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. 2010 May;125(5):1054-1060.e1.
doi: 10.1016/j.jaci.2010.02.004. Epub 2010 Apr 14.

Breast-feeding, aeroallergen sensitization, and environmental exposures during infancy are determinants of childhood allergic rhinitis

Christopher D Codispoti  1 , Linda Levin, Grace K LeMasters, Patrick Ryan, Tiina Reponen, Manuel Villareal, Jeff Burkle, Sherry Stanforth, James E Lockey, Gurjit K Khurana Hershey, David I Bernstein
Affiliations

Breast-feeding, aeroallergen sensitization, and environmental exposures during infancy are determinants of childhood allergic rhinitis

Christopher D Codispoti et al. J Allergy Clin Immunol. 2010 May.

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.

Conclusion: 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.

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Figures

Figure 1
Figure 1
Smooth plot of allergic rhinitis prevalence in relation to house dust endotoxin concentration.
See this image and copyright information in PMC

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