Purpose: Asthma is a heterogeneous disease, and factors associated with different asthma phenotypes are poorly understood. Given the higher prevalence of farming exposure and late diagnosis of asthma in more rural Western Finland as compared with the capital of Helsinki, we investigated the relationship between childhood farming environment and age at asthma diagnosis.
Methods: A cross-sectional population-based study was carried out with subjects aged 20– 69 years in Western Finland. The response rate was 52.5%. We included 3864 participants, 416 of whom had physician-diagnosed asthma at a known age and with data on the childhood environment. The main finding was confirmed in a similar sample from Helsinki. Participants were classified as follows with respect to asthma diagnosis: early diagnosis (0– 11 years), intermediate diagnosis (12– 39 years), and late diagnosis (40– 69 years).
Results: The prevalence of asthma was similar both without and with childhood exposure to a farming environment (11.7% vs 11.3%). Allergic rhinitis, family history of asthma, ex-smoker, occupational exposure, and BMI ≥ 30 kg/m² were associated with a higher likelihood of asthma. Childhood exposure to a farming environment did not increase the odds of having asthma (aOR, 1.10; 95% CI, 0.87– 1.40). It did increase the odds of late diagnosis (aOR, 2.30; 95% CI, 1.12– 4.69), but the odds were lower for early (aOR, 0.49; 95% CI, 0.30– 0.80) and intermediate diagnosis of asthma (aOR, 0.75; 95% CI, 0.47– 1.18).
Conclusion: Odds were lower for early diagnosis of asthma and higher for late diagnosis of asthma in a childhood farming environment. This suggests a new hypothesis concerning the etiology of asthma when it is diagnosed late.

Keywords: agriculture, early-diagnosed asthma, intermediate-diagnosed asthma, late-diagnosed asthma, risk factors, phenotypes

中文翻译：

---

在一项基于人群的研究中，儿童接触农业环境对哮喘诊断年龄的影响

目的：哮喘是一种异质性疾病，与不同哮喘表型相关的因素知之甚少。鉴于与首都赫尔辛基相比，芬兰西部更多农村地区的农业暴露率和哮喘诊断较晚，我们调查了儿童农业环境与哮喘诊断年龄之间的关系。
方法：在芬兰西部对 20-69 岁的受试者进行了一项基于人群的横断面研究。响应率为52.5%。我们纳入了 3864 名参与者，其中 416 人在已知年龄且有关于儿童环境的数据被医生诊断为哮喘。主要发现在赫尔辛基的一个类似样本中得到证实。参与者根据哮喘诊断分为以下几类：早期诊断（0-11 岁）、中期诊断（12-39 岁）和晚期诊断（40-69 岁）。
结果：无论儿童时期是否接触过农业环境，哮喘的患病率都相似（11.7% 对 11.3%）。过敏性鼻炎、哮喘家族史、前吸烟者、职业暴露和 BMI ≥ 30 kg/m ²患哮喘的可能性更高。儿童时期接触农业环境并未增加患哮喘的几率（aOR，1.10；95% CI，0.87–1.40）。它确实增加了晚期诊断的几率（aOR，2.30；95% CI，1.12-4.69），但早期（aOR，0.49；95% CI，0.30-0.80）和中期诊断哮喘（aOR， 0.75；95% CI，0.47–1.18）。
结论：在儿童农业环境中，哮喘早期诊断的几率较低，而哮喘的晚期诊断几率较高。这提出了一个关于哮喘诊断较晚时病因学的新假设。

关键词：农业，早诊哮喘，中诊哮喘，晚诊哮喘，危险因素，表型