Abatement of cockroach allergen (Bla g 1) in low-income, urban housing: A randomized controlled trial
Abatement of cockroach allergen (Bla g 1) in low-income, urban housing: A randomized controlled trial
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DOI：
10.1067/mai.2003.1597
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发表时间：
2003-08-01
影响因子：
14.2
通讯作者：
Zeldin, DC
中科院分区：
文献类型：
--
作者：
Arbes, SJ;Sever, M;Zeldin, DC
背景：在干预试验中，与临床相关的蟑螂过敏原暴露减少已被证明是难以实现的，蟑螂过敏原是市中心家庭哮喘的重要危险因素。目的：探讨一种降低城市低收入家庭蟑螂过敏原的方法。目标是将平均blag1浓度降低到先前提出的过敏致敏和哮喘发病率阈值以下。方法：采用16个干预家庭和15个对照家庭进行随机、非蒙面试验。研究纳入基于在3天内捕获的50至500只蟑螂。干预措施包括居住者教育、放置杀虫剂诱饵和专业清洁。在干预家庭和对照家庭分别于0、1、2、4和6个月及0和6个月收集吸尘和多次拭子样本。使用包含蟑螂和过敏原数据的房间地图来指导和监测干预措施。结果：在干预家庭中，从0个月到6个月，厨房地板的几何平均Bla g 1浓度（U/g尘埃）从633下降到24（减少96%），客厅地板/沙发从25下降到4.3（减少83%），卧室地板从46下降到7.3（减少84%），卧室床从6.1下降到1.0（减少84%）。这些减少，除了卧室地板上的减少（P = .06），相对于对照家庭的变化在统计学上是显著的。结论：城区住宅蟑螂过敏原水平可大幅度降低。在这项研究中，床上的过敏原水平降至致敏阈值（2 U/g）以下，可以说是最相关的暴露部位，卧室地板和客厅地板/沙发的过敏原水平降至哮喘发病阈值（8 U/g）以下。厨房地板上的水平虽然降低了96%，但仍高于哮喘发病阈值。未来的研究将在哮喘预防试验中测试干预措施的有效性。
Background: Clinically relevant reductions in exposure to cockroach allergen, an important risk factor for asthma in inner-city households, have proven difficult to achieve in intervention trials.Objective: This study investigated a method for the abatement of cockroach allergen in low-income, urban homes. The goal was to reduce mean Bla g 1 concentrations below the previously proposed thresholds for allergic sensitization and asthma morbidity.Methods: A prerandomized, nonmasked trial with 16 intervention and 15 control homes was conducted. Study inclusion was based on 50 to 500 cockroaches trapped in a 3-day period. The interventions consisted of occupant education, placement of insecticide bait, and professional cleaning. Vacuumed dust and multiple swab samples were collected at 0, 1, 2, 4, and 6 months in intervention homes and at 0 and 6 months in control homes. Room maps containing cockroach and allergen data were used to guide and monitor the interventions.Results: From 0 to 6 months among intervention homes, geometric mean Bla g 1 concentrations (U/g dust) decreased from 633 to 24 on kitchen floors (96% reduction), from 25 to 4.3 on living room floors/sofas (83% reduction), from 46 to 7.3 on bedroom floors (84% reduction), and from 6.1 to 1.0 in bedroom beds (84% reduction). These reductions, with the exception of that on the bedroom floor (P = .06), were statistically significant relative to changes in control homes.Conclusions: Substantial reductions in cockroach allergen levels can be achieved in inner-city homes. In this study, allergen levels were reduced below the sensitization threshold (2 U/g) in beds, arguably the most relevant site for exposure, and below the asthma morbidity threshold (8 U/g) on bedroom floors and living room floors/sofas. The level on kitchen floors, although reduced 96%, remained above the asthma morbidity threshold. Future studies will test the intervention's effectiveness in asthma prevention trials.