Endotoxin in inner-city homes: Associations with wheeze and eczema in early childhood - 17/08/11
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New York, NY, and Iowa City, Iowa
Abstract |
Background |
An inverse association between domestic exposure to endotoxin and atopy in childhood has been observed. The relevance of this aspect of the hygiene hypothesis to US inner-city communities that have disproportionately high asthma prevalence has not been determined.
Objectives |
To measure endotoxin in the dust from inner-city homes, evaluate associations between endotoxin and housing/lifestyle characteristics, and determine whether endotoxin exposure predicted wheeze, allergic rhinitis, and eczema over the first 3 years of life.
Methods |
As part of an ongoing prospective birth cohort study, children of Dominican and African-American mothers living in New York City underwent repeated questionnaire measures. Dust samples collected from bedroom floors at age 12 or 36 months were assayed for endotoxin.
Results |
Among the samples collected from 301 participants’ homes, the geometric mean endotoxin concentration (95% CI) was 75.9 EU/mg (66-87), and load was 3892 EU/m2 (3351-4522). Lower endotoxin concentrations were associated with wet mop cleaning and certain neighborhoods. Endotoxin concentration correlated weakly with cockroach (Bla g 2: r = 0.22, P < .001) and mouse (mouse urinary protein: r = 0.28; P < .001) allergens in the dust. Children in homes with higher endotoxin concentration were less likely to have eczema at age 1 year (odds ratio, 0.70 [0.53-0.93]) and more likely to wheeze at age 2 years (odds ratio, 1.34 [1.01-1.78]). These associations were stronger among children with a maternal history of asthma.
Conclusion |
Endotoxin levels in this inner-city community are similar to those in nonfarm homes elsewhere. In this community, domestic endotoxin exposure was inversely associated with eczema at age 1 year, but positively associated with wheeze at age 2 years.
Clinical implications |
Endotoxin exposure in the inner-city community may be related to wheeze in the early life; however, given the inverse association seen with eczema, the long-term development of allergic disease is still in question.
Le texte complet de cet article est disponible en PDF.Key words : Endotoxin, asthma, allergy, hygiene hypothesis, wheeze, inner-city, eczema
Abbreviations used : EU, GEE, GM, MUP, NYC, OR
Plan
Supported by the National Institute of Environmental Health Sciences (grants P50 ES09600, 5 RO1 ES08977, RO1ES111158, RO1 ES012468, P30 ES05605, 5 P30 ES009089), the US Environmental Protection Agency (grants R827027, 8260901), Irving General Clinical Research Center (grant RR00645), the Bauman Family Foundation, the Gladys and Roland Harriman Foundation, the Irving A. Hansen Memorial Foundation, the W. Alton Jones Foundation, the New York Community Trust, the Educational Foundation of America, the New York Times Company Foundation, Rockefeller Financial Services, the Horace W. Goldsmith Foundation, the Beldon Fund, the John Merck Fund, the September 11th Fund of the United Way and New York Community Trust, the New York Times 9/11 Neediest Fund, and the V. Kann Rasmussen Foundation. Dr Chew is a National Center on Minority Health and Health Disparities fellow. Disclosure of potential conflict of interest: The authors have declared that they have no conflict of interest. |
Vol 117 - N° 5
P. 1082-1089 - mai 2006 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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