Skip to main content
NCBI home page
Thorax logoLink to Thorax
. 2002 Jan;57(1):86–90. doi: 10.1136/thorax.57.1.86

Does environmental endotoxin exposure prevent asthma?

J Douwes 1, N Pearce 1, D Heederik 1
PMCID: PMC1746164  PMID: 11809997

Full Text

The Full Text of this article is available as a PDF (113.6 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Baldini M., Lohman I. C., Halonen M., Erickson R. P., Holt P. G., Martinez F. D. A Polymorphism* in the 5' flanking region of the CD14 gene is associated with circulating soluble CD14 levels and with total serum immunoglobulin E. Am J Respir Cell Mol Biol. 1999 May;20(5):976–983. doi: 10.1165/ajrcmb.20.5.3494. [DOI] [PubMed] [Google Scholar]
  2. Becker S., Clapp W. A., Quay J., Frees K. L., Koren H. S., Schwartz D. A. Compartmentalization of the inflammatory response to inhaled grain dust. Am J Respir Crit Care Med. 1999 Oct;160(4):1309–1318. doi: 10.1164/ajrccm.160.4.9901062. [DOI] [PubMed] [Google Scholar]
  3. Björkstén B. Perinatal events in relation to sensitization in the human. Am J Respir Crit Care Med. 2000 Sep;162(3 Pt 2):S105–S107. doi: 10.1164/ajrccm.162.supplement_2.ras-10. [DOI] [PubMed] [Google Scholar]
  4. Blainey A. D., Topping M. D., Ollier S., Davies R. J. Respiratory symptoms in arable farmworkers: role of storage mites. Thorax. 1988 Sep;43(9):697–702. doi: 10.1136/thx.43.9.697. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Braun-Fahrländer C., Gassner M., Grize L., Neu U., Sennhauser F. H., Varonier H. S., Vuille J. C., Wüthrich B. Prevalence of hay fever and allergic sensitization in farmer's children and their peers living in the same rural community. SCARPOL team. Swiss Study on Childhood Allergy and Respiratory Symptoms with Respect to Air Pollution. Clin Exp Allergy. 1999 Jan;29(1):28–34. doi: 10.1046/j.1365-2222.1999.00479.x. [DOI] [PubMed] [Google Scholar]
  6. Castellan R. M., Olenchock S. A., Kinsley K. B., Hankinson J. L. Inhaled endotoxin and decreased spirometric values. An exposure-response relation for cotton dust. N Engl J Med. 1987 Sep 3;317(10):605–610. doi: 10.1056/NEJM198709033171005. [DOI] [PubMed] [Google Scholar]
  7. Christiani D. C., Wang X. R., Pan L. D., Zhang H. X., Sun B. X., Dai H., Eisen E. A., Wegman D. H., Olenchock S. A. Longitudinal changes in pulmonary function and respiratory symptoms in cotton textile workers. A 15-yr follow-up study. Am J Respir Crit Care Med. 2001 Mar;163(4):847–853. doi: 10.1164/ajrccm.163.4.2006063. [DOI] [PubMed] [Google Scholar]
  8. Donham K., Haglind P., Peterson Y., Rylander R., Belin L. Environmental and health studies of farm workers in Swedish swine confinement buildings. Br J Ind Med. 1989 Jan;46(1):31–37. doi: 10.1136/oem.46.1.31. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Douwes J., Zuidhof A., Doekes G., van der Zee S. C., Wouters I., Boezen M. H., Brunekreef B. (1-->3)-beta-D-glucan and endotoxin in house dust and peak flow variability in children. Am J Respir Crit Care Med. 2000 Oct;162(4 Pt 1):1348–1354. doi: 10.1164/ajrccm.162.4.9909118. [DOI] [PubMed] [Google Scholar]
