Huang Chian-Feng, Chie Wei-Chu, Wang I-Jen
Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei 10055, Taiwan.
Miaoli General Hospital, Ministry of Health and Welfare, Miaoli 36054, Taiwan.
World Allergy Organ J. 2021 Jan 6;14(1):100495. doi: 10.1016/j.waojou.2020.100495. eCollection 2021 Jan.
Changing environmental factors are likely responsible for the rising prevalence of allergic diseases in children. However, whether environmental exposures induce allergen sensitizations, and which allergen sensitization is related to the development of allergic diseases, is not clear. The study is aimed to investigate the association between environmental exposure, allergen sensitization, and the development of allergic diseases for further preventive intervention.
We conducted the Taiwan Childhood Environment and Allergic diseases Study (TCEAS) in kindergarten children in Taiwan. Skin prick tests for 6 allergens were performed. Information on the development of allergic diseases and environmental exposure was collected using standardized questionnaires. Multiple logistic regressions were used to estimate the association between environmental factors, allergen sensitization, and the development of allergic diseases.
A total of 3192 children were recruited. 485 (15.2%) children had atopic dermatitis (AD), 1126 (35.3%) had allergic rhinitis (AR), and 552 (17.3%) had asthma. Children with environmental tobacco smoke exposure and fungi on the house wall had a higher risk of asthma, with ORs (95% CIs) of 1.25 (1.03-1.52) and 1.22 (1.01-1.47), respectively. The mite sensitization rate was found to be the highest. Mite sensitization was associated with significant increases in the risks of AD, AR, and asthma, with ORs (95% CIs) of 2.15 (1.53-3.03), 1.94 (1.46-2.58), and 2.31 (1.63-3.29), respectively. Cockroach sensitization also increased the risk of asthma, with an OR (95% CI) of 2.38 (1.01-5.61). Mite sensitization was associated with carpet in the home and fungi on the house wall, and milk sensitization was associated with breastfeeding duration.
Environmental exposures play a role in the development of allergic diseases. Allergen sensitizations were associated with certain environmental exposures. Early environmental interventions are urgently needed to prevent the development of childhood allergic diseases.
环境因素的变化可能是儿童过敏性疾病患病率上升的原因。然而，环境暴露是否会引发过敏原致敏，以及哪种过敏原致敏与过敏性疾病的发展相关，尚不清楚。本研究旨在调查环境暴露、过敏原致敏与过敏性疾病发展之间的关联，以便进一步进行预防性干预。
我们在台湾的幼儿园儿童中开展了台湾儿童环境与过敏性疾病研究（TCEAS）。对6种过敏原进行了皮肤点刺试验。使用标准化问卷收集了过敏性疾病发展和环境暴露的信息。采用多元逻辑回归分析来估计环境因素、过敏原致敏与过敏性疾病发展之间的关联。
共招募了3192名儿童。485名（15.2%）儿童患有特应性皮炎（AD），1126名（35.3%）患有过敏性鼻炎（AR），552名（17.3%）患有哮喘。暴露于环境烟草烟雾和家中墙壁有真菌的儿童患哮喘的风险较高，比值比（95%可信区间）分别为1.25（1.03 - 1.52）和1.22（1.01 - 1.47）。发现螨虫致敏率最高。螨虫致敏与AD、AR和哮喘风险的显著增加相关，比值比（95%可信区间）分别为2.15（1.53 - 3.03）、1.94（1.46 - 2.58）和2.31（1.63 - 3.29）。蟑螂致敏也增加了哮喘风险，比值比（95%可信区间）为2.38（1.01 - 5.61）。螨虫致敏与家中地毯和家中墙壁真菌有关，牛奶致敏与母乳喂养持续时间有关。
环境暴露在过敏性疾病的发展中起作用。过敏原致敏与某些环境暴露有关。迫切需要早期环境干预以预防儿童过敏性疾病的发展。
