![]() The human race has come to dominate its environment so completely that any analysis of the increase or appearance of a disease has to take changes in our lifestyle into account. Equally it is clear that the consequences of hygiene, indoor entertainment, changes in diet or in physical activity have never been predicted. Overall, the important conclusion is that sequential changes in lifestyle have led to increases in different forms of allergic diseases. This suggests the possibility that changes in lifestyle in the last 20 years could have influenced the permeability of the skin. ![]() Peanut has played a major role in the food epidemic and there is increasing evidence that sensitization to peanut can occur through the skin. ![]() Since 1990 there has been a remarkable increase in food allergy which has now reached epidemic numbers. There are many features of the move indoors that could have played a role these include: increased sensitization to indoor allergens, diet, and decreased physical activity as well as the effects of prolonged periods of shallow breathing. Asthma in children did not start to increase until 1960, but by 1990 it had clearly increased to epidemic numbers in all countries where children had adopted an indoor lifestyle. However, it is important to remember that the major changes in hygiene in Northern Europe and the USA were complete by 1920. The best explanation for the appearance and subsequent increase in hay fever at that time is the combination of hygiene and increased pollen secondary to changes in agriculture. Prior to the first description of hay fever in 1870 there was very little awareness of allergic disease, which is actually similar to the situation in pre-hygiene villages in Africa today.
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