Elevated Asthma and Indoor Environmental Exposures Among Puerto Rican Children of East Harlem

Abstract

The prevalence of current asthma was significantly higher among Puerto Ricans, who had higher symptomatic frequency and greater diagnosis rates. Although all children with asthma in the East Harlem study appear to be sensitive to selected indoor environmental risk factors, only Puerto Rican children with asthma appear to be sensitive to the presence of rodents in their buildings. However, their higher school absence rate suggests problems with routine asthma management that could be addressed by improved medical management, programs to help parents manage their children's asthma, or school staff assistance with medications.

Childhood Asthma and Extreme Values of Body Mass Index: The Harlem Children’s Zone Asthma Initiative

“…Nonetheless, the proportion of Black and Hispanic children in our study reflects the racial and ethnic profile of Central Harlem from the 2000 U.S. Census, and the high rates of current asthma and overweight observed in our dataset are similar to those in published reports of other less affluent, urban communities in New York City. 4,37,38 In short, our results are consistent with findings from other cross-sectional and prospective studies in children and adults 18,[27][28][29][30][31] and address the unresolved issue of whether gender modifies the putative association between obesity and asthma. 39 On the basis of our findings, we are in the process of implementing an intervention for overweight and at risk for overweight children with asthma enrolled in the HCZAI, which will include physical activity and nutrition sessions and an asthma educational intervention.…”

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

“…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.…”

“…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.…”

“…64 Puerto Ricans are among the racial/ethnic groups most widely affected by asthma in the USA. 24,[65][66][67][68][69][70][71][72][73][74] We hypothesized that specific building-level characteristics-presence of pests and building type and conditions-were associated with levels of indoor allergens.…”