Furry Pets Research Articles

The Home Environment of Japanese Female University Students - Association with Respiratory Health and Allergy

A study was undertaken to determine the association between the home environment along with the respiratory and allergy symptoms reported among female university students in Japan (N =153). A multiple logistic regression was applied for the determination and the study was controlled based on the age of the students, whether the student smokes and history of asthma/allergy suffering in parents. The characteristics of the population were: 15.7% are diagnosed asthma, 56.9% suffered pollen allergy, 15.7% cat allergy, 11.1% dog allergy, 25.0% wheeze in breathing, 24.2% suffered daytime breathlessness and 9.3% suffered nocturnal attacks of breathlessness. Evaluated characteristics were: 41.2% had a pet at home, 21.6% environmental tobacco smoke (ETS), 20.9% current dampness or moulds, 6.6% recent indoor painting, 7.2% new floor material, and 56.2% window condensation at home in winter. Wheeze was more common in concrete houses (OR = 3.33; p<0.05) and homes with water leakage and moulds infestation in the last 5 years (OR = 3.75; p<0.05), window condensation (OR=2.93; p<0.05) and ETS (OR=3.04; p<0.05). Nocturnal breathlessness was related to current building dampness (OR = 7.48; p<0.05), in particular to floor dampness. Furry pet allergy was more common in newer ( p<0.05) and newly painted homes (OR = 6.59; p<0.05). Airway infections were more common in homes with new floor material (OR=4.19; p<0.05). In conclusion, asthma, airway infections and allergies were common among female university students and related to home environmental exposures.

Environmental Risk Factors in the First Year of Life and Childhood Asthma in the Central South of Chile

Background. Childhood asthma has a high prevalence in South America—a region of the world currently undergoing a thorough modernization and transition process. Asthma in South America is mainly associated with poor urban environment, which actually may challenge the role of the hygiene hypothesis. We systematically assessed the impact of environmental factors in the first year of life on asthma. Methods. A case–control study including 188 asthmatics and 294 hospital-based controls aged 6–15 years was carried out in the Central South of Chile. Parents of study participants completed a computer-assisted interview on environmental factors (such as birth order, day-care attendance, pneumonia infection, regular animal and furry pet contact, and environmental tobacco smoke exposure) in the first year of life and potential confounders. Atopy was assessed using skin prick tests. Multivariate logistic regression models were calculated to assess the association between exposures and asthma, adjusting for potential confounders. Results. Day-care attendance (OR = 0.31; 95% CI: 0.10, 0.94) and regular farm animal contact (OR = 0.38; 95% CI: 0.17, 0.85) were inversely related to childhood asthma in the logistic regression models. Pneumonia infection (OR = 2.24; 95% CI: 1.21, 4.16) and mold or dampness in the home (OR = 1.87; 95% CI: 1.18, 2.97) in the first year of life were positively associated with asthma. Conclusion. Our results suggest that the hygiene hypothesis is also applicable in the Chilean setting, a South American country in epidemiological transition.

Respiratory symptoms, perceived air quality and physiological signs in elementary school pupils in relation to displacement and mixing ventilation system: an intervention study

Schools may be poorly ventilated and may contain furry pet allergens, particles and microorganisms. We studied health effects when changing from mixing ceiling ventilation to two types of displacement ventilation, front ventilation system (FVS) and floor master system (FMS). The study included pupils in three elementary school classes (N = 61), all with floor heating. One class received blinded interventions; the two others were unchanged (controls). Ventilation flow and supply air temperature was kept constant. The medical investigation included tear film stability (BUT), nasal patency and a questionnaire containing rating scales. When changing from mixing ventilation to FVS, the pupils (N = 26) perceived better air quality (P = 0.006) and less dyspnoea (P = 0.007) as compared to controls (N = 35), and BUT was improved (P = 0.03). At desk level, mean CO(2) was reduced from 867 to 655 ppm. Formaldehyde and viable bacteria were numerically lower, while total bacteria and molds were higher with displacement ventilation. There was no difference in symptoms or signs when changing from FVS to FMS. Cat (Der p1), dog (Can f1) and horse allergen (Equ cx) were common in air at all conditions. In conclusion, displacement ventilation may have certain positive health effects among pupils, as compared to conventional mixing ceiling systems. Displacement ventilation may be a suitable ventilation principle for achieving good indoor environment in classrooms. The type of supply air diffuser does not seem to be of major importance. The combination of floor heating and displacement ventilation can be a useful way of avoiding the previously described problem of thermal discomfort.

