

Hygiene hypothesis: difference in autoimmune diseases in Russia, Finland (2012) - georgecmu
http://www.ncbi.nlm.nih.gov/pubmed/23127244

======
tokenadult
I read the previously submitted comments here in this thread before reviewing
the link kindly submitted here. (I remember this report from the year it was
first published.) The paper compares the country Finland to the region Karelia
conquered from Finland by Russia and now part of Russia. Life expectancy in
Finland[1] is much better than that in Russia,[2] so if the trade-off of
growing up in a clean environment is that I don't die of something else but
life into healthy old age with some annoying allergies (I do have allergies,
so I am well aware of how annoying they can be), I'll take that trade-off. The
last time we had an active thread about the hygiene hypothesis here on HN,
there were all kinds of n=1 anecdotes from various participants here about
refraining from using soap and other socially silly practices. There is a big
attitude here on HN that modern life is bad for us somehow. That attitude is
mistaken.

The article "The Biodemography of Human Ageing" by James Vaupel,[3] originally
published in the journal Nature in 2010, is a good current reference on the
subject of how much life expectancy has improved at ALL ages in the developed
world. Vaupel is one of the leading scholars on the demography of aging and
how to adjust for time trends in life expectancy. His striking finding is
"Humans are living longer than ever before. In fact, newborn children in high-
income countries can expect to live to more than 100 years. Starting in the
mid-1800s, human longevity has increased dramatically and life expectancy is
increasing by an average of six hours a day."[4] An article in a series on
Slate, "Why Are You Not Dead Yet? Life expectancy doubled in past 150 years.
Here’s why"[5] Provides some of the background. Yep, perhaps in the clean
modern world, our immune systems aren't challenged as much as they used to be,
but we also get sick less often and live to much older ages with good health.
Life expectancy at age 40, at age 60, and at even higher ages is still rising
throughout the developed countries of the world.[6] That's a trade-off I will
happily accept. My mom (who also has allergies) is eighty-one years old and
still living independently and enjoying her favorite activities, and she has
sisters and brothers older than she is who are still in good health. Girls
born since 2000 in the developed world are more likely than not to reach the
age of 100, with boys likely to enjoy lifespans almost as long. If that's what
I have to put up with after living in a clean environment in my youth, I can
deal with that.

[1]
[https://www.google.com/search?q=Finland+life+expectancy](https://www.google.com/search?q=Finland+life+expectancy)

[2]
[https://www.google.com/search?q=Russia+life+expectancy](https://www.google.com/search?q=Russia+life+expectancy)

[3] [http://www.demographic-
challenge.com/files/downloads/2eb51e2...](http://www.demographic-
challenge.com/files/downloads/2eb51e2860ef54d218ce5ce19abe6a59/dc_biodemography_of_human_ageing_nature_2010_vaupel.pdf)

[4]
[http://www.prb.org/Journalists/Webcasts/2010/humanlongevity....](http://www.prb.org/Journalists/Webcasts/2010/humanlongevity.aspx)

[5]
[http://www.slate.com/articles/health_and_science/science_of_...](http://www.slate.com/articles/health_and_science/science_of_longevity/2013/09/life_expectancy_history_public_health_and_medical_advances_that_lead_to.html)

[6]
[http://www.nature.com/scientificamerican/journal/v307/n3/box...](http://www.nature.com/scientificamerican/journal/v307/n3/box/scientificamerican0912-54_BX1.html)

~~~
kijin
Stories like this have a certain nostalgic appeal to some people. Yeah, let's
go back to the good ol' days when kids would play in dirt, swim in raw sewage,
and eat random bugs they found in the bushes. Death to soap, death to the hand
sanitizer, death to every artificial environment... except virtual ones! Yeah,
caveman with an iPad!

The problem with such nostalgic appeals is that they grossly underestimate
modern science's ability to fix its own problems given enough time and
resources. Immune system needs germs to practice on? What about a
pill/lotion/inhaler/whatever that contains a variety of carefully selected and
relatively harmless germs to give your immune system plenty of practice
without risk of any life-threatening infection? You know, like a vaccine.

If the hygiene hypothesis becomes well-established, every pharmaceutical
company will jump into the market with "germ pills". They could become as
commonplace as multivitamins (though I hope they're more effective than
today's multivitamins). Sooner or later, even FDA might begin to recommend a
daily dose of mild pathogens for children. Problem solved, until we cause the
next problem, wash, rinse, repeat.

Usually, the solution to science is more science.

~~~
refurb
_If the hygiene hypothesis becomes well-established, every pharmaceutical
company will jump into the market with "germ pills"._

They've already tried! Coronado Biosciences was testing a drug comprised of
pig whipworm eggs for the treatment of Crohn's disease. Unfortunately it
didn't work.

