Previous research has linked stress and environmental factors to first-wave allergies (i.e., asthma, allergic rhinitis, and eczema), but their individual and combined effects on second-wave allergies (i.e., food allergies, including conditions such as egg, and milk allergies) remain unknown. We aim to investigate the effects of parental stress and its interaction with environmental factors on childhood physician-diagnosed food allergies (PFA). In Changsha (China), we performed a mixed cross-sectional and retrospective cohort investigation. we gather data on each preschooler's health status, parental stress, and living environment through questionnaires. Temperature and air pollutant exposures were calculated using inverse distance weighting methods. Multivariate logistic regression models were employed to examine relations pf PFA relates with parental stress, indoor and outdoor pollutants and allergens. We found that high/middle education and gross annual income were associated with total PFA (ORs [95% CI] = 1.89 [1.52–2.36] and 1.23 [1.01–1.50]) and other types of PFAs, while high psychological stress (fatigue, headache, and inattention) increased PFA risk (1.59 [1.34–1.90], 1.35 [1.18–1.55], and 1.41 [1.23–1.62]). Families experiencing higher economic stress reported higher PFA risk of blooming and non-blooming plants in first year. The PFA risk of mould and mildew stains in utero and the first year was higher in families with parental inattention. ORs of PFA due to PM2.5–10 and PM10 during the second trimester were higher in families with high parental social stress. PFA risk of PM2.5 in the late preconceptional and entire postnatal periods was higher in families with parental fatigue, headache, and inattention. We suggest parental stress independently and interplayed with indoor and outdoor environmental pollution and allergens, increases risk of childhood PFA.
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