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European Respiratory Journal 2008; 31:963-973

C-M. Chen, V. Morgenstern, W. Bischof, O. Herbarth, M. Borte, H. Behrendt, U. Krämer, A. von Berg, D. Berdel, C. P. Bauer, S. Koletzko, H-E. Wichmann, J. Heinrich and the Influences of Lifestyle Related Factors on the Human Immune System and Development of Allergies in Children (LISA) Study Group and the German Infant Nutrition Intervention Programme (GINI) Study Group

CORRESPONDENCE: J. Heinrich, E-mail: joachim.heinrich@helmholtz-muenchen.de

The effect of dog ownership during childhood on the development of allergy has been investigated in few studies with conflicting results. The association between dog contact and indoor endotoxin exposure during infancy and the development of allergic sensitisation and atopic disease up to age 6 yrs was investigated.

Conti, L., S. Lieb, et al. (1995).

American Journal of Public Health 85(11): 1559-61.

Interviews were conducted among 408 adults with acquired immunodeficiency syndrome at three local health departments to determine the proportion who owned pets, their perceived attachment to their pets, and the proportion who were informed about zoonoses. Nearly half (187, or 46%) were living with pets, most commonly dogs (64%), followed by cats (38%), fish (15%), birds (8%), reptiles (3%), and rodents (2%). Most pet owners (81%) reported an attachment to their pet. Only 10% were informed of zoonoses, albeit some incorrectly. Health care providers should recognize the high pet ownership rate among persons infected with human immunodeficiency virus and correctly inform their patients of strategies to sustain a low zoonotic disease incidence.

G. Liccardi, G., D'Amato et al.

Journal/Respiratory Medicine, 99, 2005.

An increasing volume of evidence suggests that early contact of children with the allergens of furred pets (especially those produced by cats) may determine a lower risk of developing allergic sensitisation to these materials. A possible explanation of this data is that an early inhalation of high levels of the major cat allergen Fel d 1 includes the production of IgG and IgG4 antibodies with a "protective" effect. Other authors have shown that the prevalence of allergic sensitisation to cats, in adults, is reduced in those patients exposed to the lowest and highest levels of the allergens. On the contrary, the risk of developing sensitisation to cats is significantly higher when patients were exposed to intermediate levels of Fel d 1. Moreover, epidemiological studies have demonstrated a relatively low prevalence of cat allergy (about 10%) in some countries where rates of cat ownership are high. This data confirm the role of indirect exposure to pet allergens in inducing allergic sensitisation. Clothes of pet owners have been indicated as the carriers for the dispersal of these allergens in pet-free environments. However, it is important to point out that exposure of highly sensitized patients to relevant amounts of pet allergens (such as in a pet show/shops) may determine a dramatic exacerbation of nasal and/or bronchial symptoms.

Siegel, J. M., F. J. Angulo, R. Detels, J. Wesch, and A. Mullen.

AIDS Care, v. 11, p. 157-70, 1999.

The impact of pet ownership on depression was tested among a sample of gay and bisexual men (n = 1,872). Multivariate analyses, controlling for demographics and baseline depressive symptomatology, showed that neither pet ownership nor the presence of HIV infection was associated with depression. Depression was influenced by the presence of AIDS and by having relatively few confidants. Analyses among HIV-infected men only showed that persons with AIDS who owned pets reported less depression than persons with AIDS who did not own pets. This beneficial effect of pet ownership occurred principally among persons who reported fewer confidants. These results suggest that by enhancing companionship for some HIV-infected persons, pets may buffer the stressful impact of AIDS.

Macharia, W. M., N. M. Mirza, et al.

East Afr Med J 67(12): 837-41. (1990).

Between January 1986 and July 1988, 356 children with bronchial asthma below 14 years of age were evaluated at the Kenyatta National Hospital. 21.3% experienced initial asthmatic attacks before the age of six months and 55.1% before 2 years. Only 8% of the study patients were below the age of 2 years at recruitment. The male:female ratio was 1:1. Physical exercise led to precipitation or worsening of attacks in 43.4% while 71.6% of the patients experienced attacks in the evening or at night. 18.5% and 42.9% had personal history of atopic dermatitis and allergic rhinitis respectively. The study shows that a substantial number of patients experience initial asthmatic attacks before the age of 6 months contrary to what has been previously believed.

Buenfil Lopez, J. A.

Rev Alerg Mex 44(3): 67-9. (1997).

