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Is allergy prevention realistic and beneficial?
1Department of Health and Environment, Linköping University, Sweden. maxkj@ped.liu.se
Insights
Childhood allergic diseases are rising, prompting a need for broader prevention strategies beyond high-risk infants. Research must identify more effective methods to combat this growing "allergy epidemic".
Area of Science:
- Pediatrics
- Immunology
- Public Health
Background:
- Childhood allergic diseases show a significant increase over recent decades.
- Current preventive measures primarily target high-risk infants (40-60% risk) with a biparental allergy history.
- Known risk factors explain only a fraction of the rise in pediatric allergies.
Discussion:
- Key recommendations include avoiding smoking during pregnancy and around children.
- Promoting breastfeeding offers immunological benefits for infants.
- Addressing indoor humidity and pet dander in homes and childcare settings may help reduce allergy development.
Key Insights:
- Effective interventions for the general population are lacking.
- Evidence-based assessment of preventive advice's acceptability, compliance, cost, and effectiveness is crucial.
- Continued preventive efforts are necessary for both high-risk and general populations.
Outlook:
- Further research is essential to discover more potent strategies against the escalating
- allergy epidemic.
Abstract:
Allergic diseases among children have shown a marked increase during the last two or three decades, despite increased awareness of possible preventive measures. Preventive efforts have focused on new-borns and infants with a biparental history of allergy as they are at particularly high risk of developing allergic disease (40-60%). No good intervention studies have been performed in the general population, only in high-risk families. Unfortunately, so far known risk factors can only explain a small part of the recent increase in allergic diseases. The most important recommendation for everyone is not to smoke during pregnancy and when living/working with young children. Breast milk is the best for every baby, even from an immunologic aspect. Humidity problems should be reduced in homes, day-care centres and schools. It is probably wise not to keep furred pets indoors in homes when babies have a family history of allergy. However, the effect of such advice should be assessed, including the acceptability, compliance, costs and effectiveness. There is no doubt that we should go on with preventive measures both in babies at high risk of allergy and also in the general population. At the same time, research should try to find even more efficient ways to reduce the current "allergy epidemic".