Relationship of indoor allergen exposure to skin test sensitivity in inner-city children with asthma

P. A. Eggleston, David L. Rosenstreich, H. Lynn, P. Gergen, D. Baker, M. Kattan, K. M. Mortimer, H. Mitchell, D. Ownby, R. Slavin, F. Malveaux

Research output: Contribution to journalArticle

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Abstract

Background: It is important to understand the relationship between environmental allergen exposure dose and the risk of atopic individuals becoming sensitized to that allergen if we are to change the risk of sensitization and morbidity from allergic disease. Objective: The objective of these studies was to determine whether there was a dose response between current exposure to mite, cockroach, and cat allergen in inner-city children and to determine the prevalence of sensitization to these allergens. Methods: A sample of 500 children was selected from the 1528 children enrolled in the National Cooperative Inner City Asthma Study. Children were selected who had a sample of home dust and valid skin test responses performed with a MultiTest skin test device. The samples of home dust were collected from the floor and furniture in the kitchen, bedroom, and television/living room and were assayed for Der p 1, Der f 1, Bla g 1, and Fel d 1 allergens. Results: Each allergen level correlated significantly between rooms in individual homes. Mite (Der p 1 and Der f 1) and cat (Fel d 1) allergen levels were frequently below the detection limit of the assay. Cockroach allergen (Bla g 1) concentrations in the child's bedroom were related to the prevalence of positive skin test responses to cockroach allergen extract among the children, with an odds ratio for sensitization of 1.45 (1.111.92). Positive skin test responses to cockroach allergen were seen in 15% of children exposed to bedroom dust with a Bla g I concentration below the level of detection compared with a rate of 32% in bedrooms with Bla g 1 levels of 1 to 2 U/g and 40% to 44% among those in rooms with 4 U/g or greater. The relationship between exposure and positive skin test responses was clearly stronger among atopic children with a greater number of positive skin test responses. Conclusions: Despite widespread exposure to household allergens, the strongest relationship between exposure and sensitization was seen in the bedroom. The dose response between exposure to cockroach allergen and sensitization suggested that exposure to low doses of allergen, 2 U/g or less, was a risk factor and that the risk plateaus above 4 U/g. Atopy modified the relationship of exposure to sensitization.

Original languageEnglish (US)
Pages (from-to)563-570
Number of pages8
JournalJournal of Allergy and Clinical Immunology
Volume102
Issue number4 I
DOIs
StatePublished - 1998

Fingerprint

Skin Tests
Allergens
Asthma
Cockroaches
Dust
Mites
Interior Design and Furnishings
Television
Environmental Exposure
Limit of Detection
Cats
Odds Ratio
Morbidity
Equipment and Supplies

Keywords

  • Allergens
  • Cat
  • Cockroach
  • Dust mite
  • Skin test

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology

Cite this

Relationship of indoor allergen exposure to skin test sensitivity in inner-city children with asthma. / Eggleston, P. A.; Rosenstreich, David L.; Lynn, H.; Gergen, P.; Baker, D.; Kattan, M.; Mortimer, K. M.; Mitchell, H.; Ownby, D.; Slavin, R.; Malveaux, F.

In: Journal of Allergy and Clinical Immunology, Vol. 102, No. 4 I, 1998, p. 563-570.

Research output: Contribution to journalArticle

Eggleston, PA, Rosenstreich, DL, Lynn, H, Gergen, P, Baker, D, Kattan, M, Mortimer, KM, Mitchell, H, Ownby, D, Slavin, R & Malveaux, F 1998, 'Relationship of indoor allergen exposure to skin test sensitivity in inner-city children with asthma', Journal of Allergy and Clinical Immunology, vol. 102, no. 4 I, pp. 563-570. https://doi.org/10.1016/S0091-6749(98)70272-6
Eggleston, P. A. ; Rosenstreich, David L. ; Lynn, H. ; Gergen, P. ; Baker, D. ; Kattan, M. ; Mortimer, K. M. ; Mitchell, H. ; Ownby, D. ; Slavin, R. ; Malveaux, F. / Relationship of indoor allergen exposure to skin test sensitivity in inner-city children with asthma. In: Journal of Allergy and Clinical Immunology. 1998 ; Vol. 102, No. 4 I. pp. 563-570.
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AU - Lynn, H.

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AU - Baker, D.

AU - Kattan, M.

AU - Mortimer, K. M.

AU - Mitchell, H.

AU - Ownby, D.

AU - Slavin, R.

AU - Malveaux, F.

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N2 - Background: It is important to understand the relationship between environmental allergen exposure dose and the risk of atopic individuals becoming sensitized to that allergen if we are to change the risk of sensitization and morbidity from allergic disease. Objective: The objective of these studies was to determine whether there was a dose response between current exposure to mite, cockroach, and cat allergen in inner-city children and to determine the prevalence of sensitization to these allergens. Methods: A sample of 500 children was selected from the 1528 children enrolled in the National Cooperative Inner City Asthma Study. Children were selected who had a sample of home dust and valid skin test responses performed with a MultiTest skin test device. The samples of home dust were collected from the floor and furniture in the kitchen, bedroom, and television/living room and were assayed for Der p 1, Der f 1, Bla g 1, and Fel d 1 allergens. Results: Each allergen level correlated significantly between rooms in individual homes. Mite (Der p 1 and Der f 1) and cat (Fel d 1) allergen levels were frequently below the detection limit of the assay. Cockroach allergen (Bla g 1) concentrations in the child's bedroom were related to the prevalence of positive skin test responses to cockroach allergen extract among the children, with an odds ratio for sensitization of 1.45 (1.111.92). Positive skin test responses to cockroach allergen were seen in 15% of children exposed to bedroom dust with a Bla g I concentration below the level of detection compared with a rate of 32% in bedrooms with Bla g 1 levels of 1 to 2 U/g and 40% to 44% among those in rooms with 4 U/g or greater. The relationship between exposure and positive skin test responses was clearly stronger among atopic children with a greater number of positive skin test responses. Conclusions: Despite widespread exposure to household allergens, the strongest relationship between exposure and sensitization was seen in the bedroom. The dose response between exposure to cockroach allergen and sensitization suggested that exposure to low doses of allergen, 2 U/g or less, was a risk factor and that the risk plateaus above 4 U/g. Atopy modified the relationship of exposure to sensitization.

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