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Published on: August 7, 2017
Primary prevention of childhood asthma and allergic disorders
Moira Chan-Yeung1, Allan Becker
1Occupational and Environmental Lung Diseases Unit, Respiratory Division, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada. myeung@interchange.ubc.ca
Insights
Primary prevention of childhood asthma and allergies is complex. Multifaceted interventions reducing allergen exposure show promise, but more research is needed on long-term effects and novel strategies.
Area of Science:
- Pediatric Allergy and Immunology
- Environmental Health
- Preventive Medicine
Background:
- Childhood asthma and allergic disorders are increasing globally.
- Environmental factors play a significant role in disease development.
- Primary prevention strategies are crucial.
Purpose of the Study:
- To review recent findings on environmental risk factors for childhood asthma and allergies.
- To examine the manipulation of these factors for primary prevention.
- To address controversies and emerging evidence in the field.
Main Methods:
- Review of recent scientific literature on environmental risk factors and interventions.
- Analysis of studies on indoor aeroallergens, viral infections, and breastfeeding.
- Evaluation of multifaceted intervention trials and other preventive measures.
Main Results:
- Controversy persists regarding indoor aeroallergen exposure and asthma risk.
- Infant bronchiolitis (RSV) increases asthma risk, but not atopy.
- Breastfeeding effects are debated; multifaceted allergen reduction interventions show reduced asthma prevalence in high-risk infants.
- Probiotics, education, and immunizations show some protective effects.
Conclusions:
- Further research is needed on long-term follow-up of intervention studies.
- Optimal timing and duration of interventions require investigation.
- Novel approaches for primary prevention of pediatric asthma and allergies warrant exploration.
Purpose Of Review:
The prevalence of asthma and allergic disorders in childhood is increasing in many parts of the world. This review focuses on recent findings with regard to environmental risk factors and their manipulation in the primary prevention of these diseases in childhood.
Recent Findings:
Recent studies have failed to resolve the controversy on the subject of exposure to indoor aeroallergens and the risk of sensitization and asthma in childhood. Bronchiolitis due to respiratory syncytial virus in infancy is associated with a significant increase in risk of asthma, but not atopy. In the prevention of these diseases, the effects of breastfeeding are controversial, with studies showing a protective effect in children without allergic predisposition, but other studies showing no effect or even the potential for an increased asthma risk. A significant reduction in the prevalence of doctor-diagnosed asthma at 7 years was found in a randomized controlled multifaceted (reduction of inhaled and ingested allergens) intervention study of high-risk infants. Other intervention measures, such as an education program on how to reduce exposure, the use of probiotics, and immunization against infections, all showed some protective effects.
Summary:
More research is required, especially with regard to longer periods of follow-up for all current intervention studies aimed at reducing exposure, the onset and duration of intervention, and other novel intervention measures in the primary prevention of asthma and allergic diseases in childhood.
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