The role of cockroach allergy and exposure to cockroach allergen in causing morbidity among inner-city children with asthma

David L. Rosenstreich, Peyton Eggleston, Meyer Kattan, Dean Baker, Raymond G. Slavin, Peter Gergen, Herman Mitchell, Kathleen Mcniff-Mortimer, Henry Lynn, Dennis Ownby, Floyd Malveaux

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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.

Original languageEnglish (US)
Pages (from-to)1356-1363
Number of pages8
JournalNew England Journal of Medicine
Volume336
Issue number19
DOIs
StatePublished - 1997

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Cockroaches
Allergens
Hypersensitivity
Asthma
Morbidity
Dust
Mites
Cats
Dander
Dermatophagoides Antigens
Immediate Hypersensitivity
Respiratory Sounds
Health
Child Behavior
Checklist
Caregivers
Sleep
Hospitalization
Parents
Enzyme-Linked Immunosorbent Assay

ASJC Scopus subject areas

  • Medicine(all)

Cite this

The role of cockroach allergy and exposure to cockroach allergen in causing morbidity among inner-city children with asthma. / Rosenstreich, David L.; Eggleston, Peyton; Kattan, Meyer; Baker, Dean; Slavin, Raymond G.; Gergen, Peter; Mitchell, Herman; Mcniff-Mortimer, Kathleen; Lynn, Henry; Ownby, Dennis; Malveaux, Floyd.

In: New England Journal of Medicine, Vol. 336, No. 19, 1997, p. 1356-1363.

Research output: Contribution to journalArticle

Rosenstreich, DL, Eggleston, P, Kattan, M, Baker, D, Slavin, RG, Gergen, P, Mitchell, H, Mcniff-Mortimer, K, Lynn, H, Ownby, D & Malveaux, F 1997, 'The role of cockroach allergy and exposure to cockroach allergen in causing morbidity among inner-city children with asthma', New England Journal of Medicine, vol. 336, no. 19, pp. 1356-1363. https://doi.org/10.1056/NEJM199705083361904
Rosenstreich, David L. ; Eggleston, Peyton ; Kattan, Meyer ; Baker, Dean ; Slavin, Raymond G. ; Gergen, Peter ; Mitchell, Herman ; Mcniff-Mortimer, Kathleen ; Lynn, Henry ; Ownby, Dennis ; Malveaux, Floyd. / The role of cockroach allergy and exposure to cockroach allergen in causing morbidity among inner-city children with asthma. In: New England Journal of Medicine. 1997 ; Vol. 336, No. 19. pp. 1356-1363.
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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.",
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AU - Kattan, Meyer

AU - Baker, Dean

AU - Slavin, Raymond G.

AU - Gergen, Peter

AU - Mitchell, Herman

AU - Mcniff-Mortimer, Kathleen

AU - Lynn, Henry

AU - Ownby, Dennis

AU - Malveaux, Floyd

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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.

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