02642nas a2200397   4500000000100000008004100001653001000042653001100052653001100063653000900074653002100083653001400104653001400118653001000132653003000142653002800172653002500200653002700225653001200252100001700264700001600281700001800297700001900315700002500334700002000359700001800379700001600397700001700413700002900430700001600459245017000475300001300645490000700658520156500665022001402230       2018                            d10aAdult10aFemale10aHumans10aMale10aChild, Preschool10aIncidence10aAustralia10aChild10aDiabetes Mellitus, Type 110aRisk Reduction Behavior10aEnterovirus B, Human10aEnterovirus Infections10aHygiene1 aPezic Angela1 aCarlin John1 aEllis Justine1 aCameron Fergus1 aPonsonby Anne-Louise1 aRodda Christine1 aDwyer Terence1 aKemp Andrew1 aHyoty Heikki1 aSioofy-Khojine Amirbabak1 aCraig Maria00aHigher parental occupational social contact is associated with a reduced risk of incident pediatric type 1 diabetes: Mediation through molecular enteroviral indices.  ae01939920 v133 a<p>We aimed to examine the association between parental occupational social contact and hygiene factors on type 1 diabetes (T1D) risk and possible mediation of these effects through child enteroviral infection. We interviewed 333 incident T1D cases and 660 controls from 2008-2011 in Melbourne, Australia. Enteroviral indices (ribonucleic acid by reverse transcription polymerase chain reaction and Coxsackie B virus antibody levels) in peripheral blood were measured in nested case control samples. Parent occupational social contact was assessed by the number of well or sick children, adults or animals contacted daily through work. Higher parental occupational social contact was strongly associated with reduced T1D risk with evidence of dose response (contact with the well or sick score, Adjusted odds ratio (AOR) per category: 0.73 (95% Confidence Interval (CI): 0.66, 0.81); P<0.001 or AOR 0.63 (95% CI: 0.53, 0.75); P<0.001) respectively). Nine of the ten parental social contact indices, were significant mediated through one or more enteroviral indices. The strength of association between enterovirus presence and T1D onset increased with child age (1.2 fold increase per year; P = 0.05). Lower child hand hygiene enhanced the adverse effect of low parental occupational contact with the sick; Synergy Index 5.16 (95% CI: 3.61, 7.36). The interaction between hand washing and parental occupational contact is more consistent with protection against parental enteroviral shedding than the sharing of a protective infectious agent or microbiome.</p>  a1932-6203