S Ryanne Corder1, Manaswita Tappata1, Olivia Shaheen1, Cary C Cotton1, Elizabeth T Jensen1,2, Evan S Dellon3,4,5. 1. Center for Esophageal Diseases and Swallowing, UNC-CH, Chapel Hill, NC, USA. 2. Department of Epidemiology and Prevention, Wake Forest School of Medicine, UNC-CH, Chapel Hill, NC, USA. 3. Center for Esophageal Diseases and Swallowing, UNC-CH, Chapel Hill, NC, USA. edellon@med.unc.edu. 4. Center for Gastrointestinal Biology and Disease, Division of Gastroenterology and Hepatology, Department of Medicine, UNC-CH, Chapel Hill, NC, USA. edellon@med.unc.edu. 5. UNC-CH, CB#7080, Bioinformatics Building, 130 Mason Farm Rd., Chapel Hill, NC, 27599-7080, USA. edellon@med.unc.edu.
Abstract
BACKGROUND: While the environment contributes to EoE pathogenesis, few environmental risk factors for EoE have been identified. AIM: To determine whether housing components such as exterior materials, heating systems, and house age are associated with EoE. METHODS: This case-control study used the UNC EoE clinicopathologic database to identify newly diagnosed EoE patients. Controls were patients without EoE who underwent endoscopy during the study time frame. Housing data were collected from publicly available online sources, and cases and controls were compared. The primary analysis was restricted to those living at their provided address at the time of diagnostic endoscopy. Multivariable logistical regression estimated associations after adjusting for potential confounders. RESULTS: Of 451 EoE cases and 2421 controls identified, the primary analysis included 158 cases and 769 controls. Compared to controls, EoE cases were more likely to have a house with a brick exterior (35% vs 26%; p = 0.04), gas heating (14% vs 8%; p = 0.06), or forced air (57% vs 45%; p = 0.009). In adjusted analysis, brick exterior was positively associated with EoE diagnosis [aOR 1.83 (95% CI 1.11-3.02)]. The average duration a patient lived in their house before EoE diagnosis was 7.2 ± 5.9 years, while symptom duration prior to diagnosis was 6.8 ± 8.4 years. CONCLUSION: EoE patients were more likely to have houses with a brick exterior, forced air, or gas heating, and brick exteriors were independently associated with EoE. Since symptoms generally started after moving into a house, housing-related environmental exposures may contribute to EoE disease development.
BACKGROUND: While the environment contributes to EoE pathogenesis, few environmental risk factors for EoE have been identified. AIM: To determine whether housing components such as exterior materials, heating systems, and house age are associated with EoE. METHODS: This case-control study used the UNC EoE clinicopathologic database to identify newly diagnosed EoE patients. Controls were patients without EoE who underwent endoscopy during the study time frame. Housing data were collected from publicly available online sources, and cases and controls were compared. The primary analysis was restricted to those living at their provided address at the time of diagnostic endoscopy. Multivariable logistical regression estimated associations after adjusting for potential confounders. RESULTS: Of 451 EoE cases and 2421 controls identified, the primary analysis included 158 cases and 769 controls. Compared to controls, EoE cases were more likely to have a house with a brick exterior (35% vs 26%; p = 0.04), gas heating (14% vs 8%; p = 0.06), or forced air (57% vs 45%; p = 0.009). In adjusted analysis, brick exterior was positively associated with EoE diagnosis [aOR 1.83 (95% CI 1.11-3.02)]. The average duration a patient lived in their house before EoE diagnosis was 7.2 ± 5.9 years, while symptom duration prior to diagnosis was 6.8 ± 8.4 years. CONCLUSION: EoE patients were more likely to have houses with a brick exterior, forced air, or gas heating, and brick exteriors were independently associated with EoE. Since symptoms generally started after moving into a house, housing-related environmental exposures may contribute to EoE disease development.