The effects of growing up on a farm on adult lung function and allergic phenotypes: an international population-based study.
Evidence has suggested that exposure to environmental or microbial biodiversity in early life may impact subsequent lung function and allergic disease risk.



To investigate the influence of childhood living environment and biodiversity indicators on atopy, asthma and lung function in adulthood.



The European Community Respiratory Health Survey II investigated ∼10 201 participants aged 26-54 years from 14 countries, including participants' place of upbringing (farm, rural environment or inner city) before age 5 years. A 'biodiversity score' was created based on childhood exposure to cats, dogs, day care, bedroom sharing and older siblings. Associations with lung function, bronchial hyper-responsiveness (BHR), allergic sensitisation, asthma and rhinitis were analysed.



As compared with a city upbringing, those with early-life farm exposure had less atopic sensitisation (adjusted OR 0.46, 95% CI 0.37 to 0.58), atopic BHR (0.54 (0.35 to 0.83)), atopic asthma (0.47 (0.28 to 0.81)) and atopic rhinitis (0.43 (0.32 to 0.57)), but not non-atopic outcomes. Less pronounced protective effects were observed for rural environment exposures. Women with a farm upbringing had higher FEV1(adjusted difference 110 mL (64 to 157)), independent of sensitisation and asthma. In an inner city environment, a higher biodiversity score was related to less allergic sensitisation.



This is the first study to report beneficial effects of growing up on a farm on adult FEV1. Our study confirmed the beneficial effects of early farm life on sensitisation, asthma and rhinitis, and found a similar association for BHR. In persons with an urban upbringing, a higher biodiversity score predicted less allergic sensitisation, but to a lesser magnitude than a childhood farm environment.
Allergy & Lung Health Unit, Centre for Epidemiology & Biostatistics, The University of Melbourne, Melbourne, Victoria, Australia.
B
B
Campbell
Unité Epidémiologie et Biostatistique, Université Bordeaux Segalen, Bordeaux, France.
C
C
Raherison
Allergy & Lung Health Unit, Centre for Epidemiology & Biostatistics, The University of Melbourne, Melbourne, Victoria, Australia.|Murdoch Children's Research Institute, Melbourne, Australia.
C J
CJ
Lodge
Allergy & Lung Health Unit, Centre for Epidemiology & Biostatistics, The University of Melbourne, Melbourne, Victoria, Australia.|Murdoch Children's Research Institute, Melbourne, Australia.
A J
AJ
Lowe
Department of Respiratory Medicine and Sleep, Landspitali University Hospital, Reykjavik, Iceland.|Faculty of Medicine, University of Iceland, Reykjavik, Iceland.
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T
Gislason
Instititute of Epidemiology I, German Research Centre for Environmental Health, Helmholtz Zentrum München, Neuherberg, Germany.|Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital Munich, Ludwig-Maximilians University Munich, Munich, Germany.
J
J
Heinrich
Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.|CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.|Departament de Ciències Experimentals i de la Salut (UPF), Universitat Pompeu Fabra, Barcelona, Spain.
J
J
Sunyer
Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway.|Centre for International Health, University of Bergen, Norway.
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F
Gómez Real
Department of Medical Sciences; Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden.
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D
Norbäck
Allergy & Lung Health Unit, Centre for Epidemiology & Biostatistics, The University of Melbourne, Melbourne, Victoria, Australia.
M C
MC
Matheson
Institute of Lung Biology and Health (iLBD), Comprehensive Pneumology Center (CPC), Helmholtz Zentrum München, Munich-Neuherberg, Germany.
M
M
Wjst
Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland.|University of Basel, Basel, Switzerland.
J
J
Dratva
Epidemiology and Medical Statistics, University of Verona, Verona, Italy.
R
R
de Marco
National Heart and Lung Institute, Imperial College, London, UK.
D
D
Jarvis
Section for Environment Occupation and Health, Department of Public Health, Aarhus University, Aarhus, Denmark.
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V
Schlünssen
Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway.
C
C
Janson
Centre de Recherche Albert Bonniot, Grenoble, France.
B
B
Leynaert
Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway.
C
C
Svanes
Allergy & Lung Health Unit, Centre for Epidemiology & Biostatistics, The University of Melbourne, Melbourne, Victoria, Australia.
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SC
Dharmage
D000328:Adult; D000818:Animals; D001249:Asthma / Q000453:epidemiology; D044822:Biodiversity; D002415:Cats; D002648:Child; D002654:Child Care; D004285:Dogs; D004781:Environmental Exposure; D000072480:Farms; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000453:epidemiology*; D038622:Internationality; D008297:Male; D008875:Middle Aged; D010641:Phenotype; D012111:Residence Characteristics; D012129:Respiratory Function Tests; D012220:Rhinitis / Q000453:epidemiology; D035781:Siblings
Allergic lung disease; Asthma Epidemiology; Respiratory Measurement