BACKGROUND: Children with asthma living in urban environments experience disproportionately high asthma hospitalization rates. Excessive exposure to perennial allergens, including cockroach and house dust mite (HDM), have been implicated, but data are limited. OBJECTIVE: To examine the relation between cockroach and HDM exposure and measures of asthma morbidity and health care utilization. METHODS: Participants included 86 atopic asthmatic children living in New Orleans, Louisiana. Sensitization status was determined by means of serum specific IgE testing, and vacuum dust samples were collected for allergen analysis. Logistic regression analysis was used to assess the odds of persistent wheezing, emergency department visits, and asthma hospitalization in those with high vs low levels of allergen exposure. RESULTS: Approximately 44% and 40% of children were exposed to Bla g 1 levels greater than 2 U/g and HDM levels greater than 2 μg/g, respectively, and 24% reported at least 1 hospitalization in the previous 4 months. The median Bla g 1 level was significantly higher in the homes of children hospitalized compared with those with no hospital admissions (7.2 vs 0.8 U/g). In multivariable models, the odds of hospitalization were significantly higher in children exposed to Bla g 1 levels greater than 2 U/g (adjusted odds ratio, 4.2; 95% confidence interval, 1.24-14.17), independent of sensitization status. Exposure to HDMs was not associated with any measure of morbidity. CONCLUSIONS: Exposure to cockroach allergen was strongly associated with increased hospitalization in children with asthma. This effect cannot be explained entirely by IgE-mediated inflammation. Controlled interventional trials are needed to determine whether isolated cockroach abatement improves asthma control.
BACKGROUND:Children with asthma living in urban environments experience disproportionately high asthma hospitalization rates. Excessive exposure to perennial allergens, including cockroach and house dust mite (HDM), have been implicated, but data are limited. OBJECTIVE: To examine the relation between cockroach and HDM exposure and measures of asthma morbidity and health care utilization. METHODS:Participants included 86 atopic asthmatic children living in New Orleans, Louisiana. Sensitization status was determined by means of serum specific IgE testing, and vacuum dust samples were collected for allergen analysis. Logistic regression analysis was used to assess the odds of persistent wheezing, emergency department visits, and asthma hospitalization in those with high vs low levels of allergen exposure. RESULTS: Approximately 44% and 40% of children were exposed to Bla g 1 levels greater than 2 U/g and HDM levels greater than 2 μg/g, respectively, and 24% reported at least 1 hospitalization in the previous 4 months. The median Bla g 1 level was significantly higher in the homes of children hospitalized compared with those with no hospital admissions (7.2 vs 0.8 U/g). In multivariable models, the odds of hospitalization were significantly higher in children exposed to Bla g 1 levels greater than 2 U/g (adjusted odds ratio, 4.2; 95% confidence interval, 1.24-14.17), independent of sensitization status. Exposure to HDMs was not associated with any measure of morbidity. CONCLUSIONS: Exposure to cockroach allergen was strongly associated with increased hospitalization in children with asthma. This effect cannot be explained entirely by IgE-mediated inflammation. Controlled interventional trials are needed to determine whether isolated cockroach abatement improves asthma control.
Authors: Jay Portnoy; Jeffrey D Miller; P Brock Williams; Ginger L Chew; J David Miller; Fares Zaitoun; Wanda Phipatanakul; Kevin Kennedy; Charles Barnes; Carl Grimes; Désirée Larenas-Linnemann; James Sublett; David Bernstein; Joann Blessing-Moore; David Khan; David Lang; Richard Nicklas; John Oppenheimer; Christopher Randolph; Diane Schuller; Sheldon Spector; Stephen A Tilles; Dana Wallace Journal: Ann Allergy Asthma Immunol Date: 2013-12 Impact factor: 6.347
Authors: Bit Na Kang; Sung Gil Ha; Xiao Na Ge; M Reza Hosseinkhani; Nooshin S Bahaie; Yana Greenberg; Malcolm N Blumenthal; Kamal D Puri; Savita P Rao; P Sriramarao Journal: Am J Physiol Lung Cell Mol Physiol Date: 2012-03-16 Impact factor: 5.464
Authors: William J Sheehan; Perdita Permaul; Carter R Petty; Brent A Coull; Sachin N Baxi; Jonathan M Gaffin; Peggy S Lai; Diane R Gold; Wanda Phipatanakul Journal: JAMA Pediatr Date: 2017-01-01 Impact factor: 16.193
Authors: Deborah A Cohen; Bing Han; Kathryn Pitkin Derose; Stephanie Williamson; Terry Marsh; Jodi Rudick; Thomas L McKenzie Journal: Soc Sci Med Date: 2012-09-12 Impact factor: 4.634