Abstract

An inverse relationship has been proposed between exposure to high quantities of cat allergen at home and both asthma and cat allergy. First- and second-grade children from Luleå, Kiruna, and Piteå, Sweden participated in an asthma questionnaire study (n = 3,431) and incidence was evaluated over the next 3 years. Skin testing was performed on the children in Luleå and Kiruna (n = 2,149). The strongest risk factor for incident cases of asthma was Type 1 allergy (relative risk [RR], 4.9 [2.9-8.4]), followed by a family history of asthma (RR, 2.83 [1.8-4.5]). Living with a cat was inversely related both to having a positive skin test to cat (RR, 0.62 [0.47-0.83]) and incidence of physician-diagnosed asthma (RR, 0.49 [0.28-0.83]). This effect on incident asthma was most pronounced among the children with a family history of asthma (RR, 0.25 [0.08-0.80]). The evidence also suggests that many of the children exposed to cats at home can develop an immune response that does not include immunoglobulin E. Weaker protective trends were seen with dog ownership. The traditional thinking that not owning cats can provide protection against developing allergy and asthma among those with a family history of allergy needs to be re-evaluated. In a community where cat sensitization was strongly associated with asthma, owning a cat was protective against both prevalent and incident asthma.

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