Markevych I, Baumbach C, Standl M, Koletzko S, Lehmann I, Bauer C-P, Hoffmann B, von Berg A, Berdel D, Heinrich J
Institute of Epidemiology I, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany.
Division of Metabolic and Nutritional Medicine, Dr. von Hauner Children's Hospital, Ludwig-Maximilians-University of Munich, Munich, Germany.
Clin Exp Allergy. 2017 Mar;47(3):395-400. doi: 10.1111/cea.12891. Epub 2017 Feb 13.
Westernized lifestyle has been blamed for allergy epidemics. One of its characteristics is increased distances and frequency of travelling from early life onwards. Early life travelling to places which substantially differ from home environment in terms of climate, vegetation and food could increase the exposure to further unknown allergens and hence promote the development of allergies, but no epidemiological study has investigated this speculation.
Detailed data on travelling during the first 2 years of life as well as a range of atopic outcomes along with potential confounders up to age 15 years were collected prospectively within two large population-based multicentre German birth cohorts - GINIplus and LISAplus. Farthest travelling destination (within Germany; middle/northern/eastern Europe; southern Europe; outside Europe), total number of trips and their combination were considered as exposures. Six atopic outcomes were used: (1) doctor-diagnosed asthma, (2) doctor-diagnosed allergic rhinitis, (3) nose and eye symptoms, (4) sensitization to food allergens, (5) sensitization to indoor and (6) outdoor inhalant allergens. Longitudinal associations between each exposure and health outcome pair were analysed using generalized estimation equations (GEEs).
The results of our longitudinal analyses of 5674 subjects do not support the research hypothesis that travelling abroad to different regions in Europe or beyond Europe and frequency of travelling increase prevalence of doctor-diagnosed asthma and allergic rhinitis, nose and eye symptoms and allergic sensitization up to 15 years of age. Furthermore, there was no indication of age-varying effects.
Early life travelling does not seem to increase risk of atopic outcomes. Nevertheless, as we could not account for the type of visited environment or length of stay, these first findings should be interpreted with caution.
西方化的生活方式被认为是过敏症流行的原因之一。其特点之一是从早年起旅行的距离和频率增加。早年前往在气候、植被和食物方面与家庭环境有很大差异的地方旅行，可能会增加接触更多未知过敏原的机会，从而促进过敏症的发展，但尚无流行病学研究对这一推测进行调查。
在德国两个大型基于人群的多中心出生队列——GINIplus和LISAplus中，前瞻性地收集了关于生命最初2年的旅行详细数据，以及一系列特应性结局和15岁前的潜在混杂因素。最远旅行目的地（德国境内；中欧/北欧/东欧；南欧；欧洲以外）、旅行总次数及其组合被视为暴露因素。使用了六种特应性结局：（1）医生诊断的哮喘，（2）医生诊断的过敏性鼻炎，（3）鼻和眼症状，（4）对食物过敏原的致敏，（5）对室内和（6）室外吸入性过敏原的致敏。使用广义估计方程（GEEs）分析每种暴露因素与健康结局对之间的纵向关联。
我们对5674名受试者的纵向分析结果不支持以下研究假设：到欧洲不同地区或欧洲以外地区旅行以及旅行频率会增加15岁前医生诊断的哮喘、过敏性鼻炎、鼻和眼症状以及过敏致敏的患病率。此外，没有年龄差异效应的迹象。
早年旅行似乎不会增加患特应性结局的风险。然而，由于我们无法考虑访问环境的类型或停留时间，这些初步发现应谨慎解释。