  10. Downs S. H., Marks G. B., Mitakakis T. Z., Lëuppi J. D., Car N. G., Peat J. K. Having lived on a farm and protection against allergic diseases in Australia. Clin Exp Allergy. 2001 Apr;31(4):570–575. doi: 10.1046/j.1365-2222.2001.01070.x. [DOI] [PubMed] [Google Scholar]
  11. Ernst P., Cormier Y. Relative scarcity of asthma and atopy among rural adolescents raised on a farm. Am J Respir Crit Care Med. 2000 May;161(5):1563–1566. doi: 10.1164/ajrccm.161.5.9908119. [DOI] [PubMed] [Google Scholar]
  12. Fishwick D., Pearce N., D'Souza W., Lewis S., Town I., Armstrong R., Kogevinas M., Crane J. Occupational asthma in New Zealanders: a population based study. Occup Environ Med. 1997 May;54(5):301–306. doi: 10.1136/oem.54.5.301. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Gereda J. E., Leung D. Y., Liu A. H. Levels of environmental endotoxin and prevalence of atopic disease. JAMA. 2000 Oct 4;284(13):1652–1653. doi: 10.1001/jama.284.13.1652. [DOI] [PubMed] [Google Scholar]
  14. Gereda J. E., Leung D. Y., Thatayatikom A., Streib J. E., Price M. R., Klinnert M. D., Liu A. H. Relation between house-dust endotoxin exposure, type 1 T-cell development, and allergen sensitisation in infants at high risk of asthma. Lancet. 2000 May 13;355(9216):1680–1683. doi: 10.1016/s0140-6736(00)02239-x. [DOI] [PubMed] [Google Scholar]
  15. Hagmar L., Schütz A., Hallberg T., Sjöholm A. Health effects of exposure to endotoxins and organic dust in poultry slaughter-house workers. Int Arch Occup Environ Health. 1990;62(2):159–164. doi: 10.1007/BF00383592. [DOI] [PubMed] [Google Scholar]
  16. Heederik D., Brouwer R., Biersteker K., Boleij J. S. Relationship of airborne endotoxin and bacteria levels in pig farms with the lung function and respiratory symptoms of farmers. Int Arch Occup Environ Health. 1991;62(8):595–601. doi: 10.1007/BF00381114. [DOI] [PubMed] [Google Scholar]
  17. Hesselmar B., Aberg N., Aberg B., Eriksson B., Björkstén B. Does early exposure to cat or dog protect against later allergy development? Clin Exp Allergy. 1999 May;29(5):611–617. doi: 10.1046/j.1365-2222.1999.00534.x. [DOI] [PubMed] [Google Scholar]
  18. Holt P. G., Sly P. D., Björkstén B. Atopic versus infectious diseases in childhood: a question of balance? Pediatr Allergy Immunol. 1997 May;8(2):53–58. doi: 10.1111/j.1399-3038.1997.tb00145.x. [DOI] [PubMed] [Google Scholar]
  19. Iversen M., Pedersen B. The prevalence of allergy in Danish farmers. Allergy. 1990 Jul;45(5):347–353. doi: 10.1111/j.1398-9995.1990.tb00510.x. [DOI] [PubMed] [Google Scholar]
  20. Kennedy S. M., Christiani D. C., Eisen E. A., Wegman D. H., Greaves I. A., Olenchock S. A., Ye T. T., Lu P. L. Cotton dust and endotoxin exposure-response relationships in cotton textile workers. Am Rev Respir Dis. 1987 Jan;135(1):194–200. doi: 10.1164/arrd.1987.135.1.194. [DOI] [PubMed] [Google Scholar]
  21. Kilpeläinen M., Terho E. O., Helenius H., Koskenvuo M. Farm environment in childhood prevents the development of allergies. Clin Exp Allergy. 2000 Feb;30(2):201–208. doi: 10.1046/j.1365-2222.2000.00800.x. [DOI] [PubMed] [Google Scholar]
