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Leigh F. Trevillian, PhD, MBBS, MPH, Anne-Louise Ponsonby, PhD, MBBS, Terence Dwyer, MD, MBBS, MPH, Andrew Kemp, PhD, MBBS, Jennifer Cochrane, BA, Lynette L.-Y. Lim, PhD, MSc, BSc and Allan Carmichael, MD, MBBS

Leigh F. Trevillian and Lynette L.-Y. Lim are with the National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australian Capital Territory, Australia. Anne-Louise Ponsonby is with the National Centre for Epidemiology and Population Health, Australian National University, and the Menzies Centre for Population Health, University of Tasmania, Hobart, Tasmania, Australia. Terence Dwyer and Jennifer Cochrane are with the Menzies Centre for Population Health, University of Tasmania. Andrew Kemp is with the Department of Allergy, Immunology and Infectious Diseases, Children’s Hospital, Westmead, and the Discipline of Paediatrics and Child Health, University of Sydney, Sydney, New South Wales, Australia. Allan Carmichael is with the Department of Paediatrics and Child Health, University of Tasmania.

Correspondence: Requests for reprints should be sent to Anne-Louise Ponsonby, PhD, MBBS, FAFPHM, Murdoch Childrens Research Institute, Royal Childrens Hospital, Fleminton Road, Parkeville, Victoria 3052 Australia (email: anne-louise.ponsonby{at}mcri.edu.au).

Objectives. We investigated the role of infant bedding items, as part of a composite bedding environment, in the development of childhood wheezing.

Methods. This prospective cohort investigation involved 863 children who participated in an infant survey in 1988 and an asthma study in Tasmania, Australia, in 1995. The derived 3 composite infant bedding categories corresponded to increasing numbers of house dust mite (HDM)–rich bedding items used. Outcomes measured included recent and frequent wheezing.

Results. Composite infant bedding used was associated with recent wheezing. Effects increased at increasing levels of HDM–rich bedding items used. Effects were further enhanced by home environmental factors of bedroom heating, recent bedroom painting, and absence of bedroom carpeting. When any 2 or more of these environmental factors were present, a strong dose–response relationship was evident.

Conclusions. Our results show that bedding exposures in infancy are prospectively associated with childhood wheezing and that home environmental conditions may modify this association.