Asthma and allergies: is the farming environment (still) protective in Poland? The GABRIEL Advanced Studies.

BACKGROUND: Evidence exists that a farming environment in childhood may provide protection against atopic respiratory disease. In the GABRIEL project based in Poland and Alpine regions of Germany, Austria and Switzerland, we aimed to assess whether a farming environment in childhood is protective against allergic diseases in Poland and whether specific exposures explain any protective effect. METHODS: In rural Poland, 23 331 families of schoolchildren completed a questionnaire enquiring into farming practices and allergic diseases (Phase I). A subsample (n = 2586) participated in Phase II involving a more detailed questionnaire on specific farm exposures with objective measures of atopy. RESULTS: Farming differed between Poland and the Alpine centres; in the latter, cattle farming was prevalent, whereas in Poland 18% of village farms kept ≥1 cow and 34% kept ≥1 pig. Polish children in villages had lower prevalences of asthma and hay fever than children from towns, and in the Phase II population, farm children had a reduced risk of atopy measured by IgE (aOR = 0.72, 95% CI 0.57, 0.91) and skin prick test (aOR = 0.65, 95% CI 0.50, 0.86). Early-life contact with grain was inversely related to the risk of atopy measured by IgE (aOR = 0.66, 95% CI 0.47, 0.92) and appeared to explain part of the farming effect. CONCLUSION: While farming in Poland differed from that in the Alpine areas as did the exposure-response associations, we found in communities engaged in small-scale, mixed farming, there was a protective farming effect against objective measures of atopy potentially related to contact with grain or associated farm activities.

Opinions of children about participation in medical genetic research.

AIMS: The objective was to evaluate children's opinions about their participation in a large research project. METHODS: Polish children between 6 and 14 years of age completed a questionnaire about their participation in the Polish Gabriel study (which aims to identify genetic and environmental causes of asthma). In total 706 questionnaires were collected. RESULTS: Children's main motivation for participation was wanting to know whether they were healthy or not. Most children could think of no reasons to reconsider participation. Children aged 6-10 years might reconsider participating because they did not know what was going to happen. A third of the children were not informed by anybody about the study. Especially the youngest children indicated a need for a tailored letter (42%). The youngest children were less often asked for their opinion about participation. All children preferred that both parents and children are asked for consent or assent. Children who were not informed or not asked for their opinion seemed less emotionally involved in the study. CONCLUSION: While researchers and parents tend to focus their information provision to older children and include them in decision-making, especially the younger children expressed a need for more tailored information and involvement in their participation in research.