  22. Kimbell-Dunn M., Bradshaw L., Slater T., Erkinjuntti-Pekkanen R., Fishwick D., Pearce N. Asthma and allergy in New Zealand farmers. Am J Ind Med. 1999 Jan;35(1):51–57. doi: 10.1002/(sici)1097-0274(199901)35:1<51::aid-ajim7>3.0.co;2-f. [DOI] [PubMed] [Google Scholar]
  23. Kline J. N., Cowden J. D., Hunninghake G. W., Schutte B. C., Watt J. L., Wohlford-Lenane C. L., Powers L. S., Jones M. P., Schwartz D. A. Variable airway responsiveness to inhaled lipopolysaccharide. Am J Respir Crit Care Med. 1999 Jul;160(1):297–303. doi: 10.1164/ajrccm.160.1.9808144. [DOI] [PubMed] [Google Scholar]
  24. Kogevinas M., Antó J. M., Sunyer J., Tobias A., Kromhout H., Burney P. Occupational asthma in Europe and other industrialised areas: a population-based study. European Community Respiratory Health Survey Study Group. Lancet. 1999 May 22;353(9166):1750–1754. doi: 10.1016/s0140-6736(98)07397-8. [DOI] [PubMed] [Google Scholar]
  25. Lewis S. A. Animals and allergy. Clin Exp Allergy. 2000 Feb;30(2):153–157. doi: 10.1046/j.1365-2222.2000.00802.x. [DOI] [PubMed] [Google Scholar]
  26. Martinez F. D. Maturation of immune responses at the beginning of asthma. J Allergy Clin Immunol. 1999 Mar;103(3 Pt 1):355–361. doi: 10.1016/s0091-6749(99)70456-2. [DOI] [PubMed] [Google Scholar]
  27. Melbostad E., Eduard W., Magnus P. Determinants of asthma in a farming population. Scand J Work Environ Health. 1998 Aug;24(4):262–269. doi: 10.5271/sjweh.319. [DOI] [PubMed] [Google Scholar]
  28. Melsom T., Brinch L., Hessen J. O., Schei M. A., Kolstrup N., Jacobsen B. K., Svanes C., Pandey M. R. Asthma and indoor environment in Nepal. Thorax. 2001 Jun;56(6):477–481. doi: 10.1136/thorax.56.6.477. [DOI] [PMC free article] [PubMed] [Google Scholar]
  29. Michel O., Dentener M., Corazza F., Buurman W., Rylander R. Healthy subjects express differences in clinical responses to inhaled lipopolysaccharide that are related with inflammation and with atopy. J Allergy Clin Immunol. 2001 May;107(5):797–804. doi: 10.1067/mai.2001.114249. [DOI] [PubMed] [Google Scholar]
  30. Michel O., Duchateau J., Plat G., Cantinieaux B., Hotimsky A., Gerain J., Sergysels R. Blood inflammatory response to inhaled endotoxin in normal subjects. Clin Exp Allergy. 1995 Jan;25(1):73–79. doi: 10.1111/j.1365-2222.1995.tb01005.x. [DOI] [PubMed] [Google Scholar]
  31. Michel O., Duchateau J., Sergysels R. Effect of inhaled endotoxin on bronchial reactivity in asthmatic and normal subjects. J Appl Physiol (1985) 1989 Mar;66(3):1059–1064. doi: 10.1152/jappl.1989.66.3.1059. [DOI] [PubMed] [Google Scholar]
  32. Michel O., Ginanni R., Duchateau J., Vertongen F., Le Bon B., Sergysels R. Domestic endotoxin exposure and clinical severity of asthma. Clin Exp Allergy. 1991 Jul;21(4):441–448. doi: 10.1111/j.1365-2222.1991.tb01684.x. [DOI] [PubMed] [Google Scholar]