[http://www.coronadobiosciences.com/research-
development/hygi...](http://www.coronadobiosciences.com/research-
development/hygiene-hypothesis.cfm)

------
trhway
George Carlin "...immune system is to kill germs. It needs germs to practice
on ... When i was a little boy in 1949 we swam in Hudson river. The Hudson
River was loaded with raw sewage. That's right, we swam in raw sewage. You
know, to cool off. ...":

[http://www.youtube.com/watch?v=CnmMNdiCz_s&list=PL4DDBE51446...](http://www.youtube.com/watch?v=CnmMNdiCz_s&list=PL4DDBE51446AC5A45)

Edit: imagine, theoretically, if there is no germs and no need for immune
system, would it mean additional biological resources available inside the
human body for something else, like for bigger/better brain, etc...?

~~~
msds
Tragically, it would - and in the non-hypothetical world, probably does. There
is a fair amount of research showing significant cognitive development
improvements when replacing dirt floors with concrete ones.

[http://web.stanford.edu/group/siepr/cgi-
bin/siepr/?q=system/...](http://web.stanford.edu/group/siepr/cgi-
bin/siepr/?q=system/files/shared/pubs/papers/pdf/SCID367.pdf)

------
rpedela
BBC Horizon just did a piece which talks about this topic [1]. The gist of it
was that the hygiene hypothesis probably isn't correct, but it is close.
Rather it is the diversity and makeup of the microbiome in our body that plays
an important role in our immune system and hygiene, among other things, plays
a role in shaping our microbiome. Pretty interesting I think. If it really is
the microbiome, then maybe we can do something about it.

1\.
[https://www.youtube.com/watch?v=6Y4ofojAe-k](https://www.youtube.com/watch?v=6Y4ofojAe-k)

------
lg
Article was behind a paywall, but they've been pointing these correlations for
a long time, yet when they actually try to test the effect of benign pathogens
(e.g. in Coronado's TRUST clinical trials) the results are disappointing. Also
why don't routine vaccinations in rich countries have a similar beneficial
effect?

~~~
ghkbrew
> Also why don't routine vaccinations in rich countries have a similar
> beneficial effect?

Presumably, it's an issue with quantity. The ~20 mandatory vaccinations in
West are simply a drop in the bucket compared to the number of different
organism/antigens you'd be exposed to without modern sanitation.

------
Shivetya
going to assume its along the lines of the old tale of, having pets is good
for kids growing up. Responsibility and exposure to various organisms only
have a pet will bring

Growing up on a farm probably gave us a bit more exposure, the only sicknesses
I could recall really weren't, it was more like the breaking things as farms
tend to be unforgiving

------
Mz
I think this is a pretty silly argument. We cannot even digest our food
without gut flora. So I don't think we are as protected from microbes as ideas
like this suggest.

What has changed in recent decades and can be proven and measured: We are
exposed to all kinds of chemicals that are known to have harmful effects, many
of which did not exist until they were recently invented.

It seems to me this is a much more likely explanation of the outbreak in
chronic health conditions and so-called "autoimmune diseases" in the developed
world.

~~~
sliverstorm
Most of the nastiest chemicals were phased out or heavily regulated decades
ago. Lead everywhere, asbestos, mercury, propellants, flame retardants,
pesticides, etc...

We have nasty stuff around still today, of course, but if there was a "dark
age" of nasty chemicals it was fifty years ago.

The point being that you would expect our immune systems to be on the
_upswing_ if it was a chemicals problem.

~~~
Mz
It is my understanding that some of those phased out chemicals persist in the
environment to this day and that you can take a blood sample from pretty much
anyone and find unacceptable levels of toxic chemicals.

Also, we don't really know what happens when parents who are contaminated with
such chemicals have babies. I have heard from people who believe that is a
major connection there: That what is relatively small amounts for an adult
nevertheless have toxic effects in utero.

Plus, we use chemical fertilizers and pesticides in recent decades on an
unprecedented scale.

I just really don't see where your argument holds water. It simply fails to
fit with my understanding of what is going on in the world today. Also, fails
to fit with my firsthand personal experience.

