Hygiene Hypothesis: Why It May Be OK to Get a Little Dirty

Reader Contribution by Linda B. White and M.D
Published on November 26, 2014
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I’ve heard that one of the theories scientists have put forth to explain the increase in asthma and allergy rates is called the “hygiene hypothesis.” What is the hygiene hypothesis, and how does it work?

Our immune systems were designed to cope with a germy world. Unless you live on a farm, postindustrial life can be relatively sterile. Theoretically, exposure to microbes and parasitic worms early in life matures the immune system, priming it to fight microbes rather than such innocuous things as pollen and dander. According to the hygiene hypothesis, a lack of exposure tips the immune system toward inflammation and allergic tendencies, as does the use of antibiotics in the first year of life. In addition, children born by caesarean section face a higher risk of allergies and asthma, because passage through the birth canal inoculates infants with bacteria that normally populate skin, the upper respiratory tract, guts and other organs. The development of healthy gut bacteria positively shapes the immune system.

Proponents of the hypothesis point out that kids who attend day care early in life, grow up in larger families, or spend time around barnyard animals (or at least dogs) are less likely to develop asthma, hay fever and eczema. Critics of the hygiene hypothesis respond that asthma rates have also soared in recent years among children in cities, who may also be exposed to different kinds of dirt and germs. Other possible factors contributing to higher allergy rates in the United States include increased consumption of junk food, inactivity and obesity.

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