Fungal DNA, allergens, mycotoxins and associations with asthmatic symptoms among pupils in schools from Johor Bahru, Malaysia

While there is a large variation of prevalence of asthma symptoms worldwide, what we do know is that it is on the rise in developing countries. However, there are few studies on allergens, moulds and mycotoxin exposure in schools in tropical countries. The aims were to measure selected fungal DNA, furry pet allergens and mycotoxins in dust samples from schools in Malaysia and to study associations with pupils' respiratory health effects. Eight secondary schools and 32 classrooms in Johor Bahru, Malaysia were randomly selected. A questionnaire with standardized questions was used for health assessment in 15 randomly selected pupils from each class. The school buildings were inspected and both indoor and outdoor climate were measured. Dust samples were collected by cotton swabs and Petri dishes for fungal DNA, mycotoxins and allergens analysis. The participation rate was 96% (462/480 invited pupils), with a mean age of 14 yr (range 14-16). The pupils mostly reported daytime breathlessness (41%), parental asthma or allergy (22%), pollen or pet allergy (21%) and doctor-diagnosed asthma (13%) but rarely reported night-time breathlessness (7%), asthma in the last 12 months (3%), medication for asthma (4%) or smoking (5%). The inspection showed that no school had any mechanical ventilation system, but all classrooms had openable windows that were kept open during lectures. The mean building age was 16 yr (range 3-40) and the mean indoor and outdoor CO(2) levels were 492 ppm and 408 ppm, respectively. The mean values of indoor and outdoor temperature and relative humidity were the same, 29°C and 70% respectively. In cotton swab dust samples, the Geometric Mean (GM) value for total fungal DNA and Aspergillus/Penicillium (Asp/Pen) DNA in swab samples (Cell Equivalents (CE)/m(2)) was 5.7*10(8) and 0.5*10(8), respectively. The arithmetic mean (CE/m(2)) for Aspergillus versicolor DNA was 8780, Stachybotrys chartarum DNA was 26 and Streptomyces DNA was 893. The arithmetic means (pg/m(2)) for the mycotoxins sterigmatocystin and verrucarol were 2547 and 17, respectively. In Petri dish dust samples, the GM value for total fungal DNA and Asp/Pen DNA (CE/m(2) per day) was 9.2*10(6) and 1.6*10(6), respectively. The arithmetic mean (CE/m(2) per day) for A. versicolor DNA was 1478, S. chartarum DNA was 105 and Streptomyces DNA was 1271, respectively. The GM value for cat (Fel d1) allergen was 5.9 ng/m(2) per day. There were positive associations between A. versicolor DNA, wheeze and daytime breathlessness and between Streptomyces DNA and doctor-diagnosed asthma. However, the associations were inverse between S. chartarum DNA and daytime breathlessness and between verrucarol and daytime breathlessness. In conclusion, fungal DNA and cat allergen contamination were common in schools from Malaysia and there was a high prevalence of respiratory symptoms among pupils. Moreover, there were associations between levels of some fungal DNA and reported respiratory health in the pupils.

Allergy prevention

The further increase of allergies in industrialized countries demands evidence-based measures of primary prevention. The recommendations as published in the guideline of 2004 were updated and consented on the basis of a systematic literature search. Evidence from the period February 2003-May 2008 was searched in the electronic databases Cochrane and MEDLINE as well as in reference lists of recent reviews and by contacting experts. The retrieved citations were screened for relevance first by title and abstract and in a second step as full paper. Levels of evidence were assigned to each included study and the methodological quality of the studies was assessed as high or low. Finally the revised recommendations were formally consented (nominal group process) by representatives of relevant societies and organizations including a self-help group. Of originally 4556 hits, 217 studies (4 Cochrane Reviews, 14 meta-analyses, 19 randomized controlled trials, 135 cohort and 45 case-control studies) were included and critically appraised. Grossly unchanged remained the recommendations on avoiding environmental tobacco smoke, breast-feeding over 4 months (alternatively hypoallergenic formulas for children at risk), avoiding a mold-promoting indoor climate, vaccination according to current recommendations, and avoidance of furry pets (especially cats) in children at risk. The recommendation on reducing the house dust mite allergen exposure as a measure of primary prevention was omitted and the impact of a delayed introduction of supplementary food was reduced. New recommendations were adopted concerning fish consumption (during pregnancy / breast-feeding and as supplementary food in the first year), avoidance of overweight, and reducing the exposure to indoor and outdoor air pollutants. The revision of this guideline on a profound evidence basis led to (1) a confirmation of existing recommendations, (2) substantial revisions, and (3) new recommendations. Thereby it is possible to give evidence-based and up-to-date recommendations on primary prevention of allergies.

