Reduced risk of hay fever and asthma among children of farmers

Abstract
The prevalence of atopic diseases is on the rise. Traditional lifestyles may be associated with a reduced risk of atopy. To test the hypothesis that children living on a farm have lower prevalences of atopic diseases. To identify differences in living conditions between farmers and other families which are associated with the development of atopic conditions. Cross-sectional survey among children entering school (aged 5–7 years). A written questionnaire including the ISAAC core questions and asking for exposures on a farm and elsewhere was administered to the parents. Setting: School health entry examination in two Bavarian districts with extensive farming activity. Subjects: 10 163 children. The prevalence of doctor's diagnoses and symptoms of hay fever, asthma and eczema as assessed by parental report. Farmers' children had lower prevalences of hay fever (adjusted odds ratio = 0.52, 95% CI 0.28–0.99), asthma (0.65, 0.39–1.09), and wheeze (0.55, 0.36–0.86) than their peers not living in an agricultural environment. The reduction in risk was stronger for children whose families were running the farm on a full-time basis as compared with families with part-time farming activity. Among farmers' children increasing exposure to livestock was related to a decreasing prevalence of atopic diseases (aOR = 0.41, 95% CI 0.23–0.74). Factors related to environmental influences on a farm such as increased exposure to bacterial compounds in stables where livestock is kept prevent the development of allergic disorders in children.