  33. Michel O., Ginanni R., Le Bon B., Content J., Duchateau J., Sergysels R. Inflammatory response to acute inhalation of endotoxin in asthmatic patients. Am Rev Respir Dis. 1992 Aug;146(2):352–357. doi: 10.1164/ajrccm/146.2.352. [DOI] [PubMed] [Google Scholar]
  34. Michel O., Ginanni R., Sergysels R. Relation between the bronchial obstructive response to inhaled lipopolysaccharide and bronchial responsiveness to histamine. Thorax. 1992 Apr;47(4):288–291. doi: 10.1136/thx.47.4.288. [DOI] [PMC free article] [PubMed] [Google Scholar]
  35. Michel O., Kips J., Duchateau J., Vertongen F., Robert L., Collet H., Pauwels R., Sergysels R. Severity of asthma is related to endotoxin in house dust. Am J Respir Crit Care Med. 1996 Dec;154(6 Pt 1):1641–1646. doi: 10.1164/ajrccm.154.6.8970348. [DOI] [PubMed] [Google Scholar]
  36. Michel O., Nagy A. M., Schroeven M., Duchateau J., Nève J., Fondu P., Sergysels R. Dose-response relationship to inhaled endotoxin in normal subjects. Am J Respir Crit Care Med. 1997 Oct;156(4 Pt 1):1157–1164. doi: 10.1164/ajrccm.156.4.97-02002. [DOI] [PubMed] [Google Scholar]
  37. Milton D. K., Amsel J., Reed C. E., Enright P. L., Brown L. R., Aughenbaugh G. L., Morey P. R. Cross-sectional follow-up of a flu-like respiratory illness among fiberglass manufacturing employees: endotoxin exposure associated with two distinct sequelae. Am J Ind Med. 1995 Oct;28(4):469–488. doi: 10.1002/ajim.4700280404. [DOI] [PubMed] [Google Scholar]
  38. Milton D. K., Wypij D., Kriebel D., Walters M. D., Hammond S. K., Evans J. S. Endotoxin exposure-response in a fiberglass manufacturing facility. Am J Ind Med. 1996 Jan;29(1):3–13. doi: 10.1002/(SICI)1097-0274(199601)29:1<3::AID-AJIM2>3.0.CO;2-V. [DOI] [PubMed] [Google Scholar]
  39. Morrison D. C., Ryan J. L. Bacterial endotoxins and host immune responses. Adv Immunol. 1979;28:293–450. doi: 10.1016/s0065-2776(08)60802-0. [DOI] [PubMed] [Google Scholar]
  40. Nejjari C., Tessier J. F., Letenneur L., Dartigues J. F., Barberger-Gateau P., Salamon R. Prevalence of self-reported asthma symptoms in a French elderly sample. Respir Med. 1996 Aug;90(7):401–408. doi: 10.1016/s0954-6111(96)90113-4. [DOI] [PubMed] [Google Scholar]
  41. Omland O., Sigsgaard T., Hjort C., Pedersen O. F., Miller M. R. Lung status in young Danish rurals: the effect of farming exposure on asthma-like symptoms and lung function. Eur Respir J. 1999 Jan;13(1):31–37. doi: 10.1183/09031936.99.13103199. [DOI] [PubMed] [Google Scholar]
  42. PERNIS B., VIGLIANI E. C., CAVAGNA C., FINULLI M. The role of bacterial endotoxins in occupational diseases caused by inhaling vegetable dusts. Br J Ind Med. 1961 Apr;18:120–129. doi: 10.1136/oem.18.2.120. [DOI] [PMC free article] [PubMed] [Google Scholar]
  43. PETERSON R. D., WICKLUNDS P. E., GOOD R. A. ENDOTOXIN ACTIVITY OF A HOUSE DUST EXTRACT. J Allergy. 1964 Mar-Apr;35:134–142. doi: 10.1016/0021-8707(64)90027-9. [DOI] [PubMed] [Google Scholar]
  44. Park J. H., Gold D. R., Spiegelman D. L., Burge H. A., Milton D. K. House dust endotoxin and wheeze in the first year of life. Am J Respir Crit Care Med. 2001 Feb;163(2):322–328. doi: 10.1164/ajrccm.163.2.2002088. [DOI] [PubMed] [Google Scholar]