Factors Associated with Furry Pet Ownership Among Patients with Asthma

Background. Exposure to indoor allergens is an established risk factor for poor asthma control. Current guidelines recommend removing pets from the home of patients with asthma. Objectives. This cross-sectional study was conducted to determine the prevalence of furry pet ownership in asthmatics compared to nonasthmatics and to identify factors associated with furry pet ownership among those with asthma. Secondary analysis assessed characteristics among asthmatics that might be associated with allowing a furry pet into the bedroom. Methods. Using data from The National Asthma Survey collected from 2003 to 2004, we carried out univariate and multiple regression analyses, in 2009, to identify independent predictors of furry pet ownership in asthma sufferers after controlling for potential confounders. Results. Overall, asthmatics were more likely to own a furry pet than nonasthmatic individuals in the general population (49.9% versus 44.8%, p < .001). Multivariate analysis showed that female sex, older age, white race, and high income were independent predictors of furry pet ownership among asthmatics. Additionally, 68.7% of patients with asthma who own a furry pet allowed them into their bedroom. Higher income and carrying out ≤2 environmental control practices in the home were associated with increased likelihood of allowing a furry pet into the bedroom. Conclusions. Furry pet ownership is equally or more common among asthmatics compared to those without asthma. The majority of asthmatics with furry pets allow them into the bedroom. Recognizing and addressing these problems may help decrease asthma morbidity.

Factors associated with acute respiratory illness in day care children

The aim of this study was to investigate the relationship between child characteristics, parental and environmental factors and the occurrence of acute respiratory illness (ARI) and acute otitis media (AOM) among Finnish children attending day care centres (DCCs). The study was a cross-sectional questionnaire of 594 children aged 1-6 y from 18 DCCs in Helsinki, Finland. Recurrent (> or =4 diseases/y) ARI was present in 44% of the 1-3-y-olds and 23% of the 4-6-y-olds, and recurrent AOM in 15% and 2.5%, respectively. Parent atopic disease (odds ratio (OR) 1.53, p = 0.033), mother's academic education (OR 1.77, p = 0.008) and a medium length of DCC attendance compared to a short period (OR 1.67, p = 0.049) increased, while furry pets (OR 0.44, p = 0.003) and older child age (OR 0.38, p < 0.001) reduced the risk of recurrent ARI. Recurrent ARI (OR 3.96, p = 0.008), mother's academic education (OR 5.02, p = 0.003), and a medium length of DCC attendance compared to a short period (OR 3.34, p = 0.044) increased, while partial breastfeeding > or =6 months (OR 0.20, p = 0.002) and older child age (OR 0.05, p < 0.001) reduced the risk of recurrent AOM. Parental and environmental factors had a significant impact on recurrent ARI and AOM episodes in children attending DCCs. These risk factors should be considered in future studies intending to reduce DCC infections.

