Indoor Allergens And Asthma

我们的哮喘研究项目包括暴露评估和预防两部分，重点关注暴露于常见室内过敏原与哮喘患病率/发病率之间的关系。国家过敏原调查是一项描述性研究，对美国住房中地板和床单灰尘中的过敏原类型和水平进行了研究，这是第一项提供美国人口过敏原暴露估计的研究。它涵盖了全国75个初级抽样单位的831个家庭。主要终点是测量尘螨、蟑螂、猫、狗、鼠、鼠和真菌过敏原水平，以及从调查家庭的一系列地点收集的灰尘样本中的内毒素。对尘螨过敏原的分析结果表明，大约24%的美国家庭的床上含有10微克尘螨过敏原/克粉尘(这一水平以前与症状性哮喘有关)，大约46%的美国家庭的床上含有&gt；2微克尘螨过敏原/克灰尘(这一水平以前与尘螨过敏原过敏有关)。对于较老的房屋、非西部地区的房屋、低收入家庭和湿度较高的卧室，床上尘螨过敏原水平较高的可能性更大。大约6%的美国家庭中存在可检测到的蟑螂过敏原。对于低收入家庭、有潮湿证据的家庭和有食物残渣证据的家庭来说，床上蟑螂过敏原水平高的可能性更大。这项具有全国代表性的调查将(A)提供美国人口室内过敏原暴露的当前估计，(B)建立一个数据库，可用于刺激未来试图将过敏原暴露与疾病结果相关联的研究，(C)提供可用作未来过敏原调查参考点的基线，以及(D)促进对过敏原负担的地区、种族、社会经济和住房特征差异的评估。我们还进行了一项随机临床试验，以测试环境干预在降低北卡罗来纳州和波士顿市中心家庭的尘螨和蟑螂过敏原水平方面的可行性/有效性。我们的研究表明，灭蟑螂和加强清洁相结合，可以显著降低高度出没家庭中的蟑螂过敏原水平。此外，如果继续根除，这种效果可以维持长达12个月。我们还证明，蒸汽清洗和化学处理相结合可以显著降低地毯中的尘螨过敏原水平。这些研究的结果将被用来设计一项预防试验，以确定旨在降低家庭室内过敏原水平的环境干预措施是否可以防止致敏，并降低高危儿童哮喘的患病率和发病率。

Our asthma research program involves both exposure assessment and prevention components, and focuses on the relationship between exposure to common indoor allergens and asthma prevalence/morbidity. The National Allergen Survey, a descriptive study of allergen types and levels in floor and bedding dust in the nation's housing, is the first study to provide estimates of allergen exposure in the U.S. population. It encompasses 831 homes in 75 primary sampling units located throughout the country. The major endpoints are measurements of dust mite, cockroach, cat, dog, mouse, rat and fungal allergen levels, and endotoxin in dust samples collected from an array of sites in the surveyed homes. Results from analysis of dust mite allergens suggest that approximately 24% of U.S. homes have beds that contain >10 microgram dust mite allergen/gram dust (a level previously associated with symptomatic asthma) and approximately 46% of U.S. homes have beds that contain >2 microgram dust mite allergen/gram dust (a level previously associated with mite allergen sensitization). The likelihood of having a high dust mite allergen level in the bed was greater for older homes, non-western region homes, lower income households and bedrooms with higher humidity. Detectable cockroach allergen is present in approximately 6% of U.S. homes. The likelihood of having a high bed cockroach allergen levels was greater for lower income households, homes with evidence of moisture, and homes with evidence of food debris. This nationally representative survey will (a) provide current estimates of indoor allergen exposure in the U.S. population, (b) establish a database that can be used to stimulate future studies which attempt to correlate allergen exposure to disease outcome, (c) provide a baseline that can be used as a reference point for future allergen surveys, and (d) facilitate evaluation of regional, ethnic, socioeconomic, and housing characteristic differences in the allergen burden. We have also conducted a randomized clinical trial to test the feasibility/effectiveness of environmental interventions in reducing dust mite and cockroach allergen levels in inner-city North Carolina and Boston homes. Our study demonstrates that the combination of cockroach extermination and intensive cleaning can significantly reduce cockroach allergen levels in highly infested homes. Moreover, the effect can be maintained for up to 12 months with continued extermination. We have also demonstrated that steam cleaning combined with chemical treatments can significantly reduce dust mite allergen levels in carpeting. The results of these studies will be used to design a prevention trial to determine if environmental intervention aimed at reducing indoor allergen levels in homes can prevent sensitization and decrease the prevalence and morbidity of asthma in high risk children.