title: Breast-feeding, aeroallergen sensitization, and environmental exposures during infancy are determinants of childhood allergic rhinitis.
abstract: BACKGROUND
  Infant predictors of early childhood allergic rhinitis (AR) are poorly understood.
  
  
  OBJECTIVE
  We sought to identify environmental exposures and host factors during infancy that predict AR at age 3 years.
  
  
  METHODS
  High-risk children from greater Cincinnati were followed annually from ages 1 to 3 years. AR was defined as sneezing, runny, or blocked nose in the prior 12 months and a positive skin prick test (SPT) response to 1 or more aeroallergens. Environmental and standardized medical questionnaires determined exposures and clinical outcomes. Primary activity area dust samples were analyzed for house dust endotoxin (HDE) and (1-3)-beta-D-glucan. Fine particulate matter sampled at 27 monitoring stations was used to estimate personal elemental carbon attributable to traffic exposure by using a land-use regression model.
  
  
  RESULTS
  Of 361 children in this analysis, 116 had AR, and 245 were nonatopic and nonsymptomatic. Prolonged breast-feeding in African American children (adjusted odds ratio [aOR], 0.8; 95% CI, 0.6-0.9) and multiple children in the home during infancy was protective against AR (aOR, 0.4; 95% CI, 0.2-0.8). Food SPT response positivity and tree SPT response positivity in infancy increased the risk of AR at age 3 years (aOR of 4.4 [95% CI, 2.1-9.2] and aOR of 6.8 [95% CI, 2.5-18.7], respectively). HDE exposure was associated with AR; the effect was dependent on exposure level. Elemental carbon attributable to traffic and environmental tobacco smoke exposure showed no effect on AR.
  
  
  CONCLUSIONS
  Prolonged breast-feeding in African American subjects and multiple children in the home during infancy reduced the risk of AR at age 3 years. SPT response positivity to food and tree allergens enhanced risk. The HDE effect on AR was related to exposure.
authors.affiliation: Department of Internal Medicine, Division of Immunology, Allergy and Rheumatology, University of Cincinnati, Cincinnati, Ohio 4267-0563, USA.
authors.forename: Christopher D
authors.initials: CD
authors.lastname: Codispoti
authors.forename: Linda
authors.initials: L
authors.lastname: Levin
authors.forename: Grace K
authors.initials: GK
authors.lastname: LeMasters
authors.forename: Patrick
authors.initials: P
authors.lastname: Ryan
authors.forename: Tiina
authors.initials: T
authors.lastname: Reponen
authors.forename: Manuel
authors.initials: M
authors.lastname: Villareal
authors.forename: Jeff
authors.initials: J
authors.lastname: Burkle
authors.forename: Sherry
authors.initials: S
authors.lastname: Stanforth
authors.forename: James E
authors.initials: JE
authors.lastname: Lockey
authors.forename: Gurjit K
authors.initials: GK
authors.lastname: Khurana Hershey
authors.forename: David I
authors.initials: DI
authors.lastname: Bernstein
mesh_terms: D000393:Air Pollutants; D016902:Air Pollution, Indoor; D000485:Allergens / Q000009:adverse effects / Q000276:immunology; D001942:Breast Feeding; D002675:Child, Preschool; D004391:Dust / Q000276:immunology; D004781:Environmental Exposure; D005260:Female; D005502:Food / Q000009:adverse effects; D006798:Housing; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000209:etiology*; D019570:Inhalation Exposure; D008297:Male; D012220:Rhinitis / Q000209:etiology*; D012307:Risk Factors; D012882:Skin Tests; D014197:Trees / Q000009:adverse effects / Q000276:immunology
chemical_list: D000393:Air Pollutants; D000485:Allergens; D004391:Dust
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