Rhinitis in children: Co-morbidities and phenotypes

Rhinitis and its co-morbidities affect quality of life; and in children, little is known. We therefore aimed to describe the co-morbidities and phenotypes of current rhinitis in 10-yr-old Norwegian children. We used information on rhinitis, asthma, allergic sensitization, anaphylaxis, and lung function tests from clinical examinations and structured parental interviews of 1019 children included in the birth cohort study, the Environment and Childhood Asthma Study, in Oslo. Current rhinitis was reported in 254 (25.0%) of the children, and 87.4% had at least one allergy-related co-morbidity of rhinitis, with conjunctivitis the most prevalent (75.6%). Overall, 11.8% of the children had conjunctivitis combined with current asthma and atopic eczema. Children with rhinitis were also more likely to have severe bronchial hyperresponsiveness (BHR) (PD(20) <or= 1 micromol methacholine) than children without rhinitis (17.5% and 5.8%, respectively, p < 0.001), as well as BHR (PD(20) <or= 8 micromol). The children with rhinitis and allergic sensitization (72.8%) had more frequently BHR, severe BHR, and conjunctivitis, but did not differ with respect to any other co-morbidity from children with rhinitis without allergic sensitization. Children with symptoms reported by exposure to both pollen and furry pets had more often asthma, wheeze, and BHR compared to the children who reported rhinitis symptoms only when exposed to pollen (91.9% of these had symptoms in spring/summer only). In conclusion, current rhinitis is closely associated with conjunctivitis, asthma, atopic eczema, and BHR in childhood. Conjunctivitis and BHR were most strongly linked to rhinitis with allergic sensitization.

Fifty key figures in science fiction

Trouble with Quibbles. Mark Bould et al. Fifty Key Figures in Science Fiction. London, UK: Routledge, 2010. 288 pp. ISBN 9780415439503. $26.95 pbk.Reviewed by Ritch CalvinIn the 1967 episode of Star Trek entitled The Trouble with Tribbles, a trader gives Lt. Uhuru a furry little pet called a tribble, which she, quite predictably, brings aboard the U.S.S. Enterprise. However, the tribbles famously multiply at an alarming rate: bring one on board, and the next thing you know, you're up to your neck in them. Havoc ensues, but in the end, the tribbles redeem themselves by revealing a Klingon plot to poison a shipment of grain. A similar sort of multiplication takes place once you start thinking about objections to and criticisms of a book that purports to identify within the field of sf. And the more harmless they seem, the more they seem to multiply. does one find a balance between useful critique and mere quibbling? Could the quibbles serve a purpose, in the end?The very nature of the collection raises a number of questions. For one, why fifty, which seems a perfectly arbitrary number? What are the criteria for inclusion, or for exclusion? In a short introduction, the editors offer some answers to these questions and some insight into the process. Each editor created a list of fifty figures. When collated, they collectively had a list of roughly one hundred. After they winnowed that back down to fifty, the outside readers suggested a few other names. Eventually, the final list of fifty emerged. True, fifty is a round(ish) number, but so is sixty. So is seventy-five. Why not fifty-three? Sixty-nine? Should the number of entries be (predetermined by an arbitrary number, or on the quality and merits of the individuals being considered? Granted, a great many other criteria might have been involved in the decision (e.g., the total number of pages, or final cost of the volume). Nevertheless, we have fifty entries. Ah, but which fifty?Of course, the immediate and most obvious response to a book of this type will be: How could you have left out X? Or: If you've included Y, how can you not include Q? Here again, the editors attempt to forestall such criticism by way of the title of the collection. Those presented here are fifty key figures, not the fifty best, and not the fifty most important. Rhetorically and editorially, that makes perfect sense. Besides, the latter claims are fundamentally unsustainable. Nevertheless, the editors acknowledge that many significant and beloved figures have been omitted. Their list of individuals who had been considered and then dropped includes the writers Charlotte Perkins Gilman, Lois McMaster Bujold, Bruce Sterling, and Pat Cadigan; editors John W. Campbell, John Carnell and Judith Merril; musicians George Clinton and David Bowie; scientists Copernicus and Wernher von Braun; performance artist Orlan; and actor Sigourney Weaver. However, even their list of exclusions excludes a great many. For example, no Sun Ra, P. Funk, or Janelle Monae? No Herbert Weiner or Ray Kurzweil? No Stelarc? To be fair, the introduction does not give a full list of those considered and dropped, so perhaps they were, in fact, included in the discussions.At 250 pages, Fifty Key Figures is a relatively short work as encyclopedias and reference works go. Perhaps the brevity leaves open the argument for including more figures. On the other hand, it also keeps the book's cost lower, thereby making it more accessible for students. While length and cost are slightly less of an issue for researchers in the field and for reference libraries, cost must remain a factor for students and general public use. As a point of comparison, Routledge Companion to Science Fiction (by the same four editors) runs twice the length (576 pages) and almost twice the cost ($49.95). (Both are also available in Kindle editions.)As a quick comparison, Routledge Companion to Science Fiction takes a different approach. …

Do allergic families avoid keeping furry pets?

