Title:Hygiene Hypothesis and Occupational Asthma to Vegetable Textile Dusts:
A Pilot Study
Volume: 17
Issue: 3
Author(s): Chayma Sridi, Maher Maoua*, Imene Kacem, Imene Jammeli, Asma Chouchane, Asma Aloui, Aicha Brahem, Houda Kalboussi, Olfa El Maalel, Souhail Chatti and Najib Mrizek
Affiliation:
- Occupational Medicine Department, Teaching Hospital “Farhat Hached”, Sousse, Tunisia
- University of Sousse,
Faculty of Medicine Ibn El Jazzar, Sousse, Tunisia
Keywords:
Asthma, occupational disease, textiles, hygiene hypothesis, allergy and immunology, prevention and control.
Abstract: Background: Over the last decades, the prevalence of allergic manifestations has increased
significantly. To explain the increase in the prevalence of asthma, Strachan advanced the
Hygiene Hypothesis, which states that decreased exposure to infectious microorganisms in infancy
may have contributed to changes in the maturation of the immune system during childhood. To the
best of our knowledge, no analytical studies detailing the links between the Hygiene Hypothesis
and occupational allergy have been carried out to date.
Objective: To study the relations between the factors involved in the Hygiene Hypothesis and the
occurrence of occupational asthma (OA) to vegetable textile dusts.
Methods: A case-control study was conducted from September 2017 to September 2018. The cases
and controls were enrolled from the occupational medicine department of the University Hospital
“Farhat Hached” of Sousse (Tunisia) among patients attending from 2009 to 2016. The case group
was composed of patients diagnosed with OA to vegetable textile dusts. Controls were age and gender
matched, working in the textile sector and not suffering from any allergic diseases.
Results: A total of 57 OA cases and 112 controls were enrolled. Four factors involved in the Hygiene
Hypothesis were independently associated with OA to vegetable textile dusts: the lowest
rank in siblings (p=0.037; ORa=0.14; 95% CI= [0.02-0.90]); contact with animals (p=0.006;
ORa=0.22; 95% CI= [0.08-0.65]) especially cats; history of parasitic and/or mycotic infections in
childhood (p=0.004; ORa=0.035; 95% CI= [0.004-0.35]) and history of viral infections in childhood
(p<10-3; ORa=0.028; 95% CI= [0.01-0.14]). Other factors had a protective effect, such as the
parents' low socioeconomic level and the father's occupation as a farmer.
Conclusion: The microorganism-rich environment during childhood is an important model for understanding
the mechanisms involved in the development of allergic asthma. Our data suggest that
prevention of OA in adults might require early intervention in childhood.
