Search tips
Search criteria 


Logo of jepicomhJournal of Epidemiology and Community HealthVisit this articleSubmit a manuscriptReceive email alertsContact usBMJ
J Epidemiol Community Health. 1989 June; 43(2): 125–132.
PMCID: PMC1052814

Environmental factors and symptoms in infants at high risk of allergy.


STUDY OBJECTIVE: To identify environmental determinants of six symptoms associated with allergic disease in infancy. DESIGN: Infants were participants in a prospective randomised controlled trial of feeding practices in families with a history of atopy. SETTING: Infants were recruited in two maternity hospitals in S Wales and followed up in the community for 1 year. PARTICIPANTS: Mothers of 519 infants agreed to participate, but 36 were excluded (mainly for moving home or failing to attend for follow-up), leaving 483 in the study (253 male, 230 female). Infants were followed up and examined for evidence of allergic disease at 3, 6, and 12 months. MEASUREMENTS AND MAIN RESULTS: At each examination, mothers were questioned about episodes of illness in the infant, and the data presented relate to (reported and observed) eczema and nasal discharge, and (reported) wheeze, prolonged colds, diarrhoea and vomiting. Mothers kept a diary with details of feeding for the first 6 months. All homes were visited by a nurse who took samples of dust for dust mite antigen analysis. Extensive socio-demographic data were collected. None of the factors studied showed a convincing relationship with eczema. In a multiple logistic regression analysis breast feeding appeared to protect against wheeze, nasal discharge, colds, vomiting and diarrhoea. Having more siblings increased the likelihood of prolonged colds, and (together with overcrowding) of wheeze and nasal discharge. Maternal smoking and low social class were associated with wheeze, and house dust antigen with prolonged colds. Respiratory symptoms were associated with some aspects of housing but these could not be distinguished clearly from other social factors. Babies born in Autumn were at increased risk of wheeze, vomiting and diarrhoea. CONCLUSIONS: Environmental factors play an important part in determining risk of symptoms in potentially atopic babies. These factors are in principle open to manipulation.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (1.0M), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Miskelly FG, Burr ML, Vaughan-Williams E, Fehily AM, Butland BK, Merrett TG. Infant feeding and allergy. Arch Dis Child. 1988 Apr;63(4):388–393. [PMC free article] [PubMed]
  • Magnusson CG. Maternal smoking influences cord serum IgE and IgD levels and increases the risk for subsequent infant allergy. J Allergy Clin Immunol. 1986 Nov;78(5 Pt 1):898–904. [PubMed]
  • Harlap S, Davies AM. Infant admissions to hospital and maternal smoking. Lancet. 1974 Mar 30;1(7857):529–532. [PubMed]
  • Fergusson DM, Horwood LJ, Shannon FT, Taylor B. Parental smoking and lower respiratory illness in the first three years of life. J Epidemiol Community Health. 1981 Sep;35(3):180–184. [PMC free article] [PubMed]
  • Chen Y, Li W, Yu S. Influence of passive smoking on admissions for respiratory illness in early childhood. Br Med J (Clin Res Ed) 1986 Aug 2;293(6542):303–306. [PMC free article] [PubMed]
  • Geller-Bernstein G, Kenett R, Weisglass L, Tsur S, Lahav M, Levin S. Atopic babies with wheezy bronchitis. Follow-up study relating prognosis to sequential IgE values, type of early infant feeding, exposure to parental smoking and incidence of lower respiratory tract infections. Allergy. 1987 Feb;42(2):85–91. [PubMed]
  • Colley JR. Respiratory symptoms in children and parental smoking and phlegm production. Br Med J. 1974 Apr 27;2(5912):201–204. [PMC free article] [PubMed]
  • Bland M, Bewley BR, Pollard V, Banks MH. Effect of children's and parents' smoking on respiratory symptoms. Arch Dis Child. 1978 Feb;53(2):100–105. [PMC free article] [PubMed]
  • Tager IB, Weiss ST, Muñoz A, Rosner B, Speizer FE. Longitudinal study of the effects of maternal smoking on pulmonary function in children. N Engl J Med. 1983 Sep 22;309(12):699–703. [PubMed]
  • Murray AB, Morrison BJ. The effect of cigarette smoke from the mother on bronchial responsiveness and severity of symptoms in children with asthma. J Allergy Clin Immunol. 1986 Apr;77(4):575–581. [PubMed]
  • Cogswell JJ, Mitchell EB, Alexander J. Parental smoking, breast feeding, and respiratory infection in development of allergic diseases. Arch Dis Child. 1987 Apr;62(4):338–344. [PMC free article] [PubMed]
  • Schilling RS, Letai AD, Hui SL, Beck GJ, Schoenberg JB, Bouhuys A. Lung function, respiratory disease, and smoking in families. Am J Epidemiol. 1977 Oct;106(4):274–283. [PubMed]
  • Martin CJ, Platt SD, Hunt SM. Housing conditions and ill health. Br Med J (Clin Res Ed) 1987 May 2;294(6580):1125–1127. [PMC free article] [PubMed]
  • Burr ML, St Leger AS, Yarnell JW. Wheezing, dampness, and coal fires. Community Med. 1981 Aug;3(3):205–209. [PubMed]
  • Burr ML. Does infant feeding affect the risk of allergy? Arch Dis Child. 1983 Jul;58(7):561–565. [PMC free article] [PubMed]
  • Taylor B, Wadsworth J, Golding J, Butler N. Breast feeding, eczema, asthma, and hayfever. J Epidemiol Community Health. 1983 Jun;37(2):95–99. [PMC free article] [PubMed]
  • Anderson HR, Bland JM, Patel S, Peckham C. The natural history of asthma in childhood. J Epidemiol Community Health. 1986 Jun;40(2):121–129. [PMC free article] [PubMed]
  • Peckham C, Butler N. A national study of asthma in childhood. J Epidemiol Community Health. 1978 Jun;32(2):79–85. [PMC free article] [PubMed]
  • Smith JM, Springett VH. Atopic disease and month of birth. Clin Allergy. 1979 Mar;9(2):153–157. [PubMed]
  • Said G, Patois E, Lellouch J. Infantile colic and parental smoking. Br Med J (Clin Res Ed) 1984 Sep 15;289(6446):660–660. [PMC free article] [PubMed]
  • Pearson DJ, Freed DL, Taylor G. Respiratory allergy and month of birth. Clin Allergy. 1977 Jan;7(1):29–33. [PubMed]
  • Carosso A, Ruffino C, Bugiani M. The effect of birth season on pollenosis. Ann Allergy. 1986 Apr;56(4):300–303. [PubMed]

Articles from Journal of Epidemiology and Community Health are provided here courtesy of BMJ Publishing Group