Community intervention and the development of allergy-related diseases in children at six years of age - The Prevention of Allergy among Children in Trondheim (PACT) study
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Background: Childhood asthma and allergy-related diseases are the most common group of non-communicable diseases in children today. Environmental risk factors of these diseases, like tobacco smoke, diet and indoor climate, are preventable. The aim of this study was to investigate whether a reduction of these risk factors could impact the prevalence of allergyrelated diseases at 6 years of age. Method: We recruited 19 795 children from an unselected population in Trondheim, Norway into a multi-centre interventional cohort, through the help of midwives, general practitioners, child health centres and schools. A control cohort was established from mid-2000 and recruitment to the intervention cohort following a health advice campaign to all pregnant women that started in mid-2002 in Trondheim, Norway. The intervention consisted of advice aimed at reducing parental smoking before and after pregnancy, increasing intake of fatty fish and cod liver oil to the pregnant women and the children, and reducing indoor dampness. Outcomes were collected with questionnaires completed in pregnancy, at 6 weeks, 1 year, 2 years and 6 years of age. Results: There was a significant reduction of lifetime asthma at 6 years of age (odds ratio (OR) = 0.66, 0.78-0.92 (95 % CI)), the change was statistically significant in girls (OR = 0.42, 0.22-0.80). The risk of current asthma (within the last 12 months) at 6 years was reduced in the intervention cohort (OR = 0.62, 0.43-0.90), and here a statistically significant difference was observed among the boys (OR = 0.63, 0.41-0.96). For current atopic dermatitis (AD) (within the last 12 months), we also observed a reduced risk in the intervention cohort (OR = 0.79, 0.67-0.92). Conclusion: A reduction in tobacco smoke and increased intake of fatty fish and cod liver oil in pregnancy and after birth could be effective in preventing asthma and AD in 6-year-old children.