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New Research - October 2009
Asthma, upper respiratory infections and daycare
Summary
Because the hygiene hypothesis proposes that decreased infections may be associated with an increase in the propensity toward the development of allergy, it has been suggested that early exposures to infections (e.g., respiratory infections) might diminish the propensity to develop allergic disease. To study this, investigators from The Netherlands followed a birth cohort of 3,963 children from birth to 8 years. They assessed daycare use and respiratory health by questionnaires. At 8 years, they evaluated sensitivity to airborne allergens and airway hyperresponsiveness. They found that children with early daycare had more wheezing in the first years of life, but less wheezing and steroid use between ages 4 and 8 years of age. At 8 years of age, early daycare was not protective for asthma symptoms. It also did not protect for allergic sensitization or airway hyperresponsiveness. The transient reduction in airway symptoms between the age of 4 and 8 years related to daycare was only seen in children without older siblings.
The authors concluded that early daycare is associated with an increase in airway symptoms until the age of 4 years, with a reduction between the ages of 4 and 8 years. However, there was no protection against asthma, hyperresponsiveness, or allergic sensitization.
Comment
This study is in contrast to earlier investigations that have found a preventive effect of daycare attendance on the development of asthma.
Reference
Caudri D, et al. Early daycare is associated with an increase in airway symptoms in early childhood, but is no protection against asthma or atopy at 8 years. American Journal of Respiratory and Critical Care Medicine 2009; 180:491-498.
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