  45. Park J. H., Spiegelman D. L., Burge H. A., Gold D. R., Chew G. L., Milton D. K. Longitudinal study of dust and airborne endotoxin in the home. Environ Health Perspect. 2000 Nov;108(11):1023–1028. doi: 10.1289/ehp.001081023. [DOI] [PMC free article] [PubMed] [Google Scholar]
  46. Pearce N., Pekkanen J., Beasley R. How much asthma is really attributable to atopy? Thorax. 1999 Mar;54(3):268–272. doi: 10.1136/thx.54.3.268. [DOI] [PMC free article] [PubMed] [Google Scholar]
  47. Post W., Heederik D., Houba R. Decline in lung function related to exposure and selection processes among workers in the grain processing and animal feed industry. Occup Environ Med. 1998 May;55(5):349–355. doi: 10.1136/oem.55.5.349. [DOI] [PMC free article] [PubMed] [Google Scholar]
  48. Preller L., Doekes G., Heederik D., Vermeulen R., Vogelzang P. F., Boleij J. S. Disinfectant use as a risk factor for atopic sensitization and symptoms consistent with asthma: an epidemiological study. Eur Respir J. 1996 Jul;9(7):1407–1413. doi: 10.1183/09031936.96.09071407. [DOI] [PubMed] [Google Scholar]
  49. Respiratory health hazards in agriculture. Am J Respir Crit Care Med. 1998 Nov;158(5 Pt 2):S1–S76. doi: 10.1164/ajrccm.158.supplement_1.rccm1585s1. [DOI] [PubMed] [Google Scholar]
  50. Riedler J., Eder W., Oberfeld G., Schreuer M. Austrian children living on a farm have less hay fever, asthma and allergic sensitization. Clin Exp Allergy. 2000 Feb;30(2):194–200. doi: 10.1046/j.1365-2222.2000.00799.x. [DOI] [PubMed] [Google Scholar]
  51. Rizzo M. C., Naspitz C. K., Fernández-Caldas E., Lockey R. F., Mimiça I., Solé D. Endotoxin exposure and symptoms in asthmatic children. Pediatr Allergy Immunol. 1997 Aug;8(3):121–126. doi: 10.1111/j.1399-3038.1997.tb00164.x. [DOI] [PubMed] [Google Scholar]
  52. Rylander R., Bergström R. Bronchial reactivity among cotton workers in relation to dust and endotoxin exposure. Ann Occup Hyg. 1993 Feb;37(1):57–63. doi: 10.1093/annhyg/37.1.57. [DOI] [PubMed] [Google Scholar]
  53. Sandström T., Bjermer L., Rylander R. Lipopolysaccharide (LPS) inhalation in healthy subjects increases neutrophils, lymphocytes and fibronectin levels in bronchoalveolar lavage fluid. Eur Respir J. 1992 Sep;5(8):992–996. [PubMed] [Google Scholar]
  54. Schwartz D. A., Donham K. J., Olenchock S. A., Popendorf W. J., Van Fossen D. S., Burmeister L. F., Merchant J. A. Determinants of longitudinal changes in spirometric function among swine confinement operators and farmers. Am J Respir Crit Care Med. 1995 Jan;151(1):47–53. doi: 10.1164/ajrccm.151.1.7812571. [DOI] [PubMed] [Google Scholar]
  55. Schwartz D. A., Thorne P. S., Yagla S. J., Burmeister L. F., Olenchock S. A., Watt J. L., Quinn T. J. The role of endotoxin in grain dust-induced lung disease. Am J Respir Crit Care Med. 1995 Aug;152(2):603–608. doi: 10.1164/ajrccm.152.2.7633714. [DOI] [PubMed] [Google Scholar]
