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1. Are children at high familial risk of developing allergy born into a low risk environment? The PIAMA Birth Cohort Study.

Author

Wijga, A., Smit, H. A., Brunekreef, B., Gerritsen, J., Kerkhof, M., Koopman, L. P., and Neijens, H. J.

Subjects
ALLERGIES, LIFESTYLES, ACCLIMATIZATION, HEALTH, GENETICS
Abstract

BackgroundA family history of allergy, reflecting genetic risk factors, increases the risk of developing allergic diseases, but environmental factors, especially those present in early life, also contribute to the actual development of allergic phenomena. ObjectiveTo identify differences in lifestyle between allergic and non-allergic parents, which may influence the prevalence of environmental risk factors in their homes. MethodsData were collected in a Dutch birth cohort study by postal questionnaire about 2 months before and 3 months after the birth of the child. ResultsOf the 3147 infants in the study 1910 (61%) had two non-allergic parents, of 315 infants (10%) only the mother was allergic, of 787 infants (25%) only the father was allergic and 135 (4%) infants had two allergic parents. If both parents were allergic, 53% reported that allergy was taken into consideration when they furnished their home and significantly more of their homes were free of cats and free of cigarette smoke; adjusted odds ratio's for two allergic parents vs. two non-allergic parents were 0.30 (confidence interval (CI) 0.17–0.50) for the presence of cats and 0.46 (CI 0.27–0.75) for smoking in the home. Parental allergy was also associated with having a smooth floor in the baby's bedroom and with postponement of the introduction of fruits and vegetables until the age of 26 weeks. The presence of dogs at home, the prevalence of mothers' smoking during pregnancy and the decision to breast feed were unrelated to parental allergy. ConclusionWe conclude that studies on the relationship between allergy in parents and allergy in their offspring should always consider the home environment as a potential confounder. For allergy prevention our results imply that among allergic parents there is awareness and willingness to take measures that reduce exposure to indoor allergens. [ABSTRACT FROM AUTHOR]

Published
2001
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2. The Prevention and Incidence of Asthma and Mite Allergy (PIAMA) birth cohort study: Design and first results

Author

bert brunekreef, Smit, J., Jongste, J., Neijens, H., Gerritsen, J., Postma, D., Aalberse, R., Koopman, L., Kerkhof, M., Wijga, A., Strien, R., University of Groningen, and Groningen Research Institute for Asthma and COPD (GRIAC)

Subjects
RISK, ENVIRONMENT, CHILDHOOD, AVOIDANCE, CHILDREN, asthma, allergy, SENSITIZATION, LIFE, natural history, HOUSE-DUST MITE, INFANCY, dust mites, EXPOSURE, intervention
Abstract

The Prevention and Incidence of Asthma and Mite Allergy (PIAMA) birth cohort study was initiated in 1996. Children born to allergic mothers were enrolled in a double-blind placebo-controlled trial for evaluating the use of mite-impermeable mattress and pillow covers. Children born to allergic and non-allergic mothers were enrolled in a 'natural history' study to assess the role of environmental and dietary risk factors for the development of allergic disease in childhood. Recruitment started by distributing a validated screening questionnaire among >10,000 pregnant women during their first visit to a prenatal health clinic. Allergic mothers-to-be were invited to participate in the intervention study. Allergic, and a random sample of non-allergic, mothers-to-be were invited to participate in the 'natural history' arm of the study. In the intervention study, homes were visited before birth, 3 months after birth, and 12 months after birth for the collection of dust samples from floors and mattresses. In addition, the homes of about one-third of the children in the 'natural history' part of the study were visited for dust collection when the children were 3 months of age. The intervention study started with 855 participants and the 'natural history' study with 3,291 participants. Follow-up at 3 years of age has now been completed with satisfactory compliance (>90%,). A medical investigation and home visit at 4 years of age are nearing completion. Preliminary results show that mite-allergen levels were lower than found in previous Dutch studies, and that the intervention measure had a significant effect on mite-allergen levels, without important clinical benefits up to age 2 years old. The allergic families lived in homes with fewer 'triggers' such as pets, smoking and carpets than the non-allergic families, regardless of the intervention. The ongoing PIAMA cohort study will probably reveal useful information concerning effects of allergen load and reduction in the setting of a relatively low mite-allergen exposure, as well as other variables on the development of allergic manifestions and asthma.

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