Association of specific allergen sensitization with socioeconomic factors and allergic disease in a population of Boston women

Lewis, Sarah; Weiss, Scott T.; Platts-Mills, Thomas A.E.; Syring, Meghan; Gold, Diane R.

doi:10.1067/mai.2001.113523

Cited by 71 publications

(47 citation statements)

References 26 publications

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“…The allergen is usually distributed throughout an infested home (502). Elevated concentrations have been observed in high-rise apartments, urban settings, pre-1940 constructions and households with low income (503)(504)(505). Cockroaches are particularly important in low-income housing (Ôinner cityÕ) where they can cause severe asthma (292).…”

Section: Other Mitesmentioning

confidence: 99%

Allergic Rhinitis and its Impact on Asthma (ARIA) 2008*

Bousquet¹,

Khaltaev²,

Cruz³

et al. 2008

Allergy

3,861

1,761

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Section: Other Mitesmentioning

confidence: 99%

Allergic Rhinitis and its Impact on Asthma (ARIA) 2008*

Bousquet¹,

Khaltaev²,

Cruz³

et al. 2008

Allergy

3,861

1,761

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“…Specific IgE antibodies were assayed for dust mite, cat, cockroach, dog, ryegrass, ragweed, Alternaria species, and Aspergillus species allergens, with each allergen attached to a cellulose sponge (ImmunoCAP). 15 The results were given as international units (IU) of IgE. We defined sensitivity to a specific allergen as CAP class level 1 or above (>0.35 IU/mL).…”

Section: Measurement Of Maternal Sensitization To Allergensmentioning

confidence: 99%

Endotoxin Exposure and Eczema in the First Year of Life

et al. 2004

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Objective-Exposure to endotoxin in early life has been proposed as a factor that may protect against the development of allergic diseases such as eczema. The objective of this study was to examine the relation between endotoxin exposure in early life and eczema in the first year of life in children with parental history of asthma or allergies.Methods-This study used a prospective birth cohort study of 498 children who had a history of allergy or asthma in at least 1 parent and lived in metropolitan Boston. A subset of 401 living rooms had house dust samples adequate for analysis of endotoxin.Results-In multivariate analyses adjusting for gender, income, and season of birth, endotoxin levels in the living room at 2 to 3 months of age was inversely associated with physician-or nursediagnosed eczema in the first year of life (odds ratio [OR] for each quartile increment: 0.76; 95% confidence interval [CI]: 0.61-0.96). Exposure to a dog in the home at age 2 to 3 months was also inversely associated with eczema in the first year of life, but the CI widened when endotoxin was included in the multivariate model (OR: 0.54; 95% CI: 0.27-1.09). Other variables associated with eczema in the first year of life included paternal history of eczema (OR: 1.91; 95% CI: 1.03-3.55) and maternal specific immunoglobulin E positivity to ≥1 allergen (OR: 1.61; 95% CI: 1.01-2.56).Conclusions-Among children with parental history of asthma or allergies, exposure to high levels of endotoxin in early life may be protective against eczema in the first year of life. In these children, paternal history of eczema and maternal sensitization to at least 1 allergen are associated with an increased risk of eczema in the first year of life. ABBREVIATIONSIg, immunoglobulin; OR, odds ratio; CI, confidence interval; T h 2, T-helper cell type 2 Eczema is the most common atopic disease in infancy, and 60% of affected individuals manifest characteristic lesions during the first year of life. 1 The prevalence of eczema has increased by 2 to 3-fold during the past 3 decades in industrialized countries. Early childhood exposure to endotoxin has been hypothesized to be protective against the development of asthma, 4 allergy, 5-7 and eczema. 7 The Home Allergens and Asthma Study is a prospective birth cohort study of children with a parental history of asthma or allergies in the Boston metropolitan area. The primary purpose of this study is to assess the relationship between exposure to indoor allergens in early childhood and the subsequent development of asthma and allergic diseases. As part of this study, exposure to endotoxin in the household was measured at 2 to 3 months of age. In this report, we describe the relation between endotoxin exposure and eczema in the first year of life among children with parental history of asthma or allergies. METHODS Study ParticipantsThe 505 infants (including 6 sets of twins) and their 499 families with a history of allergy or asthma in at least 1 parent were recruited between September 1994 and August 1996. The ...

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“…In King County in the State of Washington, the asthma hospitalization rate of children living in high-poverty areas is three times that of those living in low-poverty areas (40). In addition, being poor or a person of color is associated with increased rates of sensitization to several asthma-associated allergens (41)(42)(43)(44)(45)(46)(47)(48). Sensitization to allergens is one of the main risk factors for developing asthma and its complications (49)(50)(51).…”

mentioning

confidence: 99%

The Seattle-King County healthy homes project: implementation of a comprehensive approach to improving indoor environmental quality for low-income children with asthma.

Krieger

Takaro

Allen

et al. 2002

Environ Health Perspect

127

102

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Pediatric asthma is a growing public health issue, disproportionately affecting low-income people and people of color. Exposure to indoor asthma triggers plays an important role in the development and exacerbation of asthma. We describe the implementation of the Seattle-King County Healthy Homes Project, a randomized, controlled trial of an outreach/education intervention to improve asthma-related health status by reducing exposure to allergens and irritants in the home. We randomly assigned 274 low-income children with asthma ages 4-12 to either a high- or a low-intensity group. In the high-intensity group, community health workers called Community Home Environmental Specialists (CHES) conducted initial home environmental assessments, provided individualized action plans, and made additional visits over a 12-month period to provide education and social support, encouragement of participant actions, provision of materials to reduce exposures (including bedding encasements), assistance with roach and rodent eradication, and advocacy for improved housing conditions. Members of the low-intensity group received the initial assessment, home action plan, limited education during the assessment visit, and bedding encasements. We describe the recruitment and training of CHES and challenges they faced and explain the assessment and exposure reduction protocols addressing dust mites, mold, tobacco smoke, pets, cockroaches, rodents, dust, moisture, and toxic or hazardous chemicals. We also discuss the gap between the practices recommended in the literature and what is feasible in the home. We accomplished home interventions and participants found the project very useful. The project was limited in resolving structural housing quality issues that contributed to exposure to indoor triggers.

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Association of specific allergen sensitization with socioeconomic factors and allergic disease in a population of Boston women

Cited by 71 publications

References 26 publications

Allergic Rhinitis and its Impact on Asthma (ARIA) 2008*

Allergic Rhinitis and its Impact on Asthma (ARIA) 2008*

Endotoxin Exposure and Eczema in the First Year of Life

The Seattle-King County healthy homes project: implementation of a comprehensive approach to improving indoor environmental quality for low-income children with asthma.

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