National Prevalence and Exposure Risk for Cockroach Allergen in U.S. Households

Abstract

We characterized the prevalence of cockroach allergen exposure in a nationally representative sample of U.S. homes and assessed risk factors for elevated concentrations.DesignWe used data from the National Survey of Lead and Allergens in Housing, a population-based cross-sectional survey.ParticipantsParticipants were residents of 831 U.S. homes in the survey.Evaluations/MeasurementsWe analyzed allergen, questionnaire, and observational data of 831 U.S. homes.ResultsCockroach allergen (Bla g 1) concentrations exceed 2.0 U/g, a level associated with allergic sensitization, in 11% of U.S. living room floors and 13% of kitchen floors. Concentrations exceed 8.0 U/g, a level associated with asthma morbidity, in 3% of living room floors and 10% of kitchen floors. Elevated concentrations were observed in high-rise apartments, urban settings, pre-1940 constructions, and households with incomes < $20,000. Odds of having concentrations > 8.0 U/g were greatest when roach problems were reported or observed and increased with the number of cockroaches observed and with indications of recent cockroach activity.ConclusionsHousehold cockroach allergen exposure is characterized in a nationally representative context. The allergen is prevalent in many settings, at levels that may contribute to allergic sensitization and asthma morbidity.Relevance to Clinical or Professional PracticeLikelihood of exposure can be assessed by consideration of demographic and household determinants.

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

“…9,54 Our levels are likely less comparable to national data, because these data are generally less representative of the urban context; for example, they contain few high-rise buildings. 10,51,77,85 From this examination, we begin to understand how building-level characteristics may be related to allergen levels. We did not find associations between building-level characteristics and Der f 1 or Fel d 1 allergen in bivariate or fully adjusted linear models.…”

“…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. 5,10,24,51,[53][54][55][56][57] Likewise, recent literature has highlighted the relationship between asthma morbidity and building types such as public housing; 54,58 mixed-use buildings, i.e., property containing both residential and commercial space; [59][60][61] and building size.…”

“…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. 5,10,24,51,[53][54][55][56][57] Likewise, recent literature has highlighted the relationship between asthma morbidity and building types such as public housing; 54,58 mixed-use buildings, i.e., property containing both residential and commercial space; [59][60][61] and building size. [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.…”

“…[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.…”

Asthma cases attributable to atopy: Results from the Third National Health and Nutrition Examination Survey

“…Data from the National Survey of Lead and Allergens in Housing have shown that people in the above high school education category have a higher mean level of cat allergen in their homes than people in the lower education categories whereas people living in highly populated metropolitan areas are more likely to have elevated levels of cockroach allergen in their homes than people living in other areas. 16,17 In addition, studies from rural areas in Europe have consistently shown that children growing up on farms are less likely to develop atopy and allergic disease, 18 the presumption being that certain microbial exposures in early childhood may be beneficial. However, in NHANES III, the urbanization category "all other areas" consists only partially of rural or farm families, so it is not known whether any differences in the PAR by urbanization can be attributed to a protective effect of rural or farm exposures.…”