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The more endotoxin in the home, the less likely babies were to be diagnosed with eczema during their first year of life. When endotoxin concentrations were classified into four levels, the risk for eczema was about 25 percent lower with each increase in endotoxin level, after adjustment for other eczema-related variables. Infants whose homes had a dog also were less likely to develop eczema, but this relationship weakened after adjustment for endotoxin exposure. Eczema risk was increased in infants whose fathers had a history of eczema, or whose mothers were sensitive to at least one allergen.
Cases of eczema have increased two- to three-fold in industrialized countries since World War II, a pattern similar to that seen for asthma and other allergic conditions. According to the hygiene hypothesis, today's cleaner, more germ-free environments may deprive babies' developing immune systems of chances to practice fighting off microbes; as a result, their immune systems veer toward an allergic type of response, mistakenly attacking harmless substances. Supporters of this still-controversial idea note that children who live on farms, grow up with pets, come from large families, or start day care in early infancy are less prone to allergies and asthma.
Phipatanakul does not advise parents to buy pets, stop cleaning their homes, place their infants in daycare, or do anything else to protect them from eczema.
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