Hygiene levels in a contemporary population cohort are associated with wheezing and atopic eczema in preschool infants
Open Access
- 1 July 2002
- journal article
- Published by BMJ in Archives of Disease in Childhood
- Vol. 87 (1), 26-29
- https://doi.org/10.1136/adc.87.1.26
Abstract
Background: The hygiene hypothesis states that insufficient exposure to certain infectious agents during childhood increases the risk of developing asthma and atopic diseases. Improvements in hygiene levels may be partly responsible for this decline in exposure. Aims: To assess whether hygiene levels in infancy are associated with wheeze and/or atopic eczema, independent of a number of possible confounding factors. Methods: Data were gathered from the Avon Longitudinal Study of Parents and Children (ALSPAC). Parental self completion questionnaires provided symptom data on infant wheeze and atopic eczema at 0–6 months and 30–42 months, respectively. A simple hygiene score was derived using questionnaire responses at 15 months, which ranged from least hygienic to most hygienic. Multivariable logistic regression models analysed the effect of hygiene scores on health outcomes, while adjusting for a number of important confounding variables. Results: Increasing hygiene scores were independently associated with wheezing (OR = 1.04; 95% CI: 1.00 to 1.08) and atopic eczema (OR = 1.04; 95% CI: 1.01 to 1.07) between 30 and 42 months, but not in the first six months. The odds ratio was higher for atopic eczema if the rash was reported to have become sore and oozy (OR = 1.09; 95% CI: 1.02 to 1.16). Conclusions: High levels of hygiene at 15 months of age were independently associated with wheeze and atopic eczema reported between 30 and 42 months, and there was an increased risk for children with more severe eczema during this period. The importance of hygiene in public health should not be dismissed; however, the creation of a sterile environment through excessive cleanliness may potentially be harmful to the immune system.Keywords
This publication has 11 references indexed in Scilit:
- ALSPAC–The Avon Longitudinal Study of Parents and ChildrenPaediatric and Perinatal Epidemiology, 2001
- Family size, infection and atopy: the first decade of the 'hygiene hypothesis'Thorax, 2000
- Bauernkinder leiden selten an Heuschnupfen und AsthmaDeutsche Medizinische Wochenschrift (1946), 2000
- Age of entry to day nursery and allergy in later childhoodThe Lancet, 1999
- Assessment of the indoor environment in respiratory allergy.Ear, Nose & Throat Journal, 1998
- Risk in cleaning: chemical and physical exposureScience of The Total Environment, 1998
- Secular trend in the occurrence of asthma among children and young adults: critical appraisal of repeated cross sectional surveysBMJ, 1997
- Sibship size and self-reported inhalant allergy among adult women. ALSPAC Study Team.1997
- The U.K. Working Party's Diagnostic Criteria for Atopic Dermatitis..British Journal of Dermatology, 1994
- Individual and environmental risk factors for hand eczema in hospital workers.1986