{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:17:55Z","timestamp":1787015875237,"version":"build-2736575974"},"reference-count":30,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2019,6,28]],"date-time":"2019-06-28T00:00:00Z","timestamp":1561680000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Allergy Immunology"],"published-print":{"date-parts":[[2019,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The hygiene hypothesis suggests that a decreased microbial load contributes to an increased risk of allergies. In the Finnish municipality of Nokia, sewage water was accidentally mixed with drinking water for 2\u00a0days. We studied the association between exposure and the emergence of allergies in children.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Children aged 2\u20105\u00a0years living in the accident area and an age\u2010matched cohort from the control municipality were recruited. Based on the questionnaires, we identified 139 children exposed to the contaminated water and selected age\u2010 and sex\u2010matched controls for them (mean age 16.59\u00a0months at the time of the accident). Allergic symptoms and diseases were recorded by ISAAC questionnaires and skin prick tests (SPTs) performed 2 and 5\u00a0years after the accident.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      SPT positivity at 5\u00a0years of follow\u2010up was decreased in the children exposed to the sewage water below 1\u00a0year of age (OR 0.311, 95% CI 0.118\u20100.820;\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.019), particularly in children who did not develop gastroenteritis at exposure. In contrast, the children over 1\u00a0year of age at the exposure tended more likely to be SPT\u2010positive at 5\u00a0years of follow\u2010up (OR 1.997, 95% CI 0.963\u20104.143;\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.070).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Sewage water exposure during the first year of life, but not later, decreased the risk of IgE sensitization emphasizing the importance of age as a modulator. The modulation of IgE sensitization by the presence of clinical gastroenteritis at the exposure suggests that the nature of microbial load may have importance or alternatively shared host defense mechanisms protect from infection and atopic sensitization.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/pai.13090","type":"journal-article","created":{"date-parts":[[2019,6,6]],"date-time":"2019-06-06T10:09:38Z","timestamp":1559815778000},"page":"598-603","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Exposure to sewage water and the development of allergic manifestations in Finnish children"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9914-8536","authenticated-orcid":false,"given":"Eila","family":"Kujansuu","sequence":"first","affiliation":[{"name":"Faculty of Medicine and Life Sciences Tampere University Tampere Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leena","family":"Kujansuu","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Life Sciences Tampere University Tampere Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marita","family":"Paassilta","sequence":"additional","affiliation":[{"name":"Allergy Center Tampere University Hospital Tampere Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jukka","family":"Mustonen","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Life Sciences Tampere University Tampere Finland"},{"name":"Department of Internal Medicine Tampere University Hospital Tampere Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Outi","family":"Vaarala","sequence":"additional","affiliation":[{"name":"Clinicum University of Helsinki Helsinki 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