It was accomplished a prospective study with 100 pediatric patients (60 children- and 40 girls) with the diagnoses of chronic rhinitis and bronchial asthma and reactivity allergic to three or more antigens environmental related to exacerbation of disease and whose symptoms were impeding a normal life. It was then included in a program of immunotherapy in compliance with the plan that has in the Centro Regional para la Prevencion y el Tratamiento de las Enfermedades Alergicas (CRPTEA) of the Hospital Universitario de la Universidad Autonoma de Nuevo Leon, as well as an education and rehabilitation program of the patient and family. There was a notable improvement, clinically demonstrated by the important decrease in the quantity of asthmatic crises and rapid answer to drugs, being integrated to a life of better quality, with good scholastic exploitation, suitable allowance to exercise and quiet sleep. It was concluded that, in well selected asthmatic patients, it is justified the immunotherapy, when it can be demonstrated specific sensitisation to allergens by tests cutaneous and that unfetter the symptoms and that they do not answer adequately to pharmacotherapy of first line.

Barry, D. M., M. L. Burr, et al.

Thorax 46(6): 405-9. (1991).

A survey of 12 year old schoolchildren was carried out in New Zealand and South Wales, the same questionnaire and exercise provocation test being used. The prevalence of a history of asthma at any time was higher in New Zealand (147/873, 17%) than in South Wales (116/965, 12%). The New Zealand children were also more likely than the Welsh children to have a history of "wheeze ever" (27% versus 22%), and wheeze brought on by running (15% versus 10.5%). The sex ratio of asthmatic and wheezy children was very similar in the two countries. A history of hospital admission for chest trouble was twice as common in New Zealand as in South Wales. An exercise test produced a fall in peak expiratory flow rate of 15% or more in more New Zealand children (12.2%) than Welsh children (7.7%). These results suggest that the prevalence of childhood asthma is higher in New Zealand than in South Wales.

Ernst, P., K. Demissie, et al.

Am J Respir Crit Care Med 152(2): 570-5.(1995).

Differential access and utilization of medical care by the poor and rich may contribute to differences in asthma prevalence. We therefore studied the relationship of socioeconomic status (SES) to various indicators of asthma in the Canadian context of universal access to medical care. Information on respiratory symptoms, demographics, and home exposures of 1,111 primary school children was collected by questionnaire. Parental occupation was used to establish SES. Exercise-induced bronchospasm (EIB) after a 6-min free-running test was our measure of airways responsiveness and was available for 989 children. As compared with children from the most advantaged homes, children from the least advantaged homes were more likely to present EIB (OR: 2.26, 95% CI: 1.12 to 4.58) and to report night cough (OR: 2.30, 95% CI: 1.04 to 5.06) and cough with mucus (OR: 3.15, 95% CI: 1.06 to 9.33), while there was no significant excess of the report of wheeze or diagnosed asthma. Among factors potentially linked to SES, the presence of a cat at home (OR: 1.63, 95% CI: 1.02 to 2.61) and lower respiratory infection before 2 yr of age were associated with an excess of EIB (OR: 1.71, 95% CI: 1.16 to 2.52). Our results suggest that unidentified environmental factors contribute to the excess asthma morbidity in poor children.

Bener, A., Y. M. Abdulrazzaq, et al.

Hum Biol 68(3): 405-14. (1996).

We investigate the familial and environmental risk factors associated with asthma among United Arab Emirates schoolchildren aged 6-14 years. A cross-sectional study of 850 schoolchildren living in both urban and rural areas (average age 9.36 +/- 2.11 years; 46.8% boys, 53.2% girls) was conducted using self-administered questionnaires between October 1992 and May 1993. The population sample had a high prevalence rate of diagnosed asthma (13.6%) and allergic rhinitis (22.9%). The frequency of asthma, allergic rhinitis, and eczema among parents and siblings reflected the same pattern as that seen in the children. Environmental risk factors associated with asthma were pets, medicine, plants, dust storm, physical exercise, humidity, and perfume. All other factors, such as foods, climate, and parental smoking, showed no apparent relation to the development of asthma. The logistic regression analysis showed that parental asthma, plants, perfume, dust storm, humidity, and pets were the only significant predictors after adjusting for sex and other confounding covariates in the model. In conclusion, risk factors for asthma identified by our study are similar to those found in other community-based studies. Consistencies and discrepancies between our findings and those from other studies with respect to asthma risk factors support the hypothesis that asthma is a multifactorial disease related to both familial and environmental influences.

Alshehri, M. A.

Saudi Med J, v. 21, p. 1048-53, 2000.

OBJECTIVE: The objective of the present study was to measure the prevalence of asthma and asthma-related symptoms among male school children in Abha City and to determine some of the possible risk factors influencing its occurrence.

METHODS: A randomly selected sample of 4300 male school children aged 7 to 15 years in Abha were subjected to a previously validated questionnaire for asthma to be completed by parents. Asthma was identified based on the Rush Medical College and International Study of Asthma and Allergies in Children questionnaire. Information of asthma family history, asthma related symptoms, and other atopic conditions, smokers in the family, pets ownership and monthly family income were collected.