Lifelong farm exposure may strongly reduce the risk of asthma in adults
Lifelong farm exposure may strongly reduce the risk of asthma in adults
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DOI：
10.1111/j.1398-9995.2007.01490.x
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发表时间：
2007-10-01
期刊：
影响因子：
12.4
通讯作者：
Pearce, N.
中科院分区：
文献类型：
--
作者：
Douwes, J.;Travier, N.;Pearce, N.
背景：农场暴露可以预防儿童哮喘、花粉热和湿疹。农场暴露是否也对成年农民产生保护作用尚不清楚。此外，人们对暴露时间的作用知之甚少。我们评估了当前和儿童期农场暴露对农民和农村非农业对照人群哮喘、花粉热和湿疹的影响。方法：我们对2509个农民家庭进行了横断面问卷调查（回答率78%）和1001个非农业家庭结果：农民哮喘、花粉热、湿疹的发生率较低;在奶制品、绵羊和牛肉以及园艺农民之间没有观察到显著差异。当前和儿童期接触的组合与呼吸急促的关系更密切（OR 0.50，CL 0.39-0.66），喘息（OR 0.60，CL 0.49-0.73），哮喘药物（OR 0.48，CL 0.37-0.63）;和哮喘（OR 0.56，CL 0.46-0.68）（分别为OR 0.63，CL 0.47-0.84; OR 0.80，CL 0.65-0.99; OR 0.68，CL 0.51-0.9; OR 0.69，CL 0.56-0.85）或儿童期单独暴露（OR 0.97，CL 0.65 -1.44; OR 1.01，CL 0.75-1.34; OR 0.78，CL 0.51-1.19; OR 0.87，CL 0.63-1.19）。此外，在童年和成年的农场暴露的年数的组合显示出剂量依赖性的负相关与症状prevalence.Conclusions：虽然目前和童年农场暴露可能发挥作用，在观察到的低患病率的哮喘症状在成年农民，持续的长期暴露可能需要保持最佳的保护。
Background: Farm exposures may protect against childhood asthma, hay fever and eczema. Whether farm exposures also confer protection in adult farmers remains unclear. Moreover, little is known about the role of timing of exposure. We assessed the effects of current and childhood farm exposures on asthma, hay fever and eczema in farmers and a rural nonfarming control population.Methods: We conducted a cross-sectional questionnaire survey in 2509 farming families (response rate 78%) and 1001 nonfarming families (response rate 67%), which included 4288 farmers and 1328 nonfarmers.Results: Farmers were less likely to have asthma symptoms, hay fever and eczema; no significant differences were observed among dairy, sheep and beef, and horticulture farmers. A combination of current and childhood exposure was more strongly associated with shortness of breath (OR 0.50, CL 0.39-0.66), wheeze (OR 0.60, CL 0.49-0.73), asthma medication (OR 0.48, CL 0.37-0.63); and asthma ever (OR 0.56, CL 0.46-0.68) than current exposure alone (OR 0.63, CL 0.47-0.84; OR 0.80, CL 0.65-0.99; OR 0.68, CL 0.51-0.9; OR 0.69, CL 0.56-0.85 respectively) or childhood exposure alone (OR 0.97, CL0.65-1.44; OR 1.01, CL 0.75-1.34; OR 0.78, CL 0.51-1.19; OR 0.87, CL 0.63-1.19 respectively). Moreover, the combined number of years of farm exposure in childhood and adulthood showed a dose-dependent inverse association with symptom prevalence.Conclusions: Although both current and childhood farm exposures may play a role in the observed low prevalence of asthma symptoms in adult farmers, continued long-term exposure may be required to maintain optimal protection.