Against the hygiene hypothesis as the cause of allergic diseases

The article argues against the hygiene hypothesis for causation of allergic diseases:
https://www.annallergy.org/article/S1081-1206(22)00585-3/fulltext

The authors make the case that the basic changes in hygiene, clean water, complete separation of fecal matter from food production, and helminth eradication were complete before most of the major rises in allergic disease. Thus, all the allergic diseases increase occurred “post-hygiene.”

The look for another cause: There is one major change that has decreased the severity of 2 allergic diseases, that is air conditioning and the closing of houses so that air exchange rates are as low as 0.6 air changes per hour. This means that only minimal quantities of pollen can enter the houses but also that houses become drier and less hospitable to mites. Both hay fever and asthma have become less severe since 2000.

References:

https://www.annallergy.org/article/S1081-1206(22)00585-3/fulltext

https://www.annallergy.org/article/S1081-1206(22)00504-X/fulltext

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