  56. Shaheen S. O., Aaby P., Hall A. J., Barker D. J., Heyes C. B., Shiell A. W., Goudiaby A. Cell mediated immunity after measles in Guinea-Bissau: historical cohort study. BMJ. 1996 Oct 19;313(7063):969–974. doi: 10.1136/bmj.313.7063.969. [DOI] [PMC free article] [PubMed] [Google Scholar]
  57. Sigsgaard T., Pedersen O. F., Juul S., Gravesen S. Respiratory disorders and atopy in cotton, wool, and other textile mill workers in Denmark. Am J Ind Med. 1992;22(2):163–184. doi: 10.1002/ajim.4700220204. [DOI] [PubMed] [Google Scholar]
  58. Smid T., Heederik D., Houba R., Quanjer P. H. Dust- and endotoxin-related acute lung function changes and work-related symptoms in workers in the animal feed industry. Am J Ind Med. 1994 Jun;25(6):877–888. doi: 10.1002/ajim.4700250611. [DOI] [PubMed] [Google Scholar]
  59. Smid T., Heederik D., Houba R., Quanjer P. H. Dust- and endotoxin-related respiratory effects in the animal feed industry. Am Rev Respir Dis. 1992 Dec;146(6):1474–1479. doi: 10.1164/ajrccm/146.6.1474. [DOI] [PubMed] [Google Scholar]
  60. Stellman S. D., Boffetta P., Garfinkel L. Smoking habits of 800,000 American men and women in relation to their occupations. Am J Ind Med. 1988;13(1):43–58. doi: 10.1002/ajim.4700130104. [DOI] [PubMed] [Google Scholar]
  61. Sterling T. D., Weinkam J. J. Smoking patterns by occupation, industry, sex, and race. Arch Environ Health. 1978 Nov-Dec;33(6):313–317. doi: 10.1080/00039896.1978.10667354. [DOI] [PubMed] [Google Scholar]
  62. Strachan D. P. Hay fever, hygiene, and household size. BMJ. 1989 Nov 18;299(6710):1259–1260. doi: 10.1136/bmj.299.6710.1259. [DOI] [PMC free article] [PubMed] [Google Scholar]
  63. Svanes C., Jarvis D., Chinn S., Burney P. Childhood environment and adult atopy: results from the European Community Respiratory Health Survey. J Allergy Clin Immunol. 1999 Mar;103(3 Pt 1):415–420. doi: 10.1016/s0091-6749(99)70465-3. [DOI] [PubMed] [Google Scholar]
  64. Thorn J., Rylander R. Inflammatory response after inhalation of bacterial endotoxin assessed by the induced sputum technique. Thorax. 1998 Dec;53(12):1047–1052. doi: 10.1136/thx.53.12.1047. [DOI] [PMC free article] [PubMed] [Google Scholar]
  65. Torén K., Hörte L. G., Järvholm B. Occupation and smoking adjusted mortality due to asthma among Swedish men. Br J Ind Med. 1991 May;48(5):323–326. [PMC free article] [PubMed] [Google Scholar]
  66. Tulić M. K., Wale J. L., Holt P. G., Sly P. D. Modification of the inflammatory response to allergen challenge after exposure to bacterial lipopolysaccharide. Am J Respir Cell Mol Biol. 2000 May;22(5):604–612. doi: 10.1165/ajrcmb.22.5.3710. [DOI] [PubMed] [Google Scholar]
  67. Van der Zwan J. C., Orie N. G., Kauffman H. F., Wiers P. W., de Vries K. Bronchial obstructive reactions after inhalation with endotoxin and precipitinogens of Haemophilus influenzae in patients with chronic non-specific lung disease. Clin Allergy. 1982 Nov;12(6):547–559. doi: 10.1111/j.1365-2222.1982.tb02553.x. [DOI] [PubMed] [Google Scholar]
