Allergic disease and sensitization in Steiner school children
Helen Flöistrup, MSc, Jackie Swartz, MD, Anna Bergström, PhD, Johan S. Alm, MD, PhD, Annika Scheynius, MD, PhD, Marianne van Hage, MD, PhD, Marco Waser, PhD, Charlotte Braun-Fahrländer, MD, Dieneke Schram-Bijkerk, MSc, Machteld Huber, MD, Anne Zutavern, MD, Erika von Mutius, MD, Ellen Üblagger, MD,k Josef Riedler, MD, PhD,l Karin B. Michaels, ScD, PhD, Göran Pershagen, MD, PhD, and the PARSIFAL Study Group
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 receivedmeasles,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.
(J Allergy Clin Immunol 2006;117:59-66.)
Keywords: Allergy, anthroposophic lifestyle, antibiotics, antipyretics,
asthma, biodynamic diet, measles, sensitization, vaccination