But thank you for replying.

~~~
sliverstorm
_some of those phased out chemicals persist in the environment to this day_

In ever decreasing levels. There aren't any that remain at the same levels as
decades ago.

 _we don 't really know what happens when parents who are contaminated with
such chemicals have babies_

Right. So we can hardly draw conclusions, now can we? "We don't know what
happens" isn't an argument that proves something happens.

 _I have heard from people who believe that is a major connection there_

There are people out there who will tell you anything. "People" is not an
authoritative source.

 _we use chemical fertilizers and pesticides in recent decades on an
unprecedented scale._

Nope:

[http://www.panna.org/blog/long-last-epa-releases-
pesticide-u...](http://www.panna.org/blog/long-last-epa-releases-pesticide-
use-statistics)

Oh, and looping way back to your comment about how gut flora is required to
digest food- the presence of bacteria in the belly does not confer resistance
to viruses. Your exposure to viruses is all from the environment.

~~~
Mz
From the link you submitted:

 _Pesticide use in agriculture is down slightly, from 948 million pounds in
2000 to 877 million pounds in 2007. But that 's only about 1% per year, and
still close to a billion pounds of toxic chemicals intentionally introduced
into the environment and our food supply each year._

So, just because it is down compared to some earlier period within the last
few decades does not mean it is not historically unprecedented. I am talking
on the scale of human history and how what we are doing chemically in recent
decades is different from what was done for many thousands of years before
that.

Some of the people I have talked to about such subjects have phd's and are
published authors. I really don't think you are making a good faith effort to
engage me here. So I think I shall bow out of this conversation at this point.

~~~
sliverstorm
You made up your mind before I even made my first post...

My point is that if "harmful chemical use" is _down_ (even if only a little)
over the last 50-70 years, then it seems unlikely said chemicals are the cause
of an epidemic that appeared only a few decades ago and has been growing ever
since. If they were the cause, you would expect the epidemic to start even
earlier, and you certainly wouldn't expect the epidemic to _grow_ as the
chemical _decreases_.

A more dramatic example: imagine blaming the recent increase in autism
diagnoses on alcohol. It's not entirely impossible, but it is suspicious.
Alcohol has been around for millennium; if it is the cause, why is this only
happening now?

I'm not saying this is proof of anything, but it calls your theory into
question and I was curious if you had an explanation rather than simply saying
"What you say doesn't agree with what I think so you must be wrong"

~~~
Mz
_You made up your mind before I even made my first post..._

Having an (informed) opinion about something I have wrestled with a long time
somehow makes me automagically wrong or bad or something? Why is that?

 _My point is that if "harmful chemical use" is down (even if only a little)
over the last 50-70 years, then it seems unlikely said chemicals are the cause
of an epidemic that appeared only a few decades ago and has been growing ever
since. If they were the cause, you would expect the epidemic to start even
earlier, and you certainly wouldn't expect the epidemic to grow as the
chemical decreases._

A great many chemicals do not simply get rapidly dumped by the body once you
stop being exposed. For some things, once you are exposed, you are toxic for
the rest of your life _unless something is done about it_ and doctors do not
know a good way to fix it. So reducing exposure will not magically fix
anything. Some things accumulate in the tissues over time. And some of those
chemicals are out there in the general environment and people are still being
exposed to them, even though they are no longer being used.

It is also well established fact that exposing a pregnant woman to certain
things has a much bigger impact on the developing fetus than it would on an
adult. That is hardly wild, random speculation on my part.

 _A more dramatic example: imagine blaming the recent increase in autism
diagnoses on alcohol. It 's not entirely impossible, but it is suspicious.
Alcohol has been around for millennium; if it is the cause, why is this only
happening now?_

Yeah, that’s really funny since both my sons are autistic. I participated for
a time on a list where one of the things being done to help autistic kids was
chelation – ie removal of metals from the body. According to a PHD chemist
(and published author) who was an active participant on the list, about 75% of
autistic kids benefit from chelation. Metals are one of those known toxic
chemicals that, for thousands of years, most ordinary people had relatively
little exposure to but which are simply everywhere now. They are, logically,
possibly very much a part of the problem here.

Once metals get into the tissues, the body does not automatically dump them.
They tend to stay there for life, having toxic impacts on the immune function
and brain function unless you carefully follow some very specific protocols to
try to effectively remove them. Most medical doctors don’t know much about
metals removal. It’s the alternative med community, where a PHD chemist did
the math to work out the half-life of various chelators and also work out
which chelators work for which metals, which has reasonably reliable answers
on this topic. Of course, saying that is something that opens one up to
automatic dismissal by a lot of folks who think the answers they know from
peer reviewed journals (or whatever) are the only ones with any validity.

 _I 'm not saying this is proof of anything, but it calls your theory into
question and I was curious if you had an explanation rather than simply saying
"What you say doesn't agree with what I think so you must be wrong"_

If you were genuinely curious as to what I think, you could have indicated
that much, much earlier instead of positioning yourself as merely shooting me
down.

