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Risk factors for new-onset cat sensitization among adults: A population-based international cohort study - 03/02/12

Doi : 10.1016/j.jaci.2011.10.044 
Mario Olivieri, MD a, Jan-Paul Zock, PhD b, c, d, Simone Accordini, MSc e, Joachim Heinrich, PhD f, Deborah Jarvis, MBBS g, Nino Künzli, MD h, i, Josep M. Antó, MD b, c, d, j, Dan Norbäck, PhD k, Cecilie Svanes, MD l, Giuseppe Verlato, PhD e,

Indoor Working Group of the European Community Respiratory Health Survey II

a Unit of Occupational Medicine, University Hospital of Verona, Verona, Italy 
b Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain 
c Hospital del Mar Research Institute (IMIM), Barcelona, Spain 
d Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain 
e Unit of Epidemiology and Medical Statistics, University of Verona, Verona, Italy 
f Institute of Epidemiology, GSF-National Research Center for Environment and Health, Neuherberg, Germany 
g Respiratory Epidemiology and Public Health Group, Imperial College, London, United Kingdom 
h Swiss Tropical and Public Health Institute, Basel, Switzerland 
i University of Basel, Basel, Switzerland 
j Department of Health and Experimental Sciences, Universitat Pompeu Fabra, Barcelona, Spain 
k Department of Medical Science/Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden 
l Department of Thoracic Medicine, Institute of Medicine, University of Bergen, Bergen, Norway 

Corresponding author: Giuseppe Verlato, PhD, Sezione di Epidemiologia & Statistica Medica, Università di Verona, C/o Istituti Biologici II, Strada Le Grazie 8, 37134 Verona, Italy.

Abstract

Background

Cat exposure during childhood has been shown to increase the risk of developing cat sensitization, while the effect of cat exposure in adulthood has not yet been established.

Objective

To evaluate new-onset sensitization to cat in adulthood in relation to changes in cat keeping.

Methods

A total of 6292 European Community Respiratory Health Survey I (ECRHS I) participants aged 20 to 44 years from 28 European centers, who were not sensitized to cat, were reevaluated 9 years later in ECRHS II. Present and past cat ownership and total and specific IgE levels were assessed in both surveys. Allergen-specific sensitization was defined as a specific serum IgE level of 0.35 kU/L or more.

Results

A total of 4468 subjects did not have a cat in ECRHS I or ECRHS II, 473 had a cat only at baseline, 651 acquired a cat during the follow-up, and 700 had a cat at both evaluations. Two hundred thirty-one subjects (3.7%) became sensitized to cat. In a 2-level multivariable Poisson regression model, cat acquisition during follow-up was significantly associated with new-onset cat sensitization (relative risk = 1.85, 95% CI 1.23-2.78) when compared with those without a cat at both surveys. Preexisting sensitization to other allergens, a history of asthma, nasal allergies and eczema, and high total IgE level were also significant risk factors for developing cat sensitization, while cat ownership in childhood was a significant protective factor.

Conclusion

Our data support that acquiring a cat in adulthood nearly doubles the risk of developing cat sensitization. Hence, cat avoidance should be considered in adults, especially in those sensitized to other allergens and reporting a history of allergic diseases.

Le texte complet de cet article est disponible en PDF.

Key words : Sensitization, cat allergen, cat ownership, epidemiology, adulthood

Abbreviatons used : ECRHS, RR


Plan


 The coordination of ECRHS II was supported by the European Commission as part of its Quality of Life program. Funding for the individual centers is listed at www.ecrhs.org.
 Disclosure of potential conflict of interest: D. Jarvis has received grants from the European Union to coordinate ECRHS and to perform the Indoor study. J.-P. Zock and J.M. Antó have received grants from the FIS-Health Research Fund, Spain, to support the ECRHS II study in Spanish centers. The rest of the authors declare that they have no relevant conflicts of interest.


© 2011  American Academy of Allergy, Asthma & Immunology. Publié par Elsevier Masson SAS. Tous droits réservés.
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Vol 129 - N° 2

P. 420-425 - février 2012 Retour au numéro
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