title: Early-life risk factors and incidence of rhinitis: results from the European Community Respiratory Health Study--an international population-based cohort study.
abstract: BACKGROUND
  Rhinitis is an increasingly common condition with a heavy health care burden, but relatively little is known about its risk factors.
  
  
  OBJECTIVE
  To examine the association between early-life factors and the development of rhinitis in the European Community Respiratory Health Study (ECRHS).
  
  
  METHODS
  In 1992-1994, community-based samples of 20-44-year-old people were recruited from 48 centers in 22 countries. On average, 8.9 years later, 28 centers reinvestigated their samples. Onset of rhinitis was reported by 8486 participants in interviewer-led questionnaires. Cox regression was used to assess independent predictors of rhinitis at ages ≤5, 6-10, 11-20, and ≥21 years.
  
  
  RESULTS
  The crude lifelong incidence of rhinitis was 7.00/1000/year (men) and 7.95/1000/year (women) (P = .002). Women developed less rhinitis in later childhood (hazard ratios [HR], 0.63; 95% CI, 0.47-0.85) and more rhinitis in adulthood (HR, 1.36; 95% CI, 1.11-1.66) than did men. In atopic subjects, siblings were associated with lower risk of rhinitis throughout life (pooled HR, 0.94; 95% CI, 0.91-0.98 per 1 sibling). Early contact with children in the family or day care was associated with less incidence of rhinitis, predominantly before age 5 years (HR, 0.84; 95% CI, 0.72-0.99). Early childhood pets or growing up on a farm was associated with less incidence of rhinitis in adolescence (HR, 0.50; 95% CI, 0.37-0.68). Combining these factors showed evidence of a dose-response relationship (trend P = .0001).
  
  
  CONCLUSIONS
  Gender is a strong risk factor for rhinitis, with age patterns varying according to atopic status. Protective effects of early contact with children and animals were suggested for incident rhinitis, with risk patterns varying by age window and atopic status.
authors.affiliation: MEGA Epidemiology, University of Melbourne, Melbourne, Australia. mcmat@unimelb.edu.au
authors.forename: Melanie Claire
authors.initials: MC
authors.lastname: Matheson
authors.forename: Shyamali Chandrika
authors.initials: SC
authors.lastname: Dharmage
authors.forename: Michael John
authors.initials: MJ
authors.lastname: Abramson
authors.forename: Eugene Haydn
authors.initials: EH
authors.lastname: Walters
authors.forename: Jordi
authors.initials: J
authors.lastname: Sunyer
authors.forename: Roberto
authors.initials: R
authors.lastname: de Marco
authors.forename: Benedicte
authors.initials: B
authors.lastname: Leynaert
authors.forename: Joachim
authors.initials: J
authors.lastname: Heinrich
authors.forename: Deborah
authors.initials: D
authors.lastname: Jarvis
authors.forename: Dan
authors.initials: D
authors.lastname: Norbäck
authors.forename: Chantal
authors.initials: C
authors.lastname: Raherison
authors.forename: Matthias
authors.initials: M
authors.lastname: Wjst
authors.forename: Cecilie
authors.initials: C
authors.lastname: Svanes
mesh_terms: D000328:Adult; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004781:Environmental Exposure; D005062:European Union; D005260:Female; D006801:Humans; D008297:Male; D057805:Pets; D012220:Rhinitis / Q000453:epidemiology* / Q000209:etiology; D012307:Risk Factors; D012424:Rural Population; D012737:Sex Factors