Results of the National Cooperative Inner-City Asthma Study (NCICAS) environmental intervention to reduce cockroach allergen exposure in inner-city homes

Gergen, Peter J.; Mortimer, Kathleen; Eggleston, Peyton A.; Rosenstreich, David L.; Mitchell, Herman; Ownby, Dennis R.; Kattan, Meyer; Baker, Dean; Wright, Elizabeth C.; Slavin, Raymond G.; Malveaux, Floyd J.

doi:10.1016/s0091-6749(99)70477-x

Cited by 203 publications

(82 citation statements)

References 14 publications

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“…In addition, the summer sampling was done in the Franklin Hill development only, whereas the winter sampling was done in all three developments with the greatest number of winter samples collected in West Broadway. Our study had comparable median kitchen cockroach allergen concentrations with those reported for the National Cooperative Inner-City Asthma Study (NCICAS), 28 three times the levels observed in a Baltimore inner-city study, 29 and two orders of magnitude above the geometric mean concentration found in the New York City Columbia Center for Children_s Environmental Health Study (CCCEHS). 6 The bed levels for our study were comparable to CCCEHS.…”

Section: Discussionsupporting

confidence: 74%

Determinants of Allergen Concentrations in Apartments of Asthmatic Children Living in Public Housing

Peters

Levy²,

Rogers³

et al. 2007

J Urban Health

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There is growing evidence linking poor housing conditions and respiratory diseases, including asthma. The association between housing conditions and asthma in the inner city has been attributed in part to cockroach and mouse infestation and the resulting allergen exposures. Multiple social and behavioral factors can influence environmental exposures and health conditions, necessitating a thorough examination of such factors. As part of the Healthy Public Housing Initiative, we evaluated the association between physical and household characteristics and pest-related allergen levels in three public housing developments in Boston, MA. We detected cockroach allergens (Bla g 1 and Bla g 2) in bedroom air, bed, and especially high concentrations in kitchen samples. In multivariate Tobit regressions controlling for development and season, clutter and lack of cleanliness in the apartment were associated with a tenfold increase in Bla g 1 concentration in the air, a sevenfold increase in Bla g 1 and an eightfold increase in Bla g 2 concentrations in the bed, and an 11-fold increase in Bla g 2 in the kitchen (pG0.05 for all). Holes in the wall/ceiling were associated with a six-to 11-fold increase in kitchen cockroach allergen concentrations (pG0.05). Occupancy in an apartment unit of 2 years or more was also associated with increased cockroach allergen concentrations. In contrast, there were low concentrations of mouse urinary protein in this population. In conclusion, these results suggest that interventions in these homes should focus on reducing cockroach allergen concentrations and that building-wide interventions should be supplemented with targeted efforts focused on high-risk units.

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Section: Discussionsupporting

confidence: 74%

Determinants of Allergen Concentrations in Apartments of Asthmatic Children Living in Public Housing

Peters

Levy²,

Rogers³

et al. 2007

J Urban Health

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“…[22][23][24][25][26] In addition, reducing cockroach allergen in urban homes is challenging and in some studies has produced no apparent clinical benefit. 22,27 However, a recent intervention aimed at reducing exposure to multiple indoor allergens and ETS has produced a significant and sustained decrease in asthma symptoms. 28 This multifaceted intervention addressed those specific exposures to which each individual child was allergic.…”

Section: Resultsmentioning

confidence: 99%

Indoor Environmental Exposures Among Children With Asthma Seen in an Urban Emergency Department

et al. 2006

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“…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.…”

Section: Asthma and Indoor Allergensmentioning

confidence: 99%

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

et al. 2011

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Building-level characteristics are structural factors largely beyond the control of those who live in them. We explored whether building-level characteristics and indoor allergens in the household are related. We examined the relationship between building-level characteristics and indoor allergens: dust mite, cat, cockroach, and mouse. Building-level characteristics measured were presence of pests (seeing cockroaches and rodents), building type (public housing, buildings zoned commercially and residentially, and building size), and building condition (building age and violations). Allergen cutpoints were used for categorical analyses and defined as follows: dust mite: 90.25 μg/g; cat: 91 μg/g; cockroach: 91 U/g; mouse: 91.6 μg/g. In fully adjusted linear analyses, neither dust mite nor cat allergen were statistically significantly associated with any building-level characteristics. Cockroach allergen was associated with the presence of cockroaches (2.07; 95% CI, 1.23, 3.49) and living in public housing (2.14; 95% CI, 1.07, 4.31). Mouse allergen was associated with the presence of rodents (1.70; 95% CI, 1.29, 2.23), and building size: living in a low-rise (G8 floors; 0.60; 95% CI, 0.42, 0.87) or high-rise (8+floors; 0.50; 95% CI, 0.29, 0.88; compared with house/duplex). In fully adjusted logistic analyses, cat allergen was statistically significantly associated with living in a high-rise (6.29; 95% CI, 1.51, 26.21; compared with a house/duplex). Mouse allergen was associated with living in public housing (6.20; 95% CI, 1.01, 37.95) and building size: living in a low-rise (0.16; 95% CI, 0.05, 0.52) or high-rise (0.06; 95% CI, 0.01, 0.50; compared with a house/duplex). Issues concerning building size and public housing may be particularly critical factors in reducing asthma morbidity. We suggest that future research explore the possible improvement of these factors through changes to building code and violations adherence, design standards, and incentives for landlords.

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Results of the National Cooperative Inner-City Asthma Study (NCICAS) environmental intervention to reduce cockroach allergen exposure in inner-city homes

Cited by 203 publications

References 14 publications

Determinants of Allergen Concentrations in Apartments of Asthmatic Children Living in Public Housing

Determinants of Allergen Concentrations in Apartments of Asthmatic Children Living in Public Housing

Indoor Environmental Exposures Among Children With Asthma Seen in an Urban Emergency Department

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

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