The Journal of Allergy and Clinical Immunology
Volume 117, Issue 1 , Pages 59-66, January 2006

Allergic disease and sensitization in Steiner school children

  • Helen Flöistrup, MSc

      Affiliations

    • From the Institute of Environmental Medicine
    • Centre for Allergy Research, Karolinska Institutet, Stockholm
    • Corresponding Author InformationReprint requests: Helen Flöistrup, MSc, Institute of Environmental Medicine, Box 210, Karolinska Institutet, SE-171 77 Stockholm, Sweden.
    • ,
  • Jackie Swartz, MD

      Affiliations

    • Vidar Clinic, Järna
    • ,
  • Anna Bergström, PhD

      Affiliations

    • From the Institute of Environmental Medicine
    • ,
  • Johan S. Alm, MD, PhD

      Affiliations

    • Sachs' Children's Hospital, Stockholm Söder Hospital
    • ,
  • Annika Scheynius, MD, PhD

      Affiliations

    • Department of Medicine, Clinical Allergy Research Unit
    • ,
  • Marianne van Hage, MD, PhD

      Affiliations

    • Department of Medicine, Clinical Immunology and Allergy Unit, Karolinska Institutet and University Hospital, Stockholm
    • ,
  • Marco Waser, PhD

      Affiliations

    • Department of Environment and Health, Institute of Social and Preventive Medicine, University of Basel
    • ,
  • Charlotte Braun-Fahrländer, MD

      Affiliations

    • Department of Environment and Health, Institute of Social and Preventive Medicine, University of Basel
    • ,
  • Dieneke Schram-Bijkerk, MSc

      Affiliations

    • Institute for Risk Assessment Sciences, Utrecht University
    • ,
  • Machteld Huber, MD

      Affiliations

    • Louis Bolk Institute, Driebergen
    • ,
  • Anne Zutavern, MD

      Affiliations

    • Dr von Hauner Children's Hospital, University of Munich
    • ,
  • Erika von Mutius, MD

      Affiliations

    • Dr von Hauner Children's Hospital, University of Munich
    • ,
  • Ellen Üblagger, MD

      Affiliations

    • Department of Paediatric Pulmonology and Allergology, Children's Hospital, Salzburg
    • ,
  • Josef Riedler, MD, PhD

      Affiliations

    • Children's Hospital Schwarzach
    • ,
  • Karin B. Michaels, ScD, PhD

      Affiliations

    • Brigham and Women's Hospital, Harvard Medical School, and Department of Epidemiology, Harvard School of Public Health, Boston
    • ,
  • Göran Pershagen, MD, PhD

      Affiliations

    • From the Institute of Environmental Medicine
    • Department of Occupational and Environmental Health, Stockholm County Council
    • ,
  • the PARSIFAL Study Group

      Affiliations

    • Göran Pershagen, Tobias Alfvén, Johan Alm, Anna Bergström, Lars Engstrand, Helen Flöistrup, Marianne van Hage, Niclas Håkansson, Gunnar Lilja, Fredrik Nyberg, Annika Scheynius, Jackie Swartz, Magnus Wickman (Sweden); Charlotte Braun-Fahrländer, Marco Waser, Felix Sennhauser, Roger Lauener, Johannes Wildhaber, Alex Möller (Switzerland); Bert Brunekreef, Dieneke Schram-Bijkerk, Gert Doekes, Mirian Boeve, Jeroen Douwes, Machteld Huber, Mirjam Matze (The Netherlands); Erika von Mutius, Marcus R. Benz, Jörg Budde, Markus Ege (Germany); Josef Riedler, Waltraud Eder, Ellen Üblagger, Gertraud Weiss, Mynda Schreuer (Austria); Karin B. Michels (United States)

Received 10 May 2005; received in revised form 8 September 2005; accepted 12 September 2005. published online 29 November 2005.

Stockholm and Järna, Sweden, Basel, Switzerland, Utrecht and Driebergen, The Netherlands, Munich and Schwarzach, Germany, Salzburg, Austria, and Boston, Mass

Background

The anthroposophic lifestyle has several features of interest in relation to allergy: for example, a restrictive use of antibiotics and certain vaccinations. In a previous Swedish study, Steiner school children (who often have an anthroposophic lifestyle) showed a reduced risk of atopy, but specific protective factors could not be identified.

Objective

To investigate factors that may contribute to the lower risk of allergy among Steiner school children.

Methods

Cross-sectional multicenter study including 6630 children age 5 to 13 years (4606 from Steiner schools and 2024 from reference schools) in 5 European countries.

Results

The prevalence of several studied outcomes was lower in Steiner school children than in the reference group. Overall, there were statistically significant reduced risks for rhinoconjunctivitis, atopic eczema, and atopic sensitization (allergen-specific IgE ≥0.35 kU/L), with some heterogeneity between the countries. Focusing on doctor-diagnosed disease, use of antibiotics during first year of life was associated with increased risks of rhinoconjunctivitis (odds ratio [OR], 1.97; 95% CI, 1.26-3.08), asthma (OR, 2.79; 95% CI, 2.03-3.83), and atopic eczema (OR, 1.63; 95% CI, 1.22-2.17). Early use of antipyretics was related to an increased risk of asthma (OR, 1.54; 95% CI, 1.11-2.13) and atopic eczema (OR, 1.32; 95% CI, 1.02-1.71). Children having received measles, mumps, and rubella vaccination showed an increased risk of rhinoconjunctivitis, whereas measles infection was associated with a lower risk of IgE-mediated eczema.

Conclusion

Certain features of the anthroposophic lifestyle, such as restrictive use of antibiotics and antipyretics, are associated with a reduced risk of allergic disease in children.

Key words: Allergy, anthroposophic lifestyle, antibiotics, antipyretics, asthma, biodynamic diet, measles, sensitization, vaccination

Abbreviations used: MMR, Measles, mumps, and rubella, OR, Odds ratio, PARSIFAL, Prevention of Allergy—Risk Factors for Sensitization Related to Farming and Anthroposophic Lifestyle

 

 Supported by a research grant from the European Union, QLRT 1999-01391, and by funding from the Swedish Foundation for Health Care Science and Allergy Research.

PII: S0091-6749(05)02128-7

doi:10.1016/j.jaci.2005.09.039

The Journal of Allergy and Clinical Immunology
Volume 117, Issue 1 , Pages 59-66, January 2006

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