  68. Vogelzang P. F., van der Gulden J. W., Folgering H., Kolk J. J., Heederik D., Preller L., Tielen M. J., van Schayck C. P. Endotoxin exposure as a major determinant of lung function decline in pig farmers. Am J Respir Crit Care Med. 1998 Jan;157(1):15–18. doi: 10.1164/ajrccm.157.1.9703087. [DOI] [PubMed] [Google Scholar]
  69. Vogelzang P. F., van der Gulden J. W., Tielen M. J., Folgering H., van Schayck C. P. Health-based selection for asthma, but not for chronic bronchitis, in pig farmers: an evidence-based hypothesis. Eur Respir J. 1999 Jan;13(1):187–189. doi: 10.1034/j.1399-3003.1999.13a34.x. [DOI] [PubMed] [Google Scholar]
  70. Von Ehrenstein O. S., Von Mutius E., Illi S., Baumann L., Böhm O., von Kries R. Reduced risk of hay fever and asthma among children of farmers. Clin Exp Allergy. 2000 Feb;30(2):187–193. doi: 10.1046/j.1365-2222.2000.00801.x. [DOI] [PubMed] [Google Scholar]
  71. Wan G. H., Li C. S., Lin R. H. Airborne endotoxin exposure and the development of airway antigen-specific allergic responses. Clin Exp Allergy. 2000 Mar;30(3):426–432. doi: 10.1046/j.1365-2222.2000.00730.x. [DOI] [PubMed] [Google Scholar]
  72. Wright S. D., Ramos R. A., Tobias P. S., Ulevitch R. J., Mathison J. C. CD14, a receptor for complexes of lipopolysaccharide (LPS) and LPS binding protein. Science. 1990 Sep 21;249(4975):1431–1433. doi: 10.1126/science.1698311. [DOI] [PubMed] [Google Scholar]
  73. Zejda J. E., Barber E., Dosman J. A., Olenchock S. A., McDuffie H. H., Rhodes C., Hurst T. Respiratory health status in swine producers relates to endotoxin exposure in the presence of low dust levels. J Occup Med. 1994 Jan;36(1):49–56. [PubMed] [Google Scholar]
  74. Zhiping W., Malmberg P., Larsson B. M., Larsson K., Larsson L., Saraf A. Exposure to bacteria in swine-house dust and acute inflammatory reactions in humans. Am J Respir Crit Care Med. 1996 Nov;154(5):1261–1266. doi: 10.1164/ajrccm.154.5.8912733. [DOI] [PubMed] [Google Scholar]
  75. Zock J. P., Heederik D., Brunekreef B. Influence of shift work and host factors on endotoxin-related acute peak flow changes. Am J Respir Crit Care Med. 1999 Jan;159(1):137–142. doi: 10.1164/ajrccm.159.1.9803026. [DOI] [PubMed] [Google Scholar]
  76. Zock J. P., Hollander A., Heederik D., Douwes J. Acute lung function changes and low endotoxin exposures in the potato processing industry. Am J Ind Med. 1998 Apr;33(4):384–391. doi: 10.1002/(sici)1097-0274(199804)33:4<384::aid-ajim9>3.0.co;2-u. [DOI] [PubMed] [Google Scholar]
  77. van Hage-Hamsten M., Johansson S. G., Zetterström O. Predominance of mite allergy over allergy to pollens and animal danders in a farming population. Clin Allergy. 1987 Sep;17(5):417–423. doi: 10.1111/j.1365-2222.1987.tb02035.x. [DOI] [PubMed] [Google Scholar]
  78. von Mutius E., Braun-Fahrländer C., Schierl R., Riedler J., Ehlermann S., Maisch S., Waser M., Nowak D. Exposure to endotoxin or other bacterial components might protect against the development of atopy. Clin Exp Allergy. 2000 Sep;30(9):1230–1234. doi: 10.1046/j.1365-2222.2000.00959.x. [DOI] [PubMed] [Google Scholar]

Articles from Thorax are provided here courtesy of BMJ Publishing Group

RESOURCES