The Central Problem with hygiene as an explanation for the rise of asthma. =Clean water, universal wearing of shoes, helminth eradication, and separation from farm animals occurred in New York, Boston, Munich and London by 1920. =Rise in asthma didn’t start until 1960, although the rise in hay fever had started much earlier! Thus rise in allergic disease might well reflect changes in hygiene early in the 20th century but the rise in asthma requires a different explanation. Are changes still occurring today, ie is hygiene still getting better (ie worse) and if so how?
Thomas A E Platts-Mills
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