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Longitudinal Analysis of the Effect of Water Hardness on Atopic Eczema: Evidence for Gene-Environment Interaction

Longitudinal Analysis of the Effect of Water Hardness on Atopic Eczema: Evidence for Gene-Environment Interaction

Z K Jabbar-Lopez, J Craven, K Logan, D Greenblatt, T Marrs, S Radulovic, W H I McLean, G Lack, D P Strachan, M R Perkin, J L Peacock, C Flohr

Br J Dermatol. 2019 Oct 10.

PMID: 31599965

Abstract:

Background:
Several studies have identified an association between water hardness and atopic eczema (AE); however, there is a paucity of longitudinal data in early life.
Objectives:
To examine whether water hardness is associated with an increased risk of AE and skin barrier dysfunction in infants and to assess effect modification by filaggrin (FLG) loss-of-function variants.
Methods:
We performed a longitudinal analysis of data from infants in the Enquiring About Tolerance (EAT) study, who were enrolled at 3 months and followed up until 36 months of age.
Results:
Of 1303 infants enrolled in the EAT study, 91·3% (n = 1189) attended the final clinic visit and 94·0% (n = 1225) of participants' families completed the 36-month questionnaire. In total, 761 (58·4%) developed AE by 36 months. There was no overall association between exposure to harder (> 257 mg L-1 CaCO3 ) vs. softer (≤ 257 mg L-1 CaCO3 ) water: adjusted hazard ratio (HR) 1·07, 95% confidence interval (CI) 0·92-1·24. However, there was an increased incidence of AE in infants with FLG mutations exposed to hard water (adjusted HR 2·72, 95% CI 2·03-3·66), and statistically significant interactions between hard water plus FLG and both risk of AE (HR 1·80, 95% CI 1·17-2·78) and transepidermal water loss (0·0081 g m-2 h-1 per mg L-1 CaCO3 , 95% CI 0·00028-0·016).
Conclusions:
There is evidence of an interaction between water hardness and FLG mutations in the development of infantile AE.

Chemicals Related in the Paper:

Catalog Number	Product Name	Structure	CAS Number	Price
IAR42133	Water Determination			Price

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