Studies addressing the relationship between pet keeping and development of asthma and allergies may be influenced by pet avoidance in families with a history of allergic disease. Following a cohort of 1019 children in Oslo till 10 years of age, we studied the association of pet keeping with socio-economic factors and allergic disease in the family. A family history of asthma and rhinoconjunctivitis was not significantly associated with pet ownership at birth or with pet removal by 10 years. Acquiring cats and dogs was less likely if the child had allergic rhinoconjunctivitis, whereas no association was seen with asthma (in any family member). Single parenthood increased the likelihood of acquiring a cat, smoking parents more often had cats or dogs, and having older siblings was associated with keeping dogs and other furry pets. Among 319 families reporting pet avoidance, 70% never had pets, 8% had given up pets, and 22% avoided a particular type of pet only. Twenty-four per cent of the parents failed to retrospectively report pet keeping during the child's first year of life. Overall, allergic rhinitis, but not asthma was associated with actual pet avoidance, whereas the strongest predictors for keeping pets were found to be socio-economic factors. Allergic disease in a child most often does not lead to the removal of the family's furry pet. Pet avoidance is associated with allergic symptoms, but not asthma. Socio-economic factors like parental education, single parenthood and smoking affects the families' decisions on pet keeping, including the type of pets the families will avoid or acquire. The large recall error demonstrated points to the need for prospective data regarding pet keeping.

What’s new in atopic eczema? An analysis of systematic reviews published in 2007 and 2008. Part 2. Disease prevention and treatment

This review summarizes clinically important findings from systematic reviews indexed in bibliographical databases between August 2007 and August 2008 that dealt with disease prevention (six reviews) and treatment of atopic eczema (seven reviews). Regarding disease prevention, two independent systematic reviews found some clinical trial evidence that ingestion of probiotics by mothers during pregnancy might reduce the incidence of subsequent eczema. Another review failed to find any clear benefit of prebiotics in eczema prevention. Although furry pets are often cited as causing allergic disease, a systematic review of observational studies found no evidence that exposure to cats or dogs at birth increases eczema risk. One very large review of studies of breastfeeding found some evidence of a protective effect on eczema risk, although all the studies were limited by their observational nature. A German group has attempted an overview of eczema prevention studies with a view to informing national guidelines. In terms of eczema treatment, two systematic reviews have confirmed the efficacy of topical tacrolimus ointment. Another review of 31 trials confirms the efficacy of topical pimecrolimus, although many of those trials were vehicle controlled, which limits their clinical utility. A review of 23 studies of desensitization therapy for allergic diseases found some evidence of benefit for eczema, which needs to be explored further. Despite the popularity of antistaphylococcal therapies for eczema, a Cochrane Review of 21 trials failed to show any clear benefit for any of the therapies for infected or clinically noninfected eczema. Another Cochrane Review dealt with dietary exclusions for people with eczema and found little evidence to support any dietary exclusion, apart from avoidance of eggs in infants with suspected egg allergy supported by evidence of sensitization. A review of 13 studies of probiotics for treating established eczema did not show convincing evidence of a clinically worthwhile benefit, an observation that has been substantiated in a subsequent Cochrane Review.

What’s new in atopic eczema? An analysis of systematic reviews published in 2007 and 2008. Part 1. Definitions, causes and consequences of eczema

