Association of bacterial load in drinking water and allergic diseases in childhood
File(s)
Supporting information
Accepted version
Author(s)
Type
Journal Article
Abstract
Background
Treatment of drinking water may decrease microbial exposure.
Objective
To investigate whether bacterial load in drinking water is associated with altered risk of allergic diseases.
Methods
We recruited 1,110 schoolchildren aged 6‐16 years between 2011 and 2013 in Požega‐Slavonia County in Croatia, where we capitalized on a natural experiment whereby individuals receive drinking water through public mains supply or individual wells. We obtained data on microbial content of drinking water for all participants; 585 children were randomly selected for more detailed assessments, including skin prick testing. Since water supply was highly correlated with rural residence, we compared clinical outcomes across four groups (Rural/Individual, Rural/Public, Urban/Individual and Urban/Public). For each child, we derived quantitative index of microbial exposure (bacterial load in the drinking water measured during the child's first year of life).
Results
Cumulative bacterial load in drinking water was higher (median [IQR]: 6390 [4190‐9550] vs 0 [0‐0]; P < .0001), and lifetime prevalence of allergic diseases was significantly lower among children with individual supply (5.5% vs 2.3%, P = .01; 14.4% vs 6.7%, P < .001; 25.2% vs 15.1%, P < .001; asthma, atopic dermatitis [AD] and rhinitis, respectively). Compared with the reference group (Urban/Public), there was a significant reduction in the risk of ever asthma, AD and rhinitis amongst rural children with individual supply: OR [95% CI]: 0.14 [0.03,0.67], P = .013; 0.20 [0.09,0.43], P < .001; 0.17 [0.10,0.32], P < .001. Protection was also observed in the Rural/Public group, but the effect was consistently highest among Rural/Individual children. In the quantitative analysis, the risk of allergic diseases decreased significantly with increasing bacterial load in drinking water in the first year of life (0.79 [0.70,0.88], P < .001; 0.90 [0.83,0.99], P = .025; 0.80 [0.74,0.86], P < .001; current wheeze, AD and rhinitis).
Conclusions and Clinical Relevance
High commensal bacterial content in drinking water may protect against allergic diseases.
Treatment of drinking water may decrease microbial exposure.
Objective
To investigate whether bacterial load in drinking water is associated with altered risk of allergic diseases.
Methods
We recruited 1,110 schoolchildren aged 6‐16 years between 2011 and 2013 in Požega‐Slavonia County in Croatia, where we capitalized on a natural experiment whereby individuals receive drinking water through public mains supply or individual wells. We obtained data on microbial content of drinking water for all participants; 585 children were randomly selected for more detailed assessments, including skin prick testing. Since water supply was highly correlated with rural residence, we compared clinical outcomes across four groups (Rural/Individual, Rural/Public, Urban/Individual and Urban/Public). For each child, we derived quantitative index of microbial exposure (bacterial load in the drinking water measured during the child's first year of life).
Results
Cumulative bacterial load in drinking water was higher (median [IQR]: 6390 [4190‐9550] vs 0 [0‐0]; P < .0001), and lifetime prevalence of allergic diseases was significantly lower among children with individual supply (5.5% vs 2.3%, P = .01; 14.4% vs 6.7%, P < .001; 25.2% vs 15.1%, P < .001; asthma, atopic dermatitis [AD] and rhinitis, respectively). Compared with the reference group (Urban/Public), there was a significant reduction in the risk of ever asthma, AD and rhinitis amongst rural children with individual supply: OR [95% CI]: 0.14 [0.03,0.67], P = .013; 0.20 [0.09,0.43], P < .001; 0.17 [0.10,0.32], P < .001. Protection was also observed in the Rural/Public group, but the effect was consistently highest among Rural/Individual children. In the quantitative analysis, the risk of allergic diseases decreased significantly with increasing bacterial load in drinking water in the first year of life (0.79 [0.70,0.88], P < .001; 0.90 [0.83,0.99], P = .025; 0.80 [0.74,0.86], P < .001; current wheeze, AD and rhinitis).
Conclusions and Clinical Relevance
High commensal bacterial content in drinking water may protect against allergic diseases.
Date Issued
2020-04-20
Date Acceptance
2020-03-22
Citation
Clinical and Experimental Allergy, 2020, 50 (6), pp.733-740
ISSN
0954-7894
Publisher
Wiley
Start Page
733
End Page
740
Journal / Book Title
Clinical and Experimental Allergy
Volume
50
Issue
6
Copyright Statement
© 2020 John Wiley & Sons Ltd. This is the pre-peer reviewed version of the following article: Turkalj, M, Drkulec, V, Haider, S, et al. Association of bacterial load in drinking water and allergic diseases in childhood. Clin Exp Allergy. 2020; 50: 733– 740, which has been published in final form at https://doi.org/10.1111/cea.13605
Identifier
http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000527053700001&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
Subjects
Science & Technology
Life Sciences & Biomedicine
Allergy
Immunology
atopy
bacterial load
children
drinking water
microbiota
well water
RISK-FACTORS
ASTHMA
MICROBIOTA
EXPOSURE
FINNISH
URBAN
COLONIZATION
CHILDREN
SHAPES
ATOPY
Publication Status
Published
Date Publish Online
2020-04-09