Deteriorated housing contributes to high cockroach allergen levels in inner-city households.

Abstract

The high prevalence of childhood asthma in low-income, inner-city populations is not fully understood but has been at least partly attributed to the disproportionate exposures associated with socioeconomic disadvantage. The contribution of indoor allergens to asthma is well documented, but links between socioeconomic disadvantage and indoor allergen levels are not clear. We investigated levels of cockroach allergens (Bla g 2) in a sample of 132 Dominican or African American low-income households with young children in northern Manhattan in New York City (40% were receiving public assistance) to determine whether the distribution of allergens is a function of housing deterioration. Deterioration was measured by the presence and number of physical housing problems (holes in the ceilings and walls, water damage, etc.). More than 50% of the sample had two or more types of housing dilapidation, and 67% of the sample reported cockroach sightings in their homes. Samples of dust were collected from kitchen and bedroom surfaces. We hypothesized that the greater the dilapidation, the higher the allergen levels, independent of income, sociocultural factors, and pest-control methods. In addition, we hypothesized that the homes of families characterized by frequent moves (23.5%) would have higher allergen levels than more stable families. Results showed significant positive associations between housing deterioration and allergen levels in kitchens, after adjusting for income and ethnicity, with independent effects of residential stability (p< 0.05). Bedroom allergen levels were associated with housing instability (p < 0.01) and ethnicity (p< 0.01). Findings demonstrated that indoor household allergen levels are related to degree of household disrepair, after adjusting for individual family attributes, suggesting that social-structural aspects of housing may be appropriate targets for public health interventions designed to reduce allergen exposure.

Endotoxin in inner-city homes: Associations with wheeze and eczema in early childhood

“…We also did not find significant associations between endotoxin concentration or load and any of the questions addressing mold or housing disrepair (Table I), or when analyzing using a previously described housing disrepair scale as an independent variable in linear regression (β=0.02, p=0.75 for concentration endotoxin; β=0.014, p=0.82 for load) (23 …”

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

“…These results are consistent with prior literature. 25,58 The household-reported presence of rodents and building size were positively statistically significantly associated with MUP allergen in bivariate and fully adjusted linear models. The household-reported presence of rodents, living in public housing, and building size were statistically significantly associated with MUP allergen at a clinically relevant level of 91.6 μg/g.…”

“…23 High levels of indoor allergens are associated with asthma morbidity. 11,[24][25][26] Asthma and sensitization to cockroach allergen are widely known to be associated. [27][28][29] High exposure to cockroach allergen is a risk factor for both asthma medication use and asthma-related hospitalizations.…”

“…40,41 Such triggers include household environmental exposures, high parental stress, poor medication adherence, child behavioral or emotional concerns, and poor medical care. 3,16,21,22,[24][25][26][42][43][44][45][46][47] An emerging literature does suggest that indoor allergens associated with asthma are related to the buildings in which people live. 10,11,[48][49][50][51][52] Considerable literature firmly establishes that the presence of cockroaches and rodents (i.e., pests) is associated with higher levels of asthma morbidity.…”

Individual, Housing, and Neighborhood Correlates of Asthma among Young Urban Children

“…In New York City, Rauh et al showed that levels of cockroach allergens and cockroach sightings were associated with degree of housing disrepair and deterioration. 36 In a similar study carried out in Boston, Peters et al found that homes with clutter, lack of cleanliness, and holes in the wall or ceiling had elevated levels of cockroach allergen compared to other urban homes. 37 Serious housing code violations have also been linked to increased cockroach and mice allergen levels in the home.…”