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ASTHMA AND FARM EXPOSURES IN A COHORT OF RURAL IOWA CHILDREN
Citation:
MERCHANT, J. A., A. L. NALEWAY, E. R. SVENDSEN, K. M. KELLY, L. F. BURMEISTER, A. M. STROMQUIST, C. D. TAYLOR, P. S. THORNE, S. J. REYNOLDS, W. T. SANDERSON, AND E. A. CHRISCHILLES. ASTHMA AND FARM EXPOSURES IN A COHORT OF RURAL IOWA CHILDREN. ENVIRONMENTAL HEALTH PERSPECTIVES. National Institute of Environmental Health Sciences (NIEHS), Research Triangle Park, NC, 113(3):350-356, (2005).
Impact/Purpose:
research results
Description:
Epidemiological studies of farm children are of international interest because farm children have been found to be less often atopic, to have less allergic disease, and to often have less asthma than non-farm children, findings consistent with the hygiene hypothesis. We studied a cohort of rural Iowa children to determine the association between farm and other environmental risk factors with four asthma outcomes-doctor-diagnosed asthma, doctor-diagnosed asthma/medication for wheeze, current wheeze, and cough with exercise. Doctor-diagnosed asthma prevalence was 12%, but any one of these four health outcomes was found in over a third of the cohort. These findings are similar to urban studies of childhood asthma and suggest asthma under-diagnosis and under-treatment. Multi variable models of the four health outcomes found independent associations between male gender (three asthma outcomes), age (three asthma outcomes), a personal history of allergies (four asthma outcomes), family history of allergic disease (two asthma outcomes), premature birth (one asthma outcome), early respiratory infection (three asthma outcomes), high risk birth (two asthma outcomes) and farm exposure to raising swine given antibiotics with feed (two asthma outcomes). The high prevalence of rural childhood asthma and asthma symptoms underscores the need for asthma screening programs and improved asthma diagnosis and treatment. The high prevalence of asthma health outcomes among farm children living on farms that raise swine, despite lower rates of atopy and personal histories of allergy, suggest the need for more population-based studies to further assess environmental and genetic determinants of asthma among farm children.