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Br Med J (Clin Res Ed). 1988 April 2; 296(6627): 956–958.
PMCID: PMC2545433

Acute appendicitis and bathrooms in three samples of British children


The occurrence of appendicectomy in three national samples of British children was analysed in relation to household amenities, crowding in the home, and social class. The risk of having the operation depended on the amenities present in the home, in particular whether or not there was a bathroom. This risk was independent of social class.

The findings support a relation between acute appendicitis and Western hygiene, which would explain the geographical distribution of the disease and its changing incidence over time. In the developing world, where children grow up in conditions of poor hygiene, there may be outbreaks of appendicitis when housing improves.

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Selected References

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  • Barker DJ. Acute appendicitis and dietary fibre: an alternative hypothesis. Br Med J (Clin Res Ed) 1985 Apr 13;290(6475):1125–1127. [PMC free article] [PubMed]
  • Wadsworth ME. Follow-up of the first national birth cohort: findings from the Medical Research Council National Survey of Health and Development. Paediatr Perinat Epidemiol. 1987 Apr;1(1):95–117. [PubMed]
  • Butler NR, Golding J, Haslum M, Stewart-Brown S. Recent findings from the 1970 child health and education study: preliminary communication. J R Soc Med. 1982 Oct;75(10):781–784. [PMC free article] [PubMed]
  • Spencer AM. Aetiology of Appendicitis. Br Med J. 1938 Jan 29;1(4021):227–230. [PMC free article] [PubMed]
  • Attwood SE, Cafferkey MT, West AB. High appendicectomy rates in Ireland: why? J Epidemiol Community Health. 1987 Mar;41(1):72–73. [PMC free article] [PubMed]
  • Attwood SE, Mealy K, Cafferkey MT, Buckley TF, West AB, Boyle N, Healy E, Keane FB. Yersinia infection and acute abdominal pain. Lancet. 1987 Mar 7;1(8532):529–533. [PubMed]
  • Burkitt DP. The aetiology of appendicitis. Br J Surg. 1971 Sep;58(9):695–699. [PubMed]
  • Schaefer O. Aetiology of appendicitis. Br Med J. 1979 May 5;1(6172):1215–1215. [PMC free article] [PubMed]

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