Early-life risk factors and incidence of rhinitis: Results from the European Community Respiratory Health Study-an international population-based cohort study
Matheson, MC and Dharmage, SC and Abramson, MJ and Walters, EH and Sunyer, J and de Marco, R and Leynaert, B and Heinrich, J and Jarvis, D and Norback, D and Raherison, C and Wjst, M and Svanes, C, Early-life risk factors and incidence of rhinitis: Results from the European Community Respiratory Health Study-an international population-based cohort study, Journal of Allergy and Clinical Immunology, 128, (4) pp. 816-823. ISSN 0091-6749 (2011) [Refereed Article]
Background: Rhinitis is an increasingly common condition with
a heavy health care burden, but relatively little is known about
its risk factors.
Objective: To examine the association between early-life factors
and the development of rhinitis in the European Community
Respiratory Health Study (ECRHS).
Methods: In 1992-1994, community-based samples of 20-44-yearold
people were recruited from 48 centers in 22 countries. On
average, 8.9 years later, 28 centers reinvestigated their samples.
Onset of rhinitis was reported by 8486 participants in interviewerled
questionnaires. Cox regression was used to assess independent
predictors of rhinitis at ages <5, 6-10, 11-20, and >21 years.
Results: The crude lifelong incidence of rhinitis was 7.00/1000/
year (men) and 7.95/1000/year (women) (P 5 .002). Women
developed less rhinitis in later childhood (hazard ratios [HR],
0.63; 95% CI, 0.47-0.85) and more rhinitis in adulthood (HR,
1.36; 95% CI, 1.11-1.66) than did men. In atopic subjects,
siblings were associated with lower risk of rhinitis throughout
life (pooled HR, 0.94; 95% CI, 0.91-0.98 per 1 sibling). Early
contact with children in the family or day care was associated
with less incidence of rhinitis, predominantly before age 5 years
(HR, 0.84; 95% CI, 0.72-0.99). Early childhood pets or growing
up on a farm was associated with less incidence of rhinitis in
adolescence (HR, 0.50; 95% CI, 0.37-0.68). Combining these
factors showed evidence of a dose-response relationship (trend
P 5 .0001).
Conclusions: Gender is a strong risk factor for rhinitis, with age
patterns varying according to atopic status. Protective effects of
early contact with children and animals were suggested for
incident rhinitis, with risk patterns varying by age window and
Rhinitis, atopy, gender, pet exposure, siblings, farming lifestyle