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The Urban-Rural Gradient In Asthma: A Population-Based Study in Northern Europe
Aarhus Univ, Danish Ramazzini Ctr, Dept Publ Hlth, DK-8000 Aarhus C, Denmark..
Aarhus Univ, Danish Ramazzini Ctr, Dept Publ Hlth, DK-8000 Aarhus C, Denmark..
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
Univ Melbourne, Melbourne Sch Populat & Global Hlth, Ctr Epidemiol & Biostat, Allergy & Lung Hlth Unit, Melbourne, Vic 3010, Australia..
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2016 (English)In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 13, no 1, UNSP 93Article in journal (Refereed) PublishedText
Abstract [en]

The early life environment appears to have a persistent impact on asthma risk. We hypothesize that environmental factors related to rural life mediate lower asthma prevalence in rural populations, and aimed to investigate an urban-rural gradient, assessed by place of upbringing, for asthma. The population-based Respiratory Health In Northern Europe (RHINE) study includes subjects from Denmark, Norway, Sweden, Iceland and Estonia born 1945-1973. The present analysis encompasses questionnaire data on 11,123 RHINE subjects. Six categories of place of upbringing were defined: farm with livestock, farm without livestock, village in rural area, small town, city suburb and inner city. The association of place of upbringing with asthma onset was analysed with Cox regression adjusted for relevant confounders. Subjects growing up on livestock farms had less asthma (8%) than subjects growing up in inner cities (11%) (hazard ratio 0.72 95% CI 0.57-0.91), and a significant urban-rural gradient was observed across six urbanisation levels (p = 0.02). An urban-rural gradient was only evident among women, smokers and for late-onset asthma. Analyses on wheeze and place of upbringing revealed similar results. In conclusion, this study suggests a protective effect of livestock farm upbringing on asthma development and an urban-rural gradient in a Northern European population.

Place, publisher, year, edition, pages
2016. Vol. 13, no 1, UNSP 93
Keyword [en]
asthma, early life environment, farming, microbial exposure, urban-rural gradient, hygiene hypothesis, RHINE
National Category
Respiratory Medicine and Allergy
URN: urn:nbn:se:uu:diva-296878DOI: 10.3390/ijerph13010093ISI: 000374186100142OAI: diva2:940042
Swedish Heart Lung FoundationForte, Swedish Research Council for Health, Working Life and Welfare
Available from: 2016-06-20 Created: 2016-06-20 Last updated: 2016-06-20Bibliographically approved

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