Abatement of cockroach allergen (bla g 1) in low-income, urban housing: A randomized controlled trial

Arbes, Samuel J.; Sever, Michelle L.; Archer, Janet I.; Long, Elizabeth H.; Gore, J. Chad; Schal, Coby; Walter, Michelle; Nuebler, Betsy; Vaughn, Ben; Mitchell, Herman; Liu, Eric; Collette, Nicholas; Adler, Peter B.; Sandel, Megan; Zeldin, Darryl C.

doi:10.1067/mai.2003.1597

Cited by 85 publications

(54 citation statements)

References 13 publications

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“…The NCICAS bedroom values were a combination of bedroom floor and bed, 3 and studies that report both levels often report much higher levels for floor dust than for bed dust. 10,30 As a whole, mouse allergen does not appear to be a major problem in these developments in terms of allergen concentrations and number of detects. Self-report of mouse problems was also low.…”

Section: Discussionmentioning

confidence: 99%

Determinants of Allergen Concentrations in Apartments of Asthmatic Children Living in Public Housing

Peters

Levy²,

Rogers³

et al. 2007

J Urban Health

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There is growing evidence linking poor housing conditions and respiratory diseases, including asthma. The association between housing conditions and asthma in the inner city has been attributed in part to cockroach and mouse infestation and the resulting allergen exposures. Multiple social and behavioral factors can influence environmental exposures and health conditions, necessitating a thorough examination of such factors. As part of the Healthy Public Housing Initiative, we evaluated the association between physical and household characteristics and pest-related allergen levels in three public housing developments in Boston, MA. We detected cockroach allergens (Bla g 1 and Bla g 2) in bedroom air, bed, and especially high concentrations in kitchen samples. In multivariate Tobit regressions controlling for development and season, clutter and lack of cleanliness in the apartment were associated with a tenfold increase in Bla g 1 concentration in the air, a sevenfold increase in Bla g 1 and an eightfold increase in Bla g 2 concentrations in the bed, and an 11-fold increase in Bla g 2 in the kitchen (pG0.05 for all). Holes in the wall/ceiling were associated with a six-to 11-fold increase in kitchen cockroach allergen concentrations (pG0.05). Occupancy in an apartment unit of 2 years or more was also associated with increased cockroach allergen concentrations. In contrast, there were low concentrations of mouse urinary protein in this population. In conclusion, these results suggest that interventions in these homes should focus on reducing cockroach allergen concentrations and that building-wide interventions should be supplemented with targeted efforts focused on high-risk units.

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Section: Discussionmentioning

confidence: 99%

Determinants of Allergen Concentrations in Apartments of Asthmatic Children Living in Public Housing

Peters

Levy²,

Rogers³

et al. 2007

J Urban Health

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“…[9][10][11]62,63 Lastly, indoor allergens and asthma morbidity have also been linked to building conditions; in particular older buildings and building violations in or near the residential building have been associated. 8,10,48,49,51,52 However, little explicit examination by building type and condition has occurred, especially in the USA.…”

Section: Asthma and Indoor Allergensmentioning

confidence: 99%

“…In addition, housing type and building age have been examined. [8][9][10][11] We explored the relationship between a set of building-level characteristics (presence of pests, building type, and building condition) and common urban indoor allergens (dust mite …”

Section: Introductionmentioning

confidence: 99%

Are Building-Level Characteristics Associated with Indoor Allergens in the Household?

et al. 2011

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Building-level characteristics are structural factors largely beyond the control of those who live in them. We explored whether building-level characteristics and indoor allergens in the household are related. We examined the relationship between building-level characteristics and indoor allergens: dust mite, cat, cockroach, and mouse. Building-level characteristics measured were presence of pests (seeing cockroaches and rodents), building type (public housing, buildings zoned commercially and residentially, and building size), and building condition (building age and violations). Allergen cutpoints were used for categorical analyses and defined as follows: dust mite: 90.25 μg/g; cat: 91 μg/g; cockroach: 91 U/g; mouse: 91.6 μg/g. In fully adjusted linear analyses, neither dust mite nor cat allergen were statistically significantly associated with any building-level characteristics. Cockroach allergen was associated with the presence of cockroaches (2.07; 95% CI, 1.23, 3.49) and living in public housing (2.14; 95% CI, 1.07, 4.31). Mouse allergen was associated with the presence of rodents (1.70; 95% CI, 1.29, 2.23), and building size: living in a low-rise (G8 floors; 0.60; 95% CI, 0.42, 0.87) or high-rise (8+floors; 0.50; 95% CI, 0.29, 0.88; compared with house/duplex). In fully adjusted logistic analyses, cat allergen was statistically significantly associated with living in a high-rise (6.29; 95% CI, 1.51, 26.21; compared with a house/duplex). Mouse allergen was associated with living in public housing (6.20; 95% CI, 1.01, 37.95) and building size: living in a low-rise (0.16; 95% CI, 0.05, 0.52) or high-rise (0.06; 95% CI, 0.01, 0.50; compared with a house/duplex). Issues concerning building size and public housing may be particularly critical factors in reducing asthma morbidity. We suggest that future research explore the possible improvement of these factors through changes to building code and violations adherence, design standards, and incentives for landlords.

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“…While effective strategies to reduce exposure to cockroaches are available (especially integrated pest management), evidence of impact on asthma morbidity is currently lacking. [45][46][47] Single-component interventions also not very effective Similarly, the evidence for the effectiveness of single interventions on clinical outcomes is weak. While vacuuming and/or steam cleaning may reduce exposure to mites and pet allergens, most studies have not assessed or demonstrated clinical improvements.…”

Section: Interventions To Reduce Exposure To Triggersmentioning

confidence: 99%

Home is Where the Triggers Are: Increasing Asthma Control by Improving the Home Environment

Krieger

2010

Pediatric Allergy, Immunology, and Pulmonology

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Asthma remains the most common chronic condition of childhood. Strong evidence has linked exposure to allergens and other triggers commonly found in homes to allergen sensitization and asthma incidence and morbidity. A growing body of evidence has demonstrated that a home visit strategy that includes an environmental component that addresses multiple triggers through multiple interventions is effective. Such home visits reduce exposure to triggers, decrease symptoms and urgent health-care use, and increase quality of life. To make home visits widely available will require health-care payor reimbursement, government and health plan funding, training and certification of home visitors, and active referrals from health-care providers. However, a strategy based solely on education and behavior change is limited, because it cannot adequately reduce exposures due to adverse housing conditions. Therefore, approaches that address substandard housing are needed. These include remediation of existing housing and construction of new asthma-friendly homes. Most studies of remediation have made relatively narrow and focused improvements, such as insulation, heating, or ventilation. Outcomes have been mixed. Studies of new asthma-friendly homes are in their infancy, with promising pilot data. Further investigation is needed to establish the effectiveness of improving housing. A final strategy is improving housing quality through policy change, such as implementation of healthy housing guidelines for new construction, enhancement and increased enforcement of housing codes, and assuring smoke-free multi-unit homes. The combination of home visits, improved housing construction, and policy change has great potential for reducing the global burden of asthma.

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Abatement of cockroach allergen (bla g 1) in low-income, urban housing: A randomized controlled trial

Cited by 85 publications

References 13 publications

Determinants of Allergen Concentrations in Apartments of Asthmatic Children Living in Public Housing

Determinants of Allergen Concentrations in Apartments of Asthmatic Children Living in Public Housing

Are Building-Level Characteristics Associated with Indoor Allergens in the Household?

Home is Where the Triggers Are: Increasing Asthma Control by Improving the Home Environment

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