Early pet exposure: friend or foe?
OBJECTIVE
Sensitization to pets is a risk factor for asthma and it was assumed that pet ownership was a risk factor for sensitization. Epidemiological studies failed to confirm this, some even suggesting that keeping pets decreased the risk of sensitization and asthma. In the last year, 10 studies have been published which have, at least in part, attempted to address the question. The results, however, are heterogeneous and it is still not clear how we should advise our patients on this issue of pet ownership.


RESULTS
Results of studies of the association between exposure to cat or cat allergen and the development of sensitization are such that almost any view on the relationship could be supported by evidence from the literature. For dogs, there are fewer data, but there is little to suggest that keeping a dog increases the risk of sensitization to dog. The majority of studies reviewed find either no association or a reduced risk of asthma amongst pet owners, but only one of these selectively excludes those who deliberately avoid pets from the analysis. There is evidence to suggest that amongst non-pet owners, the risk of sensitization and of asthma increases in areas with a high proportion of pet owners. There is evidence emerging that the effect of exposure to pets may be different in different relative risk groups, based on parental allergy. There is also evidence that asthma is more severe amongst pet sensitized pet owners.


CONCLUSIONS
There are several large birth cohort studies being conducted around the world designed to measure the development of asthma and allergies in children with prospective and objective measures of environmental exposures. The results of such studies are required before the association between pets and asthma can be determined.
Simpson
Angela
A
North West Lung Center, Wythenshawe Hospital, Manchester, UK. asimpson@fs1.with.man.ac.uk
Custovic
Adnan
A
D000293:Adolescent; D000328:Adult; D000485:Allergens / Q000276:immunology*; D000818:Animals; D000829:Animals, Domestic / Q000276:immunology*; D001249:Asthma / Q000209:etiology*; D002415:Cats; D002648:Child; D002675:Child, Preschool; D004285:Dogs; D004781:Environmental Exposure / Q000009:adverse effects*; D006801:Humans; D006967:Hypersensitivity / Q000209:etiology*; D007223:Infant; D012307:Risk Factors
D000485:Allergens