Early daycare may not lower asthma risk

Contrary to what some previous studies have suggested, children who enter daycare at an early age may not have a reduced risk of allergies and asthma later on, researchers reported Tuesday.

In a study of more than 3,600 children followed from birth, the investigators found that children who entered daycare before the age of 2 were no less likely than their peers to suffer from allergies or asthma at the age of 8.

But early daycare did not appear to raise those risks either, senior researcher Dr. Johan C. de Jongste, of Erasmus University in Rotterdam, the Netherlands, told Reuters Health in an email.

Instead, the findings suggest that daycare has little long-term effect on children’s respiratory health — and that it should not be seen as a way to protect them from allergies and asthma down the road, the researchers report in the journal American Journal of Respiratory and Critical Care Medicine.

The study, de Jongste said, challenges what is known as the “hygiene hypothesis” — the theory that the increasingly germ-free surroundings of modern life are actually contributing to an increase in allergies and asthma.

Some researchers speculate that exposure to viruses and other bugs at daycare may help push a young child’s immune system toward infection-fighting mode, and away from a tendency to over-react to the normally benign substances — the basis of allergic conditions.

Along with daycare attendance, certain other factors that suggest greater early-life exposure to infections — like having older siblings — have also been linked to lower risks of childhood allergies and asthma.

But in the current study, neither daycare nor the presence of older siblings showed long-term effects.

Of the 3,643 children followed from birth to age 8, 30 percent started daycare before age 2. These children were twice as likely as the rest to suffer breathing difficulties in the first year of life.

But the pattern shifted with time, and by the age of 8, early-daycare children were no more — or no less — likely to have episodes of wheezing or other signs or symptoms of asthma. Nor did early daycare affect the risk of showing reactions to airborne allergens during allergy testing.

Children with older siblings were also more likely to have wheezing symptoms in the first year of life, but were no more or no less likely to have signs or symptoms of allergies or asthma at age 8.

The findings, de Jongste’s team writes, suggests that early daycare simply “shifts the burden” of respiratory symptoms to an earlier age, with no tradeoff of protective effects later on.

“Hence,” they conclude, “early daycare should not be promoted for reasons of preventing allergy and asthma.”

SOURCE: American Journal of Respiratory and Critical Care Medicine, September 15, 2009.

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Ethnically dense neighborhood good for health

Living in a neighborhood with a lot of people of similar ethnic background may have some health benefit, hints a new study from the United Kingdom.

In the study, fewer activity-limiting long-term illnesses were reported by people who lived in neighborhoods they felt were more than half made up of people with whom they shared a common ethnicity.

This effect was seen among white (primarily of British and Irish ancestry), Indian, Pakistani, Bangladeshi, and African race and ethnic groups, despite the tendency of ethnic minorities to “live in deprived neighborhoods,” Dr. Mai Stafford, from University College London, told Reuters Health in an email correspondence.

Stafford’s team measured actual ethnic density of various neighborhoods and asked residents for their views on the ethnic makeup of their own neighborhood.

The study included 8,850 whites, 1,299 Indians, 678 Pakistanis, 233 Bangladeshis, 690 Africans, and 820 of Caribbean ethnicity.

The investigators found general agreement between actual and perceived ethnic density, except that whites tended to underestimate the proportion of whites in their neighborhoods.

By contrast, “ethnic minority participants tended to overestimate the proportion of people from the same ethnic background as themselves in the local area,” Stafford said.

A health benefit of living in neighborhood with people of the same ethnic background was evident for all ethnic groups – except those of Caribbean ethnicity.

For unexplained reasons that need further study, those of Caribbean ethnicity reported fewer long-term illnesses associated with actual, rather than perceived, ethnic density.

In earlier research, Stafford and colleagues reported ethnic minorities living in areas with greater proportions of “co-ethnics” experience less racial discrimination and associated stress, which may partially explain the current findings.

They call for continued investigations to further explain and clarify the impact neighborhood ethnic density has on overall health.

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Early daycare may not lower asthma risk

Early daycare may not lower asthma risk

Ethnically dense neighborhood good for health

Ethnically dense neighborhood good for health