Association of pediatric asthma severity with exposure to common household dust allergens

• Published in: Environmental research 2009-08, Vol.109 (6), p.768-774
• Main Authors: Gent, Janneane F., Belanger, Kathleen, Triche, Elizabeth W., Bracken, Michael B., Beckett, William S., Leaderer, Brian P.
• Format: Article
• Language: English
• Subjects: 60 APPLIED LIFE SCIENCES; Air; Air Pollution, Indoor - adverse effects; Air Pollution, Indoor - analysis; Allergens - adverse effects; Allergens - analysis; Allergens - immunology; Animals; Animals, Domestic - immunology; ASTHMA; Asthma - diagnosis; Asthma - etiology; Asthma - immunology; Biological and medical sciences; CATS; Child; CHILDREN; Chronic obstructive pulmonary disease, asthma; COCKROACHES; Der p 1; Dermatophagoides; Dermatophagoides pteronyssinus; DOGS; Dose-Response Relationship, Drug; DOSE-RESPONSE RELATIONSHIPS; Dust; Dust - analysis; Dust - immunology; Dust mite; DUSTS; Environmental pollutants toxicology; Female; Household dust allergens; HOUSEHOLDS; Houses; Housing - standards; Humans; Male; Mathematical models; Medical sciences; MITES; Pediatric asthma; PEDIATRICS; Pet allergens; Pneumology; Pyroglyphidae - immunology; Severity of Illness Index; SYMPTOMS; Toxicology
• ISSN: 0013-9351; 1096-0953
• DOI: 10.1016/j.envres.2009.04.010

Reducing exposure to household dust inhalant allergens has been proposed as one strategy to reduce asthma. To examine the dose–response relationships and health impact of five common household dust allergens on disease severity, quantified using both symptom frequency and medication use, in atopic and non-atopic asthmatic children. Asthmatic children ( N=300) aged 4–12 years were followed for 1 year. Household dust samples from two indoor locations were analyzed for allergens including dust mite ( Der p 1, Der f 1), cat ( Fel d 1), dog ( Can f 1), cockroach ( Bla g 1). Daily symptoms and medication use were collected in monthly telephone interviews. Annual disease severity was examined in models including allergens, specific IgE sensitivity and adjusted for age, gender, atopy, ethnicity, and mother's education. Der p 1 house dust mite allergen concentration of 2.0 μg/g or more from the main room and the child's bed was related to increased asthma severity independent of allergic status (respectively, OR 2.93, 95% CI 1.37, 6.30 for 2.0–10.0 μg/g and OR 2.55 95% CI 1.13, 5.73 for ⩾10.0 μg/g). Higher pet allergen levels were associated with greater asthma severity, but only for those sensitized (cat OR 2.41 95% CI 1.19, 4.89; dog OR 2.06 95% CI 1.01, 4.22). Higher levels of Der p 1 and pet allergens were associated with asthma severity, but Der p 1 remained an independent risk factor after accounting for pet allergens and regardless of Der p 1 specific IgE status.