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Capstone

The Relationship between Environmental Allergies in Children and Indoor Pets; A Review of the Current Literature

1 August 2007

Abstract

Purpose of Review: Sensitization to pets and animal dander is a risk factor for atopic eczema, allergic rhinitis, and asthma, and it has been assumed that pet ownership was a risk for sensitization. Several studies in the past decade have attempted to address this question, but it is still not clear if this is true and how we should advise our patients on the issue of pet ownership.

Background: Many children around the United States suffer from allergies including allergic rhinitis, eczema, and asthma. The most common indoor allergens were generated from molds, house dust mites, and household pets. Repeated trips to the emergency room and doctor's office for allergy related conditions are strenuous on the medical community as well as the patient's and their families. It has been common practice to advise families who suffer from allergies to avoid keeping indoor pets. Results from recent studies have challenged this practice, as they show negative associations between early-life exposure to domestic pets and occurrence of atopy-related conditions.

Atopic eczema is a common condition that affects more than one in ten children, and the incidence is only rising. It is defined as an itchy inflammation of the skin which causes a dry, red, flaky or scaly rash, also known as atopic dermatitis. Affected individuals must cope with a significant psychosocial burden, in addition to dealing with the medical aspects of the disease.

Asthma is a disease caused by increased responsiveness of the tracheobronchial tree to various stimuli, which results in episodic narrowing and inflammation of the airways. Asthma can be a debilitating disease as well as a deadly disease if not taken seriously. According to the Center of Disease Control (CDC), in 2004 alone, there were a total of 198,000 hospitalizations for asthma in children, and a total of 186 children died from asthma.

Allergic rhinitis is defined as inflammation of the nasal passages that causes symptoms including sneezing, itching, nasal congestion, runny nose, and post-nasal drip. The most recent data from the CDC is a 1993 census that suggests at least 35.9 million people have symptoms associated with allergic rhinitis, and up to 79.5 million people experience greater than 7 days of nasal and ocular symptoms yearly.

Objective: To find a correlation between indoor pets and childhood allergies including atopic eczema, allergic rhinitis, and asthma. As well as compile the latest recommendations for our patients and their families who suffer from these diseases.

Methods: An extensive literature review and search was completed via Ovid and PubMed. Three main articles were used to compile this data "Early Pet Exposure: Friend or Foe", "Exposure to Dogs and Cats in the First Year of Life and Risk Allergic Sensitization at 6 to 7 Years of Age", and "Exposure to Pets and Atopy-related Diseases in the First 4 Years of Life." These articles were published from 2001-2003. For the latest data and up to date literature a more complete literature review was complied from research as current as this year, 2007.

Results: The majority of studies reviewed found either no association or a decrease in risk of atopic eczema, allergic rhinitis, and asthma amongst pet owners. While there were a few articles that support the findings of an increased risk of asthma with an increased amount of animal dander. In the case of atopic eczema, the correlation between the presence of house dust mites and an increase in symptoms was stronger than animal dander and an increase in symptoms. The results of this literature review indicate that early-life exposure to pets or a lifestyle associated with pets might reduce the risk of developing atopy-related diseases, specifically asthma, eczema, and allergic rhinitis.

Conclusion: Specific recommendations on whether patients who suffer from atopic eczema, allergic rhinitis, or asthma, should or should not avoid pets were not conclusive through this literature review. Even with multiple articles in support of both sides, a general consensus has not been reached in the medical community. Although recommendations can be made to help decrease the amount of allergens in the home to hopefully decrease the symptoms of asthma, allergic rhinitis, and atopic eczema.


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