This review summarizes clinically important findings from nine systematic reviews indexed in bibliographical databases between August 2007 and August 2008, dealing with the definitions, causes and consequences of atopic eczema (AE). One review of diagnostic criteria found that out of 10 sets of criteria, only the UK refinement of the Hanifin and Rajka criteria have been adequately tested (in 19 studies). Another review of 20 named outcome measures found that only three [SCORing Atopic Dermatitis (SCORAD), the Eczema Area and Severity Index (EASI) and the Patient Oriented Eczema Measure (POEM)] had been tested and found to perform adequately. In terms of risk factors for developing disease, a review found that birth by caesarean section increased the risk of asthma and hay fever but not eczema in offspring. A review of cohort studies also found evidence that adverse psychological factors in early life predispose to more atopic disease and a worse prognosis. Another review found that filaggrin gene mutations were a consistently strong risk factor for AE, with a person carrying one of these mutations being over three times more likely to exhibit eczema. It has been suggested that eczema might protect against some forms of cancer, and a detailed systematic review of brain cancers that included 53,233 participants from eight case-control and cohort studies found that having atopic disease was associated with a 39% reduction in glioma risk, a finding that was also present for just those with AE (odds ratio 0.69, 95% CI 0.58-0.82). A further review of case-control and cohort studies failed to find any association between keeping furry pets at birth and subsequent risk of eczema, although pet fur might still exacerbate established disease. In terms of disease consequences, a review found that eczema was the commonest cause of chronic sleep loss in young people, affected the whole family. A review of four economic studies from the US found that the annual cost of AE in the States was as high as $3.8 billion when indirect costs are included.

Allergy prevention.

Evidence-based primary prevention of allergic conditions is important in view of their increasing prevalence in Western industrialized countries. The Cochrane and Medline databases were searched for relevant scientific publications that appeared from February 2003 to May 2008. Articles in the reference lists of recent reviews were also considered, and experts were directly asked for their opinions. The retrieved publications were screened for relevance by evaluation of the title and abstract, and then by evaluation of the entire text. Each study chosen for inclusion was assigned an evidence grade as well as a grade for study quality relating to its potential for bias (low or high). The revised recommendations were then formally accepted by a consensus of representatives of medical specialist societies and other organizations, including a patient self-help group. The search initially yielded 4556 results out of which 217 articles (4 Cochrane reviews, 14 meta-analyses, 19 randomized clinical trials, 135 cohort studies, and 45 case-control studies) were chosen for inclusion and critical appraisal. No major changes ensued in the existing recommendations to avoid exposure to tobacco smoke, breast-feed for 4 months (or use hypoallergenic formulas), avoid a mould-promoting indoor climate, avoid exposure to furry pets (particularly cats), and vaccinate according to the current recommendations of the Standing Committee on Vaccination of the Robert Koch Institute (Ständige Impfkommission, STIKO). Neither the delayed introduction of solid food nor the avoidance of potent dietary allergens is recommended as a means of primary prevention. New recommendations were issued regarding fish consumption (by the mother while breastfeeding and nursing, and by the infant as solid food), avoidance of overweight, and reduction of exposure to air pollutants. This updated guideline serves as an aid in giving patients current, evidence-based recommendations for allergy prevention.

Re: Exposure to furry pets and the risk of asthma and allergic rhinitis: a meta‐analysis

Re: Exposure to furry pets and the risk of asthma and allergic rhinitis: a meta‐analysis

Exposure to furry pets and the risk of asthma and allergic rhinitis: a meta‐analysis

Exposure to pets has been implicated as a risk factor for asthma. However, this relation has been difficult to assess in individual studies because of the large potential of selection bias. We sought to examine the association between exposure to furry pets and asthma and allergic rhinitis by means of a meta-analysis. We retrieved studies published in any language by searching systematically Medline (1966-March 2007), Embase, LILACS and ISI Proceedings computerized databases, and by examining manually the references of the original articles and reviews retrieved. We included cohort and case-control studies reporting relative risk estimates and confidence intervals of exposure to cats, dogs and unspecified furry animals and subsequent asthma and allergic rhinitis. We excluded cross-sectional studies and those studies that did not measure exposure but rather sensitization to pets. Thirty-two studies were included. For asthma, the pooled relative risk related to dog exposure was 1.14 (95% CI 1.01-1.29), that related to exposure to any furry pet was 1.39 (95% CI 1.00-1.95). Among cohort studies, exposure to cats yielded a relative risk of 0.72 (95% CI 0.55-0.93). For rhinitis, the pooled relative risk of exposure to any furry pet was 0.79 (95% CI 0.68-0.93). Exposure to cats exerts a slight preventive effect on asthma, an effect that is more pronounced in cohort studies. On the contrary, exposure to dogs increases slightly the risk of asthma. Exposure to furry pets of undermined type is not conclusive. More studies with exact measurement of exposure are needed to elucidate the role of pet exposures in atopic diseases.

