Results of a Home-Based Environmental Intervention among Urban Children with Asthma (original) (raw)
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Allergen avoidance does not alter airborne cat allergen levels in classrooms
Allergy, 2004
Background: Some schools in Sweden offer allergen avoidance classrooms for allergic children with severe asthma. However, the measures commonly used to achieve a reduction in allergen levels have not been properly evaluated. The aim of the present prospective study was to study whether the levels of airborne cat allergen are altered after introducing feasible intervention measures in classrooms, without interfering with peoples’ freedom of choice regarding pet ownership.Methods: Twenty‐five classes, including five established allergy prevention classrooms participated in the study during a school year. After one term, six classes underwent a number of intervention measures recommended by the Swedish National Institute of Public Health. Curtains, upholstery and plants were removed, bookshelves were replaced with cupboards and regular cleaning was increased. Airborne dust was collected weekly (32 weeks) using duplicate Petri dishes (n = 1574) and on six occasions using two personal ...
The effect of cat removal on allergen content in household-dust samples
Journal of Allergy and Clinical Immunology, 1989
To evaluate the effect of cat removal on cat-allergen content in the home, serial house dust samples were collected from 15 homes during a 9-to 43-week period after cat removal. Samples were obtained with a hand-held vacuum cleaner, and allergen content was quantitated by a radioimmunoassay speciJic for the major cat allergen, Fe1 d I. Baseline Fe1 d I content ranged from 7.8 Food and Drug Administration units per gram of dust to 436.7 Ulgm (median 61.2 Uigmj, consistent with levels found in homes with a pet cat. Fe1 d I levels declined gradually in most homes, and by 20 to 24 weeks after cat removal, eight of 15 reached levels consistent with levels found in control homes without cats. In two of those homes, allergen levels fell much more rapidly after aggressive environmental control measures were undertaken. In the other seven homes, however, the decline occurred at a much slower rate, with three homes demonstrating persistent elevations in Fe1 d I content for 20 or more weeks. These data demonstrate that the task of allergen elimination from an indoor environment is extremely dificult, even when the source of a speciJic allergen can be identified and removed. (J tiU.ERGY CLIN IMMUNOL 1989;83:730-4.) Domestic cats are a common cause of allergic reactions in individuals with allergic rhinitis and asthma.ld Since avoidance of cat allergen is the treatment of choice for such reactions, it is frequently recommended that cats be removed from the homes of cat-sensitive individuals. Trials of cat avoidance are also commonly recommended in which a cat may be temporarily removed from a home in an effort to determine its contribution to a patient's symptoms. These practices are based on the assumption that levels of cat allergen will decline after a cat is removed from From the
Domestic cat allergen and allergic sensitisation in young children
International Journal of Hygiene and Environmental Health, 2008
Studies have presented conflicting associations between cat allergen exposure and sensitisation and atopic disease. We therefore investigated the association between the observed domestic cat allergen level and cat sensitisation in young children in four study populations from three European countries. We recruited children from a nested case-control study, which is composed of four ongoing birth cohorts conducted in three European countries. Children at 2-4 years of age in the four cohorts who were sensitised to cat allergens (n ¼ 106) were compared with 554 nonsensitised children (controls). House dust samples were collected when the children were 5 to 7 years old, and cat allergen levels were measured in ng/g dust and ng/m 2 surface area. In the German study population we found a positive association between domestic cat allergen in house dust and cat sensitisation (OR (CI) ¼ 3.01 (1.16, 7.99)) while in the Swedish study population, we found a negative association (OR (CI) ¼ 0.41 (0.16, 0.98)). No association was found in the Dutch study population (OR (CI) ¼ 0.83 (0.22, 2.93)). Looking into the family history of cat keeping, we found the lowest prevalence of cat sensitisation in children who were cat owners at the age of blood sampling (11%) and the highest prevalence was found in those who have had a cat but not anymore, at the age of blood sampling (41%). The mixed results may be explained by differences in age and avoidance patterns.
