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Environ Health Perspect. Sep 2002; 110(9): 939–945.
PMCID: PMC1240995
Research Article

Home and allergic characteristics of children with asthma in seven U.S. urban communities and design of an environmental intervention: the Inner-City Asthma Study.

Abstract

Most published environmental remediation interventions have been directed at single allergens and have employed demanding strategies; few have been performed in the homes of inner-city children disproportionately burdened by asthma. Our objective was a) to describe the allergen sensitivities, environmental tobacco smoke (ETS) exposure, and home environmental characteristics of a national sample of inner-city children with moderate to severe asthma and b) to develop and implement a multifaceted, home-based comprehensive intervention to reduce home allergens and ETS, tailored to the specific sensitization and exposure profiles of those children. Allergen skin testing and a home evaluation were performed to determine the presence of ETS and factors known to be associated with increased indoor allergen levels. Based on published remediation techniques, a home environmental intervention, organized into modules, each addressing one of five specific allergen groups or ETS, was designed. Of 994 allergic children from seven U.S. urban communities, 937 successfully completed baseline interviews and home allergen surveys and were enrolled. More than 50% of children had positive skin tests to three or more allergen groups. Cockroaches were reported in 58% of homes, wall-to-wall carpeting in the child's bedroom in 55%, a smoker in 48%, mice or rats in 40%, and furry pets in 28%. More than 60% of enrolled families received four or more modules, and between 94% and 98% of all modules were completed. We conclude that most inner-city children with moderate to severe asthma are sensitized to multiple indoor allergens and that environmental factors known to be associated with asthma severity are commonly present in their homes. The intervention developed for the Inner-City Asthma Study employs accepted methods to address an array of allergens and ETS exposure while ensuring that the intervention is tailored to the specific sensitization profiles and home characteristics of these children.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Mannino DM, Homa DM, Pertowski CA, Ashizawa A, Nixon LL, Johnson CA, Ball LB, Jack E, Kang DS. Surveillance for asthma--United States, 1960-1995. MMWR CDC Surveill Summ. 1998 Apr 24;47(1):1–27. [PubMed]
  • Gelber LE, Seltzer LH, Bouzoukis JK, Pollart SM, Chapman MD, Platts-Mills TA. Sensitization and exposure to indoor allergens as risk factors for asthma among patients presenting to hospital. Am Rev Respir Dis. 1993 Mar;147(3):573–578. [PubMed]
  • Kang BC, Johnson J, Veres-Thorner C. Atopic profile of inner-city asthma with a comparative analysis on the cockroach-sensitive and ragweed-sensitive subgroups. J Allergy Clin Immunol. 1993 Dec;92(6):802–811. [PubMed]
  • Sporik R, Holgate ST, Platts-Mills TA, Cogswell JJ. Exposure to house-dust mite allergen (Der p I) and the development of asthma in childhood. A prospective study. N Engl J Med. 1990 Aug 23;323(8):502–507. [PubMed]
  • Rosenstreich DL, Eggleston P, Kattan M, Baker D, Slavin RG, Gergen P, Mitchell H, McNiff-Mortimer K, Lynn H, Ownby D, et al. The role of cockroach allergy and exposure to cockroach allergen in causing morbidity among inner-city children with asthma. N Engl J Med. 1997 May 8;336(19):1356–1363. [PubMed]
  • Strachan DP, Cook DG. Health effects of passive smoking. 6. Parental smoking and childhood asthma: longitudinal and case-control studies. Thorax. 1998 Mar;53(3):204–212. [PMC free article] [PubMed]
  • Ehrlich RI, Du Toit D, Jordaan E, Zwarenstein M, Potter P, Volmink JA, Weinberg E. Risk factors for childhood asthma and wheezing. Importance of maternal and household smoking. Am J Respir Crit Care Med. 1996 Sep;154(3 Pt 1):681–688. [PubMed]
  • Chilmonczyk BA, Salmun LM, Megathlin KN, Neveux LM, Palomaki GE, Knight GJ, Pulkkinen AJ, Haddow JE. Association between exposure to environmental tobacco smoke and exacerbations of asthma in children. N Engl J Med. 1993 Jun 10;328(23):1665–1669. [PubMed]
  • Phipatanakul W, Eggleston PA, Wright EC, Wood RA. Mouse allergen. II. The relationship of mouse allergen exposure to mouse sensitization and asthma morbidity in inner-city children with asthma. J Allergy Clin Immunol. 2000 Dec;106(6):1075–1080. [PubMed]
