Indoor environmental exposures and obstructive lung disease phenotypes among children with asthma living in poor urban neighborhoods - 03/03/23
Graphical abstract |
Abstract |
Background |
Air trapping is an obstructive phenotype that has been associated with more severe and unstable asthma in children. Air trapping has been defined using pre- and postbronchodilator spirometry. The causes of air trapping are not completely understood. It is possible that environmental exposures could be implicated in air trapping in children with asthma.
Objective |
We investigated the association between indoor exposures and air trapping in urban children with asthma.
Methods |
Children with asthma aged 5 to 17 years living in Baltimore and enrolled onto the Environmental Control as Add-on Therapy for Childhood Asthma study were evaluated for air trapping using spirometry. Aeroallergen sensitization was assessed at baseline, and spirometry was performed at 0, 3, and 6 months. Air trapping was defined as an FVC z score of less than −1.64 or a change in FVC with bronchodilation of ≥10% predicted. Logistic normal random effects models were used to evaluate associations of air trapping and indoor exposures.
Results |
Airborne and bedroom floor mouse allergen concentrations were associated with air trapping but not airflow limitation (odds ratio 1.19, 95% confidence interval 1.02-1.37, P = .02 per 2-fold increase in airborne mouse allergen; odds ratio 1.23, 95% confidence interval 1.07-1.41, P = .003 per 2-fold increase in bedroom floor mouse allergen). Other indoor exposures (cockroach, cat, dog, dust mite, particulate matter, and nicotine) were not associated with air trapping or airflow limitation.
Conclusion |
Mouse allergen exposure, but not other indoor exposure, was associated with air trapping in urban children with asthma.
Le texte complet de cet article est disponible en PDF.Key words : Pediatric asthma, urban asthma, mouse allergen exposure, air trapping, indoor environmental exposures
Abbreviations used : BD, ECATCh, GLI, LLD, OR, PM, PM2.5/10
Plan
Supported by the following sources: to T.G., National Institutes of Health (NIH) grant K23AI159144 and the American Academy of Allergy, Asthma & Immunology (AAAAI) Foundation Faculty Development Award; to M.M., NIH grant P50ES018176 and US Environmental Protection Agency (EPA) assistance agreement 83615201; to C.K., NIH grant U01AI125290; to M.D., NIH grant K01OD019918; and to E.M., NIH grants K24AI114769, R01ES023447, and R01ES026170. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH, AAAAI, or EPA. |
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Disclosure of potential conflict of interest: The authors declare that they have no relevant conflicts of interest. |
Vol 151 - N° 3
P. 716 - mars 2023 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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