Is allergen exposure the major primary cause of asthma?. Pearce, N.; Douwes, J.; and Beasley, R. Thorax, 55(5):424-431, 2000.
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In recent decades a number of authors have argued that allergen exposure is the major primary cause of asthma, and that the global increases in asthma prevalence are due to increases in exposure to aero-allergens. We have assessed the epidemio-logical evidence in support of this hypothesis. No longitudinal studies were identified in which allergen exposure dur-ing infancy in a random population sam-ple has been related to asthma risk after the age of six years. Two studies have been conducted in selected populations chosen on the basis of a family history of asthma or allergy; one study found a non-statistically significant association where-as the other study found no association. Many of the identified prevalence studies in children showed negative associations between allergen exposure and current asthma, and the weighted averages of the population attributable risks in children were 4% for Der p 1, 11% for Fel d 1, –4% for Bla g 2, and 6% for Can f 1. There was little change in these estimates in studies in which children whose parents had adopted allergen avoidance measures were excluded. Furthermore, evidence from population studies is equivocal and provides little consistent evidence that allergen exposure is associated with the prevalence of asthma at the population level. Population-based cohort studies are clearly required, but currently available evidence does not indicate that allergen exposure is a major risk factor for the pri-mary causation of asthma in children. (Thorax 2000;55:424–431)
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 year = {2000},
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 keywords = {5 furthermore,across populations or time,allergen,asthma,atopy,between the,childhood exposure,half,periods show only a,standardised comparisons,weak and inconsistent association},
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 abstract = {In recent decades a number of authors have argued that allergen exposure is the major primary cause of asthma, and that the global increases in asthma prevalence are due to increases in exposure to aero-allergens. We have assessed the epidemio-logical evidence in support of this hypothesis. No longitudinal studies were identified in which allergen exposure dur-ing infancy in a random population sam-ple has been related to asthma risk after the age of six years. Two studies have been conducted in selected populations chosen on the basis of a family history of asthma or allergy; one study found a non-statistically significant association where-as the other study found no association. Many of the identified prevalence studies in children showed negative associations between allergen exposure and current asthma, and the weighted averages of the population attributable risks in children were 4% for Der p 1, 11% for Fel d 1, –4% for Bla g 2, and 6% for Can f 1. There was little change in these estimates in studies in which children whose parents had adopted allergen avoidance measures were excluded. Furthermore, evidence from population studies is equivocal and provides little consistent evidence that allergen exposure is associated with the prevalence of asthma at the population level. Population-based cohort studies are clearly required, but currently available evidence does not indicate that allergen exposure is a major risk factor for the pri-mary causation of asthma in children. (Thorax 2000;55:424–431)},
 bibtype = {article},
 author = {Pearce, N. and Douwes, J. and Beasley, R.},
 journal = {Thorax},
 number = {5}
}
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