Socioeconomic status and race as risk factors for cockroach allergen exposure and sensitization in children with asthma
Socioeconomic status and race as risk factors for cockroach allergen exposure and sensitization in children with asthma
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DOI：
10.1016/s0091-6749(96)70209-9
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发表时间：
1996-06-01
影响因子：
14.2
通讯作者：
Adkinson, NF
中科院分区：
文献类型：
--
作者：
Sarpong, SB;Hamilton, RG;Adkinson, NF
背景：在温带和热带气候下，家蟑螂已被确定为世界范围内室内空气过敏原的重要来源。由于蟑螂在拥挤的城市地区数量最多，一些人认为，市中心哮喘发病率和死亡率的增加可能部分与蟑螂过敏原接触有关。我们检查了城市和郊区哮喘儿童家中的蟑螂过敏原暴露情况，并将暴露率和致敏率与社会经济、种族和人口因素联系起来。目的：本研究旨在确定种族、社会经济地位和居住地对哮喘儿童蟑螂过敏原暴露和致敏风险的独立贡献。方法：对87例5 ~ 17岁的中重度过敏性哮喘患儿进行前瞻性免疫治疗试验。采用双位点单克隆免疫分析法对3个住家的粉尘样本进行主要蟑螂变应原（Bla g1和Bla g2）的分析。87名受试者中有81人进行了混合蟑螂过敏原提取物穿刺皮肤试验。结果：在评估的87个家庭中，26%的卧室灰尘样本检测到蟑螂过敏原。在可检测到卧室蟑螂过敏原水平的家庭中，城市和郊区家庭的平均Bla g 1和Bla g 2浓度相似。超过80%的卧室Bla g 1或Bla g 2≥1 U/gm的儿童表现出对蟑螂过敏原的皮肤敏感。蟑螂致敏率与卧室暴露水平直接相关。非裔美国人种族是唯一与蟑螂过敏原暴露独立相关的因素（p = 0.05）。经逐步多元线性回归分析，社会经济地位低、年龄大于11岁、接触蜚蠊、非裔美国人种族与蜚蠊变应原致敏均独立相关。结论：非裔美国人种族和低社会经济地位均是异应性哮喘儿童蟑螂过敏原致敏的独立、显著危险因素。蟑螂过敏原在整个房子里都可以检测到，包括关键的卧室环境。
Background: The domestic cockroach has been identified as an important source of indoor aeroallergens worldwide in both temperate and tropical climates. Because cockroach populations are highest in crowded urban areas, some have suggested that the increased asthma morbidity and mortality rates in inner cities could be related in part to cockroach allergen exposure. We have examined cockroach allergen exposure in the homes of children with asthma in both urban and suburban locations and have related the rates of exposure and sensitization to socioeconomic, racial, and demographic factors.Objective: The study was designed to determine the independent contribution of race, socioeconomic status, and place of residence to the risk of cockroach allergen exposure and sensitization in children with asthma.Methods: Eighty-seven children with moderate to severe allergic asthma, aged 5 to 17 years, participating in a prospective trial of immunotherapy, were evaluated. Extracted dust samples from three home locations were analyzed by using two-site monoclonal immunoassays for major cockroach allergens (Bla g 1 and Bla g 2). A puncture skin test with a mixed cockroach allergen extract was performed in 81 of the 87 subjects.Results: In the 87 homes evaluated 26% of the bedroom dust samples had detectable levels of cockroach allergen. In homes with detectable bedroom cockroach allergen levels, mean Bla g 1 and Bla g 2 concentrations in urban and suburban homes were similar. Over 80% of children with bedroom Bla g 1 or Bla g 2 of 1 U/gm or greater demonstrated skin sensitivity to cockroach allergen. The rate of cockroach sensitization was directly related to the level of bedroom exposure. African-American race was the only factor that was independently associated with cockroach allergen exposure (p = 0.05). Lower socioeconomic status, age greater than 11 years, cockroach exposure, and African-American race were all independently associated with cockroach allergen sensitization on the basis of stepwise multiple linear regression analysis.Conclusions: African-American race and low socioeconomic status were both independent, significant risk factors for cockroach allergen sensitization in children with atopic asthma. Cockroach allergen is detectable throughout the house, including the critical bedroom environment.