Kim J L, Elfman L, Mi Y, Johansson M, Smedje G, Norbäck D
Department of Medical Sciences, Uppsala University and University Hospital, Uppsala, Sweden.
Indoor Air. 2005 Jun;15(3):170-82. doi: 10.1111/j.1600-0668.2005.00334.x.
The aim was to study asthma and allergy in relation to diet and the school environment. Pupils (5-14 years) in eight schools received a questionnaire, 1014 participated (68%). Settled dust was collected on ALK-filters and analyzed for allergens from cat (Fel d 1), dog (Can f 1), horse (Equ cx), house dust mites (Der p 1, Der f 1), and cockroach (Bla g 1) by ELISA. In total, 6.8% reported cat allergy, 4.8% dog allergy, 7.7% doctor's diagnosed asthma and 5.9% current asthma, and 7.8% reported wheeze. Current asthma was less common among those consuming more fresh milk (P < 0.05) and fish (P < 0.01). Poly-unsaturated fatty acids was associated with more wheeze (P < 0.05), olive oil was associated with less doctors' diagnosed asthma (P < 0.05). Totally, 74% of the classrooms had mean CO(2) <1000 ppm. The median concentration per gram dust was 860 ng/g Fel d 1, 750 ng/g Can f 1 and 954 U/g Equ cx. Horse allergen was associated with more wheeze (P < 0.05), daytime breathlessness (P < 0.05), current asthma (P < 0.05) and atopic sensitization (P < 0.05). Dog allergen was associated with wheeze (P < 0.05) and daytime breathlessness (P < 0.05). The associations between allergens and respiratory symptoms were more pronounced among those consuming margarine, not consuming butter, and with a low intake of milk. In conclusion, cat, dog and horse allergens in schools could be a risk factor for asthma and atopic sensitization, and dietary factors may interact with the allergen exposure.
Previous school studies performed by us in mid-Sweden, showed that most classrooms did not fulfill the ventilation standards. In this study, most of the classrooms fulfilled the ventilation standard, but despite that had widespread allergen contamination. Most previous studies have focused on cat allergen, but our study has shown that also dog and horse allergens can be risk factors for asthma and allergy in schools. As allergens are transported from other environments, mainly the home environment, the main prevention should be to minimize transfer of allergens. This could be achieved by reducing contacts with furry pets and horses, or using different clothes at home and at school (e.g. school uniforms). Increased cleaning in the schools may reduce allergen levels, but the efficiency of this measure must be evaluated in further intervention studies. Finally, our study supports the view that dietary habits among pupils should not be neglected and interaction between dietary factors and indoor allergen exposure needs to be further investigated.
目的是研究哮喘和过敏与饮食及学校环境的关系。八所学校的5至14岁学生收到了一份问卷，1014人参与（68%）。在ALK过滤器上收集沉降灰尘，并通过酶联免疫吸附测定法分析猫（Fel d 1）、狗（Can f 1）、马（Equ cx）、屋尘螨（Der p 1、Der f 1）和蟑螂（Bla g 1）的过敏原。总体而言，6.8%的人报告对猫过敏，4.8%对狗过敏，7.7%被医生诊断为哮喘，5.9%为当前哮喘患者，7.8%报告有喘息症状。在饮用更多鲜奶（P < 0.05）和鱼类（P < 0.01）的人群中，当前哮喘不太常见。多不饱和脂肪酸与更多喘息症状相关（P < 0.05），橄榄油与医生诊断的哮喘较少相关（P < 0.05）。总体而言，74%的教室平均二氧化碳浓度<1000 ppm。每克灰尘的中位浓度为860 ng/g Fel d 1、750 ng/g Can f 1和954 U/g Equ cx。马过敏原与更多喘息症状（P < 0.05）、白天呼吸急促（P < 0.05）、当前哮喘（P < 0.05）和特应性致敏（P < 0.05）相关。狗过敏原与喘息症状（P < 0.05）和白天呼吸急促（P < 0.05）相关。在食用人造黄油、不食用黄油且牛奶摄入量低的人群中，过敏原与呼吸道症状之间的关联更为明显。总之，学校中的猫、狗和马过敏原可能是哮喘和特应性致敏的危险因素，饮食因素可能与过敏原暴露相互作用。
我们之前在瑞典中部进行的学校研究表明，大多数教室不符合通风标准。在本研究中，大多数教室符合通风标准，但尽管如此，仍存在广泛的过敏原污染。之前的大多数研究都集中在猫过敏原上，但我们的研究表明，狗和马过敏原也可能是学校中哮喘和过敏的危险因素。由于过敏原是从其他环境（主要是家庭环境）传播而来的，主要预防措施应是尽量减少过敏原的传播。这可以通过减少与毛茸茸的宠物和马的接触，或在家中和学校穿不同的衣服（如校服）来实现。学校增加清洁可能会降低过敏原水平，但这一措施的效果必须在进一步的干预研究中进行评估。最后，我们的研究支持这样一种观点，即学生的饮食习惯不应被忽视，饮食因素与室内过敏原暴露之间的相互作用需要进一步研究。
