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The role of cockroach allergy and exposure to cockroach allergen in causing morbidity among inner-city children with asthma.
N Engl J Med 1997; 336(19):1356-63NEJM

Abstract

BACKGROUND

It has been hypothesized that asthma-related health problems are most severe among children in inner-city areas who are allergic to a specific allergen and also exposed to high levels of that allergen in bedroom dust.

METHODS

From November 1992 through October 1993, we recruited 476 children with asthma (age, four to nine years) from eight inner-city areas in the United States. Immediate hypersensitivity to cockroach, house-dust-mite, and cat allergens was measured by skin testing. We then measured major allergens of cockroach (Bla g 1), dust mites (Der p 1 and Der f 1), and cat dander (Fel d 1) in household dust using monoclonal-antibody-based enzyme-linked immunosorbent assays. High levels of exposure were defined according to proposed thresholds for causing disease. Data on morbidity due to asthma were collected at base line and over a one-year period.

RESULTS

Of the children, 36.8 percent were allergic to cockroach allergen, 34.9 percent to dust-mite allergen, and 22.7 percent to cat allergen. Among the children's bedrooms, 50.2 percent had high levels of cockroach allergen in dust, 9.7 percent had high levels of dust-mite allergen, and 12.6 percent had high levels of cat allergen. After we adjusted for sex, score on the Child Behavior Checklist, and family history of asthma, we found that children who were both allergic to cockroach allergen and exposed to high levels of this allergen had 0.37 hospitalization a year, as compared with 0.11 for the other children (P=0.001), and 2.56 unscheduled medical visits for asthma per year, as compared with 1.43 (P<0.001). They also had significantly more days of wheezing, missed school days, and nights with lost sleep, and their parents or other care givers were awakened during the night and changed their daytime plans because of the child's asthma significantly more frequently. Similar patterns were not found for the combination of allergy to dust mites or cat dander and high levels of the allergen.

CONCLUSIONS

The combination of cockroach allergy and exposure to high levels of this allergen may help explain the frequency of asthma-related health problems in inner-city children.

Authors+Show Affiliations

Department of Medicine, Albert Einstein College of Medicine, Bronx, NY 10461, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

9134876

Citation

Rosenstreich, D L., et al. "The Role of Cockroach Allergy and Exposure to Cockroach Allergen in Causing Morbidity Among Inner-city Children With Asthma." The New England Journal of Medicine, vol. 336, no. 19, 1997, pp. 1356-63.
Rosenstreich DL, Eggleston P, Kattan M, et al. The role of cockroach allergy and exposure to cockroach allergen in causing morbidity among inner-city children with asthma. N Engl J Med. 1997;336(19):1356-63.
Rosenstreich, D. L., Eggleston, P., Kattan, M., Baker, D., Slavin, R. G., Gergen, P., ... Malveaux, F. (1997). The role of cockroach allergy and exposure to cockroach allergen in causing morbidity among inner-city children with asthma. The New England Journal of Medicine, 336(19), pp. 1356-63.
Rosenstreich DL, et al. The Role of Cockroach Allergy and Exposure to Cockroach Allergen in Causing Morbidity Among Inner-city Children With Asthma. N Engl J Med. 1997 May 8;336(19):1356-63. PubMed PMID: 9134876.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The role of cockroach allergy and exposure to cockroach allergen in causing morbidity among inner-city children with asthma. AU - Rosenstreich,D L, AU - Eggleston,P, AU - Kattan,M, AU - Baker,D, AU - Slavin,R G, AU - Gergen,P, AU - Mitchell,H, AU - McNiff-Mortimer,K, AU - Lynn,H, AU - Ownby,D, AU - Malveaux,F, PY - 1997/5/8/pubmed PY - 1997/5/8/medline PY - 1997/5/8/entrez SP - 1356 EP - 63 JF - The New England journal of medicine JO - N. Engl. J. Med. VL - 336 IS - 19 N2 - BACKGROUND: It has been hypothesized that asthma-related health problems are most severe among children in inner-city areas who are allergic to a specific allergen and also exposed to high levels of that allergen in bedroom dust. METHODS: From November 1992 through October 1993, we recruited 476 children with asthma (age, four to nine years) from eight inner-city areas in the United States. Immediate hypersensitivity to cockroach, house-dust-mite, and cat allergens was measured by skin testing. We then measured major allergens of cockroach (Bla g 1), dust mites (Der p 1 and Der f 1), and cat dander (Fel d 1) in household dust using monoclonal-antibody-based enzyme-linked immunosorbent assays. High levels of exposure were defined according to proposed thresholds for causing disease. Data on morbidity due to asthma were collected at base line and over a one-year period. RESULTS: Of the children, 36.8 percent were allergic to cockroach allergen, 34.9 percent to dust-mite allergen, and 22.7 percent to cat allergen. Among the children's bedrooms, 50.2 percent had high levels of cockroach allergen in dust, 9.7 percent had high levels of dust-mite allergen, and 12.6 percent had high levels of cat allergen. After we adjusted for sex, score on the Child Behavior Checklist, and family history of asthma, we found that children who were both allergic to cockroach allergen and exposed to high levels of this allergen had 0.37 hospitalization a year, as compared with 0.11 for the other children (P=0.001), and 2.56 unscheduled medical visits for asthma per year, as compared with 1.43 (P<0.001). They also had significantly more days of wheezing, missed school days, and nights with lost sleep, and their parents or other care givers were awakened during the night and changed their daytime plans because of the child's asthma significantly more frequently. Similar patterns were not found for the combination of allergy to dust mites or cat dander and high levels of the allergen. CONCLUSIONS: The combination of cockroach allergy and exposure to high levels of this allergen may help explain the frequency of asthma-related health problems in inner-city children. SN - 0028-4793 UR - https://www.unboundmedicine.com/medline/citation/9134876/full_citation L2 - http://www.nejm.org/doi/full/10.1056/NEJM199705083361904?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -