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Background: Epidemiologic reports on the effect of microbe exposure on the development of atopy and allergic asthma are inconsistent. Objectives: The study investigates the association between serologic markers of infections and occurrence of atopy, allergic asthma, and rhinitis among adults in Iceland, Sweden, and Estonia. Methods: Individuals (n = 1249; mean age, 42 years) from Iceland, Sweden, and Estonia underwent a structured interview and blood sampling. Specific IgE was measured against 4 allergens, and IgG antibodies were measured against Helicobacter pylori, Toxoplasmosis gondii, hepatitis A virus, herpes simplex virus 1, Chlamydia pneumoniae, EBV, and cytomegalovirus. Results: Nonatopic subjects more often had positive serology for Helicobacter pylori, herpes simplex virus 1, Chlamydia pneumoniae, and cytomegalovirus. Having a low number (≤3) of IgG antibodies against the various infectious agents was an independent risk factor for atopy (odds ratio [OR], 1.43; 95% CI, 1.06-1.93), allergic asthma (OR, 1.82; 95% CI, 1.12-2.98), and allergic rhinitis (OR, 1.69; 95% CI, 1.21-2.37). The proportion of atopy that can be explained by a lower number (≤3) of infections was 6.7% in Iceland, 9.2% in Estonia, and 16.4% in Sweden, and 6.7%, 48.2%, and 33.4% for allergic asthma, respectively. Conclusion: Our data are consistent with cumulative protective effect of infections against atopy and respiratory allergies irrespective of route of infection. Clinical implications: The study indicates what microbes or combination of microbes play a role in the complex interplay between hygiene and allergy and may contribute toward the understanding of the allergy epidemic. [Copyright &y& Elsevier]

Summary: Aim of the study: To evaluate if perennial non-infectious rhinitis is associated with sleep disturbances in asthma. Materials and methods: This is a questionnaire based study in a random population sample from Denmark, Estonia, Iceland, Norway and Sweden aged 30–54yr. A total of 1127 individuals reporting asthma from an original random population sample of 16,191 were analysed regarding their quality of sleep in relation to perennial non-infectious rhinitis. Perennial non-infectious rhinitis was defined as having nasal symptoms such as nasal blockage and secretion in the absence of common cold, always. Asthma was defined as both ever having had asthma and having physician diagnosed asthma. Odds ratios (OR) for difficulties inducing sleep, difficulties maintaining sleep, early morning awakenings and daytime sleepiness were calculated in a multiple logistic regression controlling for other risk factors for sleep disturbances such as snoring, wheeze, obesity and smoking. Results: The response rate was 74%. A total of 189 (17%) of the subjects with asthma reported perennial non-infectious rhinitis. Perennial non-infectious rhinitis was associated with an increased OR for difficulties maintaining sleep (1.6 (95% confidence interval (CI) 1.1–2.3)), early morning awakenings (1.5 (95% CI 1.1–2.2)) and daytime sleepiness (1.8 (95% CI 1.2–2.9)). The result show that perennial non-infectious rhinitis is an independant risk factor for sleep disturbances in asthma. [Copyright &y& Elsevier]