INFLAMMATORY BOWEL DISEASE

Environmental risk factors in paediatric inflammatory bowel diseases: a population based case control study

S Baron¹, D Turck², C Leplat¹, V Merle³, C Gower-Rousseau¹, R Marti¹, T Yzet⁴, E Lerebours³, J-L Dupas⁴, S Debeugny¹, J-L Salomez¹, A Cortot⁵, J-F Colombel⁵

¹ Registre des Maladies Inflammatoires Chroniques de l’Intestin (EPIMAD), Service d’Epidémiologie et de Santé Publique, Hôpital Calmette, Lille, France
² EPIMAD, Clinique de Pédiatrie, Hôpital Jeanne de Falndre, Lille, France
³ EPIMAD, Centre de Rouen, Hôpital Charles Nicolle, Rouen, France
⁴ EPIMAD, Centre d’ Amiens, Hôpital Nord, Amiens, France
⁵ EPIMAD, Service d’Hépato-Gastroentérologie, Hôpital Huriez, Lille, France

Correspondence to:
Correspondence to:
Professor J-F Colombel
Department of Hepato-Gastroenterology and Registre EPIMAD, Hopital Claude Huriez, CH et U de Lille, 59037 Lille Cedex, France; jfcolombel{at}chru-lille.fr

Background: Environmental exposures in early life have been implicated in the aetiology of inflammatory bowel disease.

Objective: To examine environmental risk factors prior to the development of inflammatory bowel disease in a paediatric population based case control study.

Methods: A total of 222 incident cases of Crohn’s disease and 60 incident cases of ulcerative colitis occurring before 17 years of age between January 1988 and December 1997 were matched with one control subject by sex, age, and geographical location. We recorded 140 study variables in a questionnaire that covered familial history of inflammatory bowel disease, events during the perinatal period, infant and child diet, vaccinations and childhood diseases, household amenities, and the family’s socioeconomic status.

Results: In a multivariate model, familial history of inflammatory bowel disease (odds ratio (OR) 4.3 (95% confidence interval 2.3–8)), breast feeding (OR 2.1 (1.3–3.4)), bacille Calmette-Guerin vaccination (OR 3.6 (1.1–11.9)), and history of eczema (OR 2.1 (1–4.5)) were significant risk factors for Crohn’s disease whereas regular drinking of tap water was a protective factor (OR 0.56 (0.3–1)). Familial history of inflammatory bowel disease (OR 12.5 (2.2–71.4)), disease during pregnancy (OR 8.9 (1.5–52)), and bedroom sharing (OR 7.1 (1.9–27.4)) were risk factors for ulcerative colitis whereas appendicectomy was a protective factor (OR 0.06 (0.01–0.36)).

Conclusions: While family history and appendicectomy are known risk factors, changes in risk based on domestic promiscuity, certain vaccinations, and dietary factors may provide new aetiological clues.

Abbreviations: IBD, inflammatory bowel disease; CD, Crohn’s disease; UC, ulcerative colitis; BCG, bacille Calmette-Guerin; MMR, measles-mumps-rubella; OR, odds ratio

Keywords: environment; children; inflammatory bowel disease; ulcerative colitis; risk factors

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

Relevant Article

Digest

Robin Spiller
Gut 2005 54: 317. [Extract] [Full Text] [PDF]

This article has been cited by other articles:

• Carbonnel, F., Boutron, M. C. (2009). Ulcerative colitis: is it in the diet?. Gut 58: 1577-1579 [Full Text]  
• Frisch, M., Pedersen, B. V, Andersson, R. E (2009). Appendicitis, mesenteric lymphadenitis, and subsequent risk of ulcerative colitis: cohort studies in Sweden and Denmark. BMJ 338: b716-b716 [Abstract] [Full Text]  
• Radon, K., Windstetter, D., Poluda, A. L., Mueller, B., Mutius, E. v., Koletzko, S., Chronische Autoimmunerkrankungen und Kontakt zu Ti, (2007). Contact With Farm Animals in Early Life and Juvenile Inflammatory Bowel Disease: A Case-Control Study. Pediatrics 120: 354-361 [Abstract] [Full Text]  
• Qualls, J. E., Kaplan, A. M., van Rooijen, N., Cohen, D. A. (2006). Suppression of experimental colitis by intestinal mononuclear phagocytes. J. Leukoc. Biol. 80: 802-815 [Abstract] [Full Text]  
• Frisch, M. (2006). Inverse association between appendicectomy and ulcerative colitis. BMJ 332: 561-562 [Full Text]  
• Jantchou, P., Turck, D., Balde, M., Gower-Rousseau, C. (2005). Breastfeeding and risk of inflammatory bowel disease: results of a pediatric, population-based, case-control study. Am. J. Clin. Nutr. 82: 485-486 [Full Text]  
• Klement, E., Reif, S. (2005). Breastfeeding and risk of inflammatory bowel disease. Am. J. Clin. Nutr. 82: 486-486 [Full Text]  
• (2005). Lucina. Arch. Dis. Child. 90: 770-770 [Full Text]  

eLetters:

Read all eLetters

Perinatal passive smoke exposure and risk of developing Childhood IBD

Richard K Russell, et al.

Gut Online, 19 Apr 2005 [Full text]

Author's reply

Mamadou Baldé, et al.

Gut Online, 5 May 2005 [Full text]