness and timing of early animal exposure.