Diet among Japanese female university students and asthmatic symptoms, infections, pollen and furry pet allergy

To study associations between diet, respiratory symptoms and allergy among female university students in Japan. A standardised questionnaire was distributed to students in Kobe and Kamakura (N=153). Multiple logistic/linear regression was applied, controlling for age, smoking, heredity and diet. Totally 15.7% reported doctor-diagnosed asthma, 3.3% current asthma medication, 56.9% pollen allergy, 15.7% cat allergy, 11.1% dog allergy, 25.0% wheeze, 24.2% daytime and 9.3% nocturnal attacks of breathlessness. Meat consumption was related to wheeze (OR=2.00; 95% CI 1.12-3.60) and respiratory infections (OR=2.10; 95% CI 1.08-4.09). Fish consumption was related to less respiratory infections (OR=0.49; 95% CI 9.28-0.86), seafood to less pollen allergy (OR=0.66; 95% CI 0.44-0.99), and milk consumption to less daytime breathlessness (OR=0.72; 95% CI 0.55-0.95). Fast food consumption was related to wheeze (OR=1.89; 95% CI 1.23-2.91), daytime breathlessness (OR=1.50; 95% CI 1.00-2.28) and pollen allergy (OR=1.69; 95% CI 1.07-2.65). In total, 23.0% used butter, 21.7% margarine, 40.1% olive oil and 55.3% rapeseed oil. Those consuming butter (OR=2.65; 95% CI 1.11-6.32) and rapeseed oil (OR=2.35; 95% CI 1.03-5.38) had more wheeze. Those consuming margarine had more nocturnal breathlessness (OR=4.40; 95% CI 1.42-13.7). An asthma symptom score was related to fast food (p<0.05) and margarine consumption (p<0.01). Factor analysis identified five dietary patterns. A pattern including fast food, juice and soft drinks was related to wheeze and respiratory infections. Fish, seafood and milk consumption seems to be beneficial, while butter, margarine, rapeseed oil, fast food and soft drinks could be risk factors for allergy and respiratory health.

A Prospective Crossover Study to Understand Interactions Between the Environment and Symptom Control

National asthma guidelines emphasize symptom control as a function of asthma management, which includes allergen avoidance and medical therapy. This paper describes the impact of environmental mitigation on symptom control, use of short acting beta agonists, hospitalizations and emergency room visits. Patients were enrolled in a randomized, crossover environmental mitigation/education study. Group 1 began active phase at enrollment, switching to inactive phase at six months. Group 2 began inactive phase at enrollment, and active phase at six months. Observations of environment and asthma symptom diaries were collected every 2 weeks. 264 children were enrolled, mean age 6.5 years. Successful reduction of dust antigen, roaches, rodents, carpet and increasing mattress and pillow cover use seen in both groups. For Group 1, decreased nighttime coughing was associated with reduction of furry pets (p 0.008) and roaches (p 0.05) with increase mattress covers (p 0.04); and decreased nighttime wheezing was associated with reduction of furry pets (p 0.08) and increased mattress covers (p 0.01). For Group 2, decreased nighttime cough was associated with reduction of furry pets (p 0.02). Albuterol use was not affected by any trigger. Both groups showed reduction in emergency room (p < 0.0001) and inpatient visits (p 0.0006) as compared to 12 months before enrollment. Nighttime coughing appears to be more sensitive to trigger reduction than nighttime wheezing. Since nighttime wheezing is considered to be more severe than coughing, it may be that children for whom wheezing is their primary symptom, will not respond as quickly to changes in their environment.

