the defence of dirt

BMJ 2004; 328 doi: (Published 20 May 2004) Cite this as: BMJ 2004;328:1226
  1. Geoff Watts (, science editor, BMJ1
  1. 1 28 New End Square, London NW3 1LS

    As the Duchess of Windsor once remarked, one can never be too thin or too rich—wisely, she did not add too clean. The hygiene hypothesis aims to explain why some people have allergies and some do not, and why the prevalence of allergic disorders has been increasing over the past century. It suggests that the modern obsession with cleanliness may be counterproductive; in childhood, at least, it may encourage the development of allergic disorders. Benn and colleagues have attempted to untangle the link between infections in infancy and atopic disease.1

    Formalised in the late 1980s, the hypothesis seemed to fly in the face of common sense. After all, …

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