影响城市及农村儿童过敏的环境因素
创作:吴芹 审核:szx 2019年10月29日
  • 纳入来自南非的1185名1-3岁的城市幼儿和398名农村幼儿,发现影响儿童过敏性疾病的主要因素是环境与饮食,与种族无关;
  • 城市和农村环境的风险和保护因素不同,农村环境中婴儿及其母亲在妊娠期间与农场动物的接触可降低过敏的发生率;
  • 而在城市环境中,剖腹产和滥用抗生素会增加食物过敏的风险,食用发酵乳制品可减少哮喘和过敏性皮炎的发生;
  • 无论城市还是农村,哮喘均与孕妇吸烟及吸烟环境暴露有关,过敏均与食用快餐和油炸肉类有关。
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szx
Journal of Allergy and Clinical Immunology上发表的一项队列研究结果,纳入了超过1000名城市儿童及近400名农村儿童,发现影响农村与城市儿童的过敏风险的因素有所差异,而孕妇吸烟、吸烟环境暴露均影响了城市与农村儿童的哮喘风险,快餐及油炸肉类的摄入均影响了城市与农村儿童的过敏风险。
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Environmental factors associated with allergy in urban and rural children from the South AFrican Food Allergy (SAFFA) cohort

南非食物过敏队列中与城市和农村儿童过敏相关的环境因素

10.1016/j.jaci.2019.07.048

2019-10-10, Article

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BACKGROUND: The prevalence of allergic diseases differs in urban and rural populations.
OBJECTIVE: To assess associations between environmental and dietary factors with allergic diseases in urban and rural South African children.
METHODS: Toddlers aged 12-36 months were assessed for food- and aero-allergen sensitisation, atopic dermatitis, allergic rhinitis, asthma and challenge-proven food allergy. Information was collected on family history of allergic diseases, household size, socioeconomic status, delivery mode, antibiotic and probiotic use, exposure to fermented and unpasteurised milk, antihelminth treatment, sunlight exposure, pet and farm animal exposure, cigarette smoke and household cooking and heating fuels. Antenatal exposures to pets, livestock and cigarette smoke was assessed. A subsection completed questions on consumption of fruit/vegetables, fast foods, soft drinks/fruit juices and fried/microwaved meat.
RESULTS: Risk and protective factors differed between urban and rural settings. Exposure to farm animals in infants and their mothers during pregnancy was protective against allergic outcomes in the rural population. Consumption of unpasteurised milk is uncommon in this group of rural children and is unlikely to be an important factor in rural protection. In urban children birth by caesarean section is associated with food allergy and consumption of fermented milk products is associated with reduced asthma and atopic dermatitis. In both cohorts antenatal maternal smoking and environmental smoking exposure were predominantly associated with asthma and consumption of fast foods and fried meat were associated with allergy.
CONCLUSION: In this rural environment exposure to livestock is the strongest protective factor. In urban communities, where animal contact is rare, risk factors include caesarian section and protective factors include consumption of fermented milk products. Modifiable risk factors urgently require interventions to prevent increasing allergies in countries undergoing rapid urbanization.

First Authors:
Michael E Levin

Correspondence Authors:
Michael E Levin

All Authors:
Michael E Levin,Maresa Botha,Wisdom Basera,Heidi E Facey-Thomas Dip Nursing RN ACN (Allergy),Ben Gaunt,Claudia L Gray,Wanjiku Kiragu,Jordache Ramjith,Alexandra Watkins,Jon Genuneit

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