Alfvén T, Braun-Fahrländer C, Brunekreef B, von Mutius E, Riedler J, Scheynius A, van Hage M, Wickman M, Benz M R, Budde J, Michels K B, Schram D, Ublagger E, Waser M, Pershagen G
Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
Allergy. 2006 Apr;61(4):414-21. doi: 10.1111/j.1398-9995.2005.00939.x.
The prevalence of allergic diseases has increased rapidly in recent decades, particularly in children. For adequate prevention it is important not only to identify risk factors, but also possible protective factors. The aim of this study was to compare the prevalence of allergic diseases and sensitization between farm children, children in anthroposophic families, and reference children, with the aim to identify factors that may protect against allergic disease.
The study was of cross-sectional design and included 14,893 children, aged 5-13 years, from farm families, anthroposophic families (recruited from Steiner schools) and reference children in Austria, Germany, The Netherlands, Sweden and Switzerland. A detailed questionnaire was completed and allergen-specific IgE was measured in blood.
Growing up on a farm was found to have a protective effect against all outcomes studied, both self-reported, such as rhinoconjunctivitis, wheezing, atopic eczema and asthma and sensitization (allergen specific IgE > or = 0.35 kU/l). The adjusted odds ratio (OR) for current rhinoconjunctivitis symptoms was 0.50 (95% confidence interval (CI) 0.38-0.65) and for atopic sensitization 0.53 (95% CI 0.42-0.67) for the farm children compared to their references. The prevalence of allergic symptoms and sensitization was also lower among Steiner school children compared to reference children, but the difference was less pronounced and not as consistent between countries, adjusted OR for current rhinoconjunctivitis symptoms was 0.69 (95% CI 0.56-0.86) and for atopic sensitization 0.73 (95% CI 0.58-0.92).
This study indicates that growing up on a farm, and to a lesser extent leading an anthroposophic life style may confer protection from both sensitization and allergic diseases in childhood.
近几十年来，过敏性疾病的患病率迅速上升，尤其是在儿童中。为了进行充分的预防，不仅识别风险因素很重要，识别可能的保护因素也同样重要。本研究的目的是比较农场儿童、人智学家庭儿童和对照儿童之间过敏性疾病和致敏的患病率，以确定可能预防过敏性疾病的因素。
本研究采用横断面设计，纳入了来自奥地利、德国、荷兰、瑞典和瑞士的14893名5至13岁的儿童，这些儿童分别来自农场家庭、人智学家庭（从施泰纳学校招募）和对照儿童。完成了一份详细的问卷，并测量了血液中的过敏原特异性IgE。
研究发现，在农场长大对所有研究结果都有保护作用，包括自我报告的结果，如鼻结膜炎、喘息、特应性皮炎和哮喘以及致敏（过敏原特异性IgE>或=0.35 kU/l）。与对照儿童相比，农场儿童当前鼻结膜炎症状的调整优势比（OR）为0.50（95%置信区间（CI）0.38 - 0.65），特应性致敏的调整优势比为0.53（95%CI 0.42 - 0.67）。与对照儿童相比，施泰纳学校儿童的过敏症状和致敏患病率也较低，但差异不太明显，且在不同国家之间不太一致，当前鼻结膜炎症状的调整OR为0.69（95%CI 0.56 - 0.86），特应性致敏的调整OR为0.73（95%CI 0.58 - 0.92）。
本研究表明，在农场长大，以及在较小程度上遵循人智学的生活方式，可能对儿童期的致敏和过敏性疾病具有保护作用。
