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American Journal of Epidemiology Advance Access originally published online on November 9, 2005
American Journal of Epidemiology 2006 163(1):99-100; doi:10.1093/aje/kwj012
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American Journal of Epidemiology Copyright © 2005 by the Johns Hopkins Bloomberg School of Public Health All rights reserved; printed in U.S.A.

Letter to the Editor

RE: "SIBSHIP CHARACTERISTICS AND RISK OF ALLERGIC RHINITIS AND ASTHMA"

Roos M. D. Bernsen

Department of General Practice, Erasmus MC, University Medical Center, Rotterdam 3000 DR, The Netherlands

(e-mail: rmdbernsen{at}gmail.com)

The interesting study by Westergaard et al. (1Go) gives us detailed data on the associations between the presence of, and intervals to, older and younger siblings and asthma and allergic rhinitis. One of the findings is that a higher number of younger siblings is, irrespective of the age interval to the closest sibling, associated with a lower risk of allergic rhinitis. The authors interpret this finding as an indication for mechanisms in the etiology of allergic rhinitis operating later in childhood. However, as the authors also mention in their results, these mechanisms seem to operate only when there are also older siblings. Another possible explanation, not considered in the paper, is that some parents of allergic children decide not to plan for more children if a chronic disease in their child becomes manifest. Maybe this explanation does not apply to firstborn children as the wish for more than one child may be predominant, and that would explain the lack of an association in firstborn children.

ACKNOWLEDGMENTS

Conflict of interest: none declared.

References

  1. Westergaard T, Rostgaard K, Wohlfahrt J, et al. Sibship characteristics and risk of allergic rhinitis and asthma. Am J Epidemiol 2005;162:125–32.[Abstract/Free Full Text]

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T. Westergaard, K. Rostgaard, J. Wohlfahrt, P. K. Andersen, P. Aaby, and M. Melbye
THE AUTHORS REPLY
Am. J. Epidemiol., January 1, 2006; 163(1): 100 - 100.
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