  • Kattan M, Mitchell H, Eggleston P, Gergen P, Crain E, Redline S, Weiss K, Evans R, 3rd, Kaslow R, Kercsmar C, et al. Characteristics of inner-city children with asthma: the National Cooperative Inner-City Asthma Study. Pediatr Pulmonol. 1997 Oct;24(4):253–262. [PubMed]
  • Call RS, Smith TF, Morris E, Chapman MD, Platts-Mills TA. Risk factors for asthma in inner city children. J Pediatr. 1992 Dec;121(6):862–866. [PubMed]
  • Ehrlich R, Kattan M, Godbold J, Saltzberg DS, Grimm KT, Landrigan PJ, Lilienfeld DE. Childhood asthma and passive smoking. Urinary cotinine as a biomarker of exposure. Am Rev Respir Dis. 1992 Mar;145(3):594–599. [PubMed]
  • Eggleston PA, Rosenstreich D, Lynn H, Gergen P, Baker D, Kattan M, Mortimer KM, Mitchell H, Ownby D, Slavin R, et al. Relationship of indoor allergen exposure to skin test sensitivity in inner-city children with asthma. J Allergy Clin Immunol. 1998 Oct;102(4 Pt 1):563–570. [PubMed]
  • Jones JA, Wahlgren DR, Meltzer SB, Meltzer EO, Clark NM, Hovell MF. Increasing asthma knowledge and changing home environments for Latino families with asthmatic children. Patient Educ Couns. 2001 Jan;42(1):67–79. [PubMed]
  • Halonen M, Stern DA, Wright AL, Taussig LM, Martinez FD. Alternaria as a major allergen for asthma in children raised in a desert environment. Am J Respir Crit Care Med. 1997 Apr;155(4):1356–1361. [PubMed]
  • Nelson HS, Lahr J, Buchmeier A, McCormick D. Evaluation of devices for skin prick testing. J Allergy Clin Immunol. 1998 Feb;101(2 Pt 1):153–156. [PubMed]
  • Bandura A. Self-efficacy: toward a unifying theory of behavioral change. Psychol Rev. 1977 Mar;84(2):191–215. [PubMed]
  • Elder JP, Ayala GX, Harris S. Theories and intervention approaches to health-behavior change in primary care. Am J Prev Med. 1999 Nov;17(4):275–284. [PubMed]
  • Platts-Mills TA, Vaughan JW, Carter MC, Woodfolk JA. The role of intervention in established allergy: avoidance of indoor allergens in the treatment of chronic allergic disease. J Allergy Clin Immunol. 2000 Nov;106(5):787–804. [PubMed]
  • Lioy PJ, Wainman T, Zhang J, Goldsmith S. Typical household vacuum cleaners: the collection efficiency and emissions characteristics for fine particles. J Air Waste Manag Assoc. 1999 Feb;49(2):200–206. [PubMed]
  • Popplewell EJ, Innes VA, Lloyd-Hughes S, Jenkins EL, Khdir K, Bryant TN, Warner JO, Warner JA. The effect of high-efficiency and standard vacuum-cleaners on mite, cat and dog allergen levels and clinical progress. Pediatr Allergy Immunol. 2000 Aug;11(3):142–148. [PubMed]
  • Horak F. Klinische Studie über die Wirksamkeit von Filtern im Staubsauger zur Reduktion der Belastung mit Hausstaubmilben im Haushalt. Wien Med Wochenschr. 1995;145(1):1–3. [PubMed]
  • van der Heide S, van Aalderen WM, Kauffman HF, Dubois AE, de Monchy JG. Clinical effects of air cleaners in homes of asthmatic children sensitized to pet allergens. J Allergy Clin Immunol. 1999 Aug;104(2 Pt 1):447–451. [PubMed]
  • Green R, Simpson A, Custovic A, Faragher B, Chapman M, Woodcock A. The effect of air filtration on airborne dog allergen. Allergy. 1999 May;54(5):484–488. [PubMed]
  • Forastiere F, Agabiti N, Corbo GM, Pistelli R, Dell'Orco V, Ciappi G, Perucci CA. Passive smoking as a determinant of bronchial responsiveness in children. Am J Respir Crit Care Med. 1994 Feb;149(2 Pt 1):365–370. [PubMed]
  • Martinez FD, Cline M, Burrows B. Increased incidence of asthma in children of smoking mothers. Pediatrics. 1992 Jan;89(1):21–26. [PubMed]
  • Maier WC, Arrighi HM, Morray B, Llewellyn C, Redding GJ. Indoor risk factors for asthma and wheezing among Seattle school children. Environ Health Perspect. 1997 Feb;105(2):208–214. [PMC free article] [PubMed]
  • Slezak JA, Persky VW, Kviz FJ, Ramakrishnan V, Byers C. Asthma prevalence and risk factors in selected Head Start sites in Chicago. J Asthma. 1998;35(2):203–212. [PubMed]
  • Strachan DP. Damp housing and childhood asthma: validation of reporting of symptoms. BMJ. 1988 Nov 12;297(6658):1223–1226. [PMC free article] [PubMed]
  • Dales RE, Miller D, McMullen E. Indoor air quality and health: validity and determinants of reported home dampness and moulds. Int J Epidemiol. 1997 Feb;26(1):120–125. [PubMed]
  • Platts-Mills T, Vaughan J, Squillace S, Woodfolk J, Sporik R. Sensitisation, asthma, and a modified Th2 response in children exposed to cat allergen: a population-based cross-sectional study. Lancet. 2001 Mar 10;357(9258):752–756. [PubMed]

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