Mite, cat, and cockroach exposure, allergen sensitisation, and asthma in children: a case-control study of three schools
- Richard Sporikc,
- Susan P Squillacea,
- Jim Mark Ingrama,
- Gary Rakesa,
- Richard W Honsingerb,
- Thomas A E Platts-Millsa
- aAsthma and Allergic Disease Center, University of Virginia, Charlottesville, Virginia 22908, USA, bLos Alamos Medical Center, Los Alamos, New Mexico 87544, USA, cInstitute of Respiratory Medicine, Sydney, Australia
- Dr T A E Platts-Mills.
- Received 16 October 1998
- Revision requested 1 December 1998
- Revised 20 April 1999
- Accepted 26 April 1999
BACKGROUND The amount of allergen necessary to sensitise genetically “at risk” children is unclear. The relation between allergen exposure and asthma is also uncertain.
METHODS To ensure a wide range of allergen exposures the data from case-control studies of asthma in children aged 12–14 years attending three schools in Los Alamos, New Mexico and Central Virginia were combined. Skin prick tests to indoor and outdoor allergens and bronchial hyperreactivity to histamine were assessed in children with and without symptoms of asthma. The concentration of mite, cat, and cockroach allergens in dust from the children’s homes was used as a marker of exposure.
RESULTS Three hundred and thirty two children (157 with asthmatic symptoms and 175 controls) were investigated. One hundred and eighty three were classified as atopic on the basis of allergen skin prick tests and 68 as asthmatic (symptoms plus bronchial responsiveness). The prevalence and degree of sensitisation to mite and cockroach, but not cat, was strongly associated in atopic children with increasing domestic concentrations of these allergens. Asthma was strongly associated with sensitisation to indoor allergens (p<10-6) and weakly to outdoor allergens (p = 0.026). There was an association between current asthma and the concentration of mite allergen amongst atopic children (p = 0.008) but not amongst those who were specifically mite sensitised (p = 0.16).
CONCLUSIONS The domestic reservoir concentration of mite and cockroach, but not cat, allergen was closely related to the prevalence of sensitisation in atopic children. However, the prevalence of current asthma had a limited relationship to these allergen measurements, suggesting that other factors play a major part in determining which allergic individuals develop asthma.