The Role of Furry Pets in Eczema

To systematically search, summarize, and critically appraise the literature to examine whether pet exposure in early life is associated with an increased risk of eczema. We searched MEDLINE (1950 to June 2006) supplemented by citation lists in retrieved articles and contact with researchers. No language restrictions were imposed. Cohort studies were sufficiently similar to allow pooled analysis. Meta-analysis was not possible for cross-sectional studies owing to differences in methods and populations. Incidence or prevalence of eczema. Evidence from longitudinal studies showed that previous exposure to cats (pooled odds ratio [OR], 0.76; 95% confidence interval [CI], 0.62-0.92), dogs (pooled OR, 0.68; 95% CI, 0.53-0.87), or "any furry pet" (pooled OR, 0.79; 95% CI, 0.74-0.84) is associated with a lower risk of eczema. However, in the only cohort study adjusted for avoidance behavior, this "protective effect" disappeared (for cats: OR, 0.80; 95% CI, 0.33-1.97). Stratified analysis by family history in 2 birth cohort studies showed that dog exposure was protective in patients with atopic families. For cats, 1 study showed reduced risk in atopic families only; the other study showed no effect. Eight cross-sectional studies evaluated past pet exposure; a protective effect was seen in 3 studies for cat, dog, or any pet; no study demonstrated an increased risk. There was no clear evidence that early pet exposure is associated with increased risks of subsequent eczema. We found some evidence of a possible protective effect of early pet exposure, but this might be explained by avoidance behavior in high-risk families.

Asthma Severity and Atopy: How Clear Is the Relationship?

Carroll WD, Lenney W, Child F, et al. Arch Dis Child. 2006;91:405–409 PURPOSE OF THE STUDY. The term “atopy” can refer to allergic conditions such as allergic rhinitis, asthma, eczema, and food allergy, which cluster in families. It can also be defined as the tendency to generate an immunoglobulin E (IgE) response to specific allergens. Is there a relationship between such IgE responses and the severity of asthma? STUDY POPULATION. The study included 400 children (aged 7–18 years) with asthma (documented episodes of wheezing in the previous 12 calendar months and physician diagnosis). METHODS. Patients completed a standardized observer-administered International Study of Asthma and Allergies in Childhood questionnaire and underwent baseline spirometry, skin-prick testing (SPT) to dust mites, grass mix, cat, dog, cockroach and Alternaria, and measurement of total serum IgE level. Atopy was defined as at least 1 SPT wheal &amp;gt;3 mm or a total serum IgE level of &amp;gt;100 IU/mL. RESULTS. Total IgE was associated with increased asthma-severity score, decreased forced expiratory volume in 1 second (FEV1) (mean IgE with FEV1 &amp;lt; 80% predicted: 812; mean IgE with FEV1 &amp;gt; 80%: 449), and risk of hospital admission (mean IgE with hospitalization in last year: 726; no hospitalization: 392). Increasing skin-prick–test reactivity was associated with increased risk of hospital admission (mean sum of SPT wheals with hospitalization in last year: 12.1 mm; no hospitalization: 6.5 mm). CONCLUSIONS. In children with asthma, increasing atopy is associated with increasing asthma severity. REVIEWER COMMENTS. The majority of children with asthma have allergy, and the more allergy they have, the worse their asthma is. This is almost certainly a causal relationship; not surprisingly, inhaling things to which you are allergic can worsen your asthma. This reinforces the importance of assessing the allergic status of all children with asthma and reducing the exposure for those whose allergies are amenable to environmental control (dust mites, furry pets, mold, and cockroach).

Sensitization to serum albumins in children allergic to cow's milk and epithelia

Patients with persistent milk allergy and specific immunoglobulin E (IgE) to bovine serum albumin (BSA) have a greater risk of rhinoconjunctivitis and asthma because of animal dander. To prove the cross-reactivity between serum albumin (SA) of different mammals in milk, meat, and epithelia and determine if heat treatment of meats decrease the allergenicity of albumins. The study was performed using SDS-PAGE and IgE-immunoblotting using sera from eight patients sensitized to milk, BSA, and animal danders. Sera from non-allergic and only animal dander allergic subjects served as a control. With one exception, all patients' sera recognized SA in different meats (beef, lamb, deer, and pork), epithelia (dog, cat, and cow), and cow's milk. Some patients even were only sensitized to SA in meat and epithelia. Danders' allergic only recognized other proteins in epithelia but not SA. No patients reacted to SA from heated meat extracts. Serum albumin is an important allergen involved in milk, meat, and epithelia allergy. The first contact with SA was through cow's milk and patients developed sensitization to epithelia SA even without direct contact with animals. Patients with both BSA and cow's milk allergy must avoid raw meats and furry pets.