Kristiane A Engebretsen1, Peter Bager2, Jan Wohlfahrt2, Lone Skov3, Claus Zachariae3, Anne-Marie Nybo Andersen4, Mads Melbye2, Jacob P Thyssen5. 1. National Allergy Research Centre, Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark; Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark. 2. Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark. 3. Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark. 4. Department of Public Health, Section of Social Medicine, University of Copenhagen, Copenhagen, Denmark. 5. National Allergy Research Centre, Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark; Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark. Electronic address: jacob.pontoppidan.thyssen@regionh.dk.
Abstract
BACKGROUND: Atopic dermatitis (AD) appears to be more common in regions with hard domestic water and in children with a fall/winter birth. However, it is unknown whether a synergistic effect exists. OBJECTIVE: We sought to evaluate the association between domestic water hardness and season of birth, respectively, with onset of AD within the first 18 months of life in a large Danish birth cohort. METHODS: Of children from the Danish National Birth Cohort, 52,950 were included. History of physician-diagnosed AD and population characteristics were obtained from interviews. Birth data were obtained from the Civil Registration System, and domestic water hardness data were obtained from the Geological Survey of Denmark and Greenland. The relative prevalence (RP) of AD was calculated by using log-linear binomial regression. RESULTS: The prevalence of AD was 15.0% (7,942/52,950). The RP of AD was 5% (RPtrend, 1.05; 95% CI, 1.03-1.07) higher for each 5° increase in domestic water hardness (range, 6.60-35.90 German degrees of hardness [118-641 mg/L]). Although the RP of AD was higher in children with a fall (RP, 1.24; 95% CI, 1.17-1.31) or winter (RP, 1.18; 95% CI, 1.11-1.25) birth, no significant interaction was observed with domestic water hardness. The population attributable risk of hard domestic water on AD was 2%. CONCLUSION: We observed that early exposure to hard domestic water and a fall/winter birth was associated with an increase in the relative prevalence of AD within the first 18 months of life. Although the 2 exposures did not interact synergistically, a dose-response relationship was observed between domestic water hardness and AD.
BACKGROUND:Atopic dermatitis (AD) appears to be more common in regions with hard domestic water and in children with a fall/winter birth. However, it is unknown whether a synergistic effect exists. OBJECTIVE: We sought to evaluate the association between domestic water hardness and season of birth, respectively, with onset of AD within the first 18 months of life in a large Danish birth cohort. METHODS: Of children from the Danish National Birth Cohort, 52,950 were included. History of physician-diagnosed AD and population characteristics were obtained from interviews. Birth data were obtained from the Civil Registration System, and domestic water hardness data were obtained from the Geological Survey of Denmark and Greenland. The relative prevalence (RP) of AD was calculated by using log-linear binomial regression. RESULTS: The prevalence of AD was 15.0% (7,942/52,950). The RP of AD was 5% (RPtrend, 1.05; 95% CI, 1.03-1.07) higher for each 5° increase in domestic water hardness (range, 6.60-35.90 German degrees of hardness [118-641 mg/L]). Although the RP of AD was higher in children with a fall (RP, 1.24; 95% CI, 1.17-1.31) or winter (RP, 1.18; 95% CI, 1.11-1.25) birth, no significant interaction was observed with domestic water hardness. The population attributable risk of hard domestic water on AD was 2%. CONCLUSION: We observed that early exposure to hard domestic water and a fall/winter birth was associated with an increase in the relative prevalence of AD within the first 18 months of life. Although the 2 exposures did not interact synergistically, a dose-response relationship was observed between domestic water hardness and AD.
Authors: Maeve M Kelleher; Suzie Cro; Victoria Cornelius; Karin C Lodrup Carlsen; Håvard O Skjerven; Eva M Rehbinder; Adrian J Lowe; Eishika Dissanayake; Naoki Shimojo; Kaori Yonezawa; Yukihiro Ohya; Kiwako Yamamoto-Hanada; Kumiko Morita; Emma Axon; Christian Surber; Michael Cork; Alison Cooke; Lien Tran; Eleanor Van Vogt; Jochen Schmitt; Stephan Weidinger; Danielle McClanahan; Eric Simpson; Lelia Duley; Lisa M Askie; Joanne R Chalmers; Hywel C Williams; Robert J Boyle Journal: Cochrane Database Syst Rev Date: 2021-02-05
Authors: Debajyoti Ghosh; Jonathan A Bernstein; Gurjit K Khurana Hershey; Marc E Rothenberg; Tesfaye B Mersha Journal: Front Immunol Date: 2018-12-12 Impact factor: 7.561
Authors: Kilian Eyerich; Sara J Brown; Bethany E Perez White; Reiko J Tanaka; Robert Bissonette; Sandipan Dhar; Thomas Bieber; Dirk J Hijnen; Emma Guttman-Yassky; Alan Irvine; Jacob P Thyssen; Christian Vestergaard; Thomas Werfel; Andreas Wollenberg; Amy S Paller; Nick J Reynolds Journal: J Allergy Clin Immunol Date: 2018-11-07 Impact factor: 10.793
Authors: Zarif K Jabbar-Lopez; Nikeeta Gurung; Danielle Greenblatt; Annette Briley; Joanne R Chalmers; Kim Suzanne Thomas; Tony Frost; Sanja Kezic; John E A Common; Heidi H Kong; Julie A Segre; Simon Danby; Michael J Cork; Janet L Peacock; Carsten Flohr Journal: BMJ Open Date: 2019-08-20 Impact factor: 2.692
Authors: Helen A Brough; Kari C Nadeau; Sayantani B Sindher; Shifaa S Alkotob; Susan Chan; Henry T Bahnson; Donald Y M Leung; Gideon Lack Journal: Allergy Date: 2020-05-18 Impact factor: 13.146