Asthma and Allergy Research Group, University Children's Hospital, Munich, Germany.
J Allergy Clin Immunol. 2012 Jun;129(6):1470-7.e6. doi: 10.1016/j.jaci.2012.03.013. Epub 2012 Apr 24.
Studies on the association of farm environments with asthma and atopy have repeatedly observed a protective effect of farming. However, no single specific farm-related exposure explaining this protective farm effect has consistently been identified.
We sought to determine distinct farm exposures that account for the protective effect of farming on asthma and atopy.
In rural regions of Austria, Germany, and Switzerland, 79,888 school-aged children answered a recruiting questionnaire (phase I). In phase II a stratified random subsample of 8,419 children answered a detailed questionnaire on farming environment. Blood samples and specific IgE levels were available for 7,682 of these children. A broad asthma definition was used, comprising symptoms, diagnosis, or treatment ever.
Children living on a farm were at significantly reduced risk of asthma (adjusted odds ratio [aOR], 0.68; 95% CI, 0.59-0.78; P< .001), hay fever (aOR, 0.43; 95% CI, 0.36-0.52; P< .001), atopic dermatitis (aOR, 0.80; 95% CI, 0.69-0.93; P= .004), and atopic sensitization (aOR, 0.54; 95% CI, 0.48-0.61; P< .001) compared with nonfarm children. Whereas this overall farm effect could be explained by specific exposures to cows, straw, and farm milk for asthma and exposure to fodder storage rooms and manure for atopic dermatitis, the farm effect on hay fever and atopic sensitization could not be completely explained by the questionnaire items themselves or their diversity.
A specific type of farm typical for traditional farming (ie, with cows and cultivation) was protective against asthma, hay fever, and atopy. However, whereas the farm effect on asthma could be explained by specific farm characteristics, there is a link still missing for hay fever and atopy.
关于农场环境与哮喘和过敏症关联性的研究一再表明，务农具有保护作用。然而，始终未能确定单一特定的与农场相关的暴露因素可以解释这种保护农场效应。
我们旨在确定可以解释务农对哮喘和过敏症的保护作用的不同农场暴露因素。
在奥地利、德国和瑞士的农村地区，79888 名学龄儿童回答了一份招募问卷（第 I 阶段）。在第 II 阶段，8419 名儿童的一个分层随机子样本回答了一份关于农场环境的详细问卷。这些儿童中有 7682 人提供了血液样本和特定 IgE 水平。广泛的哮喘定义包括症状、诊断或曾接受过治疗。
生活在农场的儿童患哮喘（调整后的优势比 [aOR]，0.68；95%CI，0.59-0.78；P<.001）、花粉热（aOR，0.43；95%CI，0.36-0.52；P<.001）、特应性皮炎（aOR，0.80；95%CI，0.69-0.93；P=.004）和特应性致敏（aOR，0.54；95%CI，0.48-0.61；P<.001）的风险显著降低，与非农场儿童相比。尽管这种整体农场效应可以通过对奶牛、稻草和农场牛奶的特定暴露来解释哮喘，通过对饲料储存室和粪便的暴露来解释特应性皮炎，但对花粉热和特应性致敏的农场效应不能完全用问卷项目本身或其多样性来解释。
一种传统农业特有的特定农场类型（即有奶牛和种植）对哮喘、花粉热和过敏症具有保护作用。然而，虽然对哮喘的农场效应可以通过特定的农场特征来解释，但花粉热和过敏症的情况仍然存在差距。
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