公衆衛生72巻3号

2008年03月発行

特集 アレルギー対策―花粉症・食物アレルギー・アトピー等への対応

アレルギー疾患の発症関連要因

著者： 田中景子¹ 三宅吉博¹

所属機関： ¹福岡大学医学部公衆衛生学

ページ範囲：P.184 - P.189

　近年，日本を含め先進国では，アレルギー疾患が急激に増加している．一方で先進国と発展途上国との間には有症率に差が認められ，また，同一国内においても有症率の地域差が観察される．これらの所見を，単に遺伝的要因のみで説明することは難しい．生活環境や食習慣をはじめとした生活習慣の変化や地域差が，アレルギー疾患発症に関与している可能性が高い．1989年にStrachan¹⁾により，衛生環境の改善による小児期の感染機会の減少がアレルギー疾患発症と関連しているのかもしれないという衛生仮説が提唱された．この衛生仮説が提示されて以降，アレルギー疾患の原因を解明し，予防方法を確立するために，多くの疫学研究が実施されてきた．しかしながらその結果は一致しておらず，今日においても未だ確たる結論が得られていない．

　以前，われわれは2000年1月以降2006年8月までに公表された環境要因とアレルギー疾患との関連に関する疫学研究を対象に，系統的なレビューを実施した²⁾．本稿では以前のレビューの結果に加えて，レビュー執筆以降に公表された最新の疫学研究結果を追加し，アレルギー疾患(喘鳴，喘息，アトピー性皮膚炎，アレルギー性鼻炎)との関連における環境要因の科学的根拠についてまとめる．

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