House John S, Wyss Annah B, Hoppin Jane A, Richards Marie, Long Stuart, Umbach David M, Henneberger Paul K, Beane Freeman Laura E, Sandler Dale P, Long O'Connell Elizabeth, Barker-Cummings Christie, London Stephanie J
Division of Intramural Research, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC.
Division of Intramural Research, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC; Department of Biological Sciences, Center for Human Health and the Environment, North Carolina State University, Raleigh, NC.
J Allergy Clin Immunol. 2017 Jul;140(1):249-256.e14. doi: 10.1016/j.jaci.2016.09.036. Epub 2016 Nov 12.
Previous studies, mostly from Europe, suggest that early-life farming exposures protect against childhood asthma and allergy; few data exist on asthma and allergy in adults.
We sought to examine associations between early-life farming exposures and current asthma and atopy in an older adult US farming population.
We analyzed data from 1746 farmers and 1555 spouses (mean age, 63) from a case-control study nested within the Agricultural Health Study. Current asthma and early-life farming exposures were assessed via questionnaires. We defined atopy based on specific IgE > 0.70 IU/mL to at least 1 of 10 allergens measured in blood. We used logistic regression, adjusted for age, sex, race, state (Iowa or North Carolina), and smoking (pack years), to estimate associations between early-life exposures and asthma (1198 cases and 2031 noncases) or atopy (578 cases and 2526 noncases).
Exposure to the farming environment in utero and in early childhood had little or no association with asthma but was associated with reduced odds of atopy. The strongest association was seen for having a mother who performed farm activities while pregnant (odds ratio, 0.60; 95% CI, 0.48-0.74) and remained significant in models with correlated early-life exposures including early childhood farm animal contact and raw milk consumption.
In a large US farming population, early-life farm exposures, particularly maternal farming activities while pregnant, were strongly associated with reduced risk of atopy in adults. These results extend previous work done primarily on childhood outcomes and suggest that protective associations of early-life farming exposures on atopy endure across the life course.
此前的研究大多来自欧洲，表明早年接触农业环境可预防儿童哮喘和过敏；关于成人哮喘和过敏的数据较少。
我们试图在美国老年农业人口中研究早年接触农业环境与当前哮喘和特应性之间的关联。
我们分析了农业健康研究中一项病例对照研究的1746名农民和1555名配偶（平均年龄63岁）的数据。通过问卷调查评估当前哮喘和早年接触农业环境的情况。我们根据血液中检测的10种过敏原中至少1种的特异性IgE>0.70 IU/mL来定义特应性。我们使用逻辑回归，对年龄、性别、种族、州（爱荷华州或北卡罗来纳州）和吸烟（包年数）进行调整，以估计早年接触与哮喘（1198例病例和2031例非病例）或特应性（578例病例和2526例非病例）之间的关联。
子宫内和幼儿期接触农业环境与哮喘几乎没有关联，但与特应性几率降低有关。最强的关联见于母亲在怀孕期间从事农场活动（比值比，0.60；95%CI，0.48 - 0.74），并且在包括幼儿期接触农场动物和饮用生牛奶等相关早年接触的模型中仍然显著。
在美国的一大群农业人口中，早年接触农场环境，特别是母亲在怀孕期间从事农场活动，与成人特应性风险降低密切相关。这些结果扩展了之前主要针对儿童结局的研究工作，并表明早年接触农业环境对特应性的保护关联在整个生命过程中持续存在。