Evaluation of Petri dish sampling for assessment of cat allergen in airborne dust
Allergy, 2002
Background: Dust reservoir sampling is the most commonly used method for assessment of indirect allergen exposure. Because assessment of personal exposure using person-carried pumps is time-consuming and expensive we evaluated the Petri dish sampling method for measurement of airborne cat allergen in classrooms. Methods: Petri dish sampling was evaluated in three study parts. Part I: by comparison between Petri dish sampling and personal air sampling in 44 classrooms with many (i20%) and few (j10%) cat owners and by additional Petri dish sampling in 40 pet-free homes. Part II: by sampling with duplicate Petri dishes in 28 classrooms. Part III: by sampling in three classrooms at four sampling heights during different sampling times. All samples were analyzed for cat allergen (Fel d 1) content with a monoclonal antibody two-site ELISA (enzyme linked immunosorbent assay), using signal amplification when necessary. Results: There was a significant correlation between Petri dish sampling and personal air sampling (r=0.66; P<0.0001). Levels were five-fold higher in classes with many cat owners than in classes with few cat owners, regardless of method. A corresponding difference was found in the homes. Duplicate sample values were in fair agreement (Bland-Altman test) and were correlated (r=0.77; P<0.0001). Cumulative levels collected weekly in one Petri dish were lower than using five daily Petri dishes, regardless of sampling height. Conclusions: Petri dish sampling can be useful as an alternative method to personal air sampling of airborne allergens.
Role of current and childhood exposure to cat and atopic sensitization☆☆☆★
Journal of Allergy and Clinical Immunology, 1999
Background: Clinical and population studies have shown that exposure and sensitization to allergens derived from furred pets, particularly cats, represent an important risk factor of allergic respiratory disease and also a significant risk factor for asthma. Objective: In the framework of the multicenter European Community Respiratory Health Survey an analysis of the association of current and childhood exposure to cat with atopic sensitization to cat was conducted. Methods: This study included cross-sectional data from 35 centers representing 16 countries. Altogether, 18,097 subjects were included, of whom 13,509 (75%) provided a blood sample for the measurement of specific IgE. Exposure data and data for potential confounders were extracted from an interviewerled questionnaire. Results: The prevalence of sensitization to cat (serum specific IgE >0.35 kU/L) was 9%. Among those who did not report allergic symptoms in the presence of pets or house dust, those who owned cats were significantly more likely to be sensitized to cats than were those who did not (odds ratio [95% confidence interval] 1.57 [1.20-2.06]. Childhood exposure to pets including cats was associated with lower sensitization to cats in adulthood, particularly among those with a positive family history of atopy (odds ratio [95% confidence interval] 0.68 [0.51-0.93]. Positive correlations were found between the community prevalence of cat and the prevalences of sensitization to cat, respiratory symptoms, physician-diagnosed asthma, and current asthma medication. Conclusions: Current cat ownership represents a significant risk for sensitization to cat if cats are allowed indoors. Our results support the hypothesis that childhood exposure to pets, including cats, might modulate immunologic mechanisms and reduce sensitization to cat in adulthood. The significant corre-lation found between the community prevalence of cat ownership and community prevalence of specific sensitization to cat represents the first documentation of such a relationship. (J Allergy Clin Immunol 1999;104:941-7.) 942 Roost et al J ALLERGY CLIN IM M UNOL NOVEM BER 1999
Clinical effects of air filters in homes of asthmatic adults sensitized and exposed to pet allergens
Clinical <html_ent glyph="@amp;" ascii="&"/> Experimental Allergy, 2003
Despite medical advice, many pet-allergic asthma sufferers refuse to remove the pet to which they are sensitized from their home. We aimed to assess the clinical effects of air cleaners in the homes of adult asthma patients sensitized and exposed to cats and/or dogs. We performed a randomized, parallel-group study of 30 asthmatic adults sensitized to and sharing a home with cats or dogs. The effects of placing air cleaners in the living room and bedroom for 12 months and using high efficiency particulate air filter vacuum cleaners (active group) were compared with using these vacuum cleaners alone (control group). Measures of airway responsiveness, treatment requirement, lung function, peak flow, reservoir and airborne allergen were recorded before, during and after the interventions. A beneficial clinical response was assessed in terms of a &amp;amp;amp;#39;combined asthma outcome&amp;amp;amp;#39;. This was defined as a two or more doubling dose improvement in bronchial hyper-reactivity to histamine and/or a reduction in treatment requirement of at least one step change on the British Thoracic Society guidelines for asthma treatment. A beneficial clinical response was observed in 10/15 subjects in the active group compared with 3/15 in the control group after 12 months intervention (P = 0.01). No significant differences between the active and control groups were detected for changes in measures of lung function, reservoir pet allergen and airborne pet allergen during the study. Whilst the study design has not allowed complete exclusion of a placebo effect, we believe that this pragmatic study of adult asthmatic patients sensitized and exposed to pets resulted in a small, but significant improvement in combined asthma outcome.
Parent report of pests and pets and indoor allergen levels in inner-city homes
Annals of Allergy, Asthma & Immunology, 2008
Background-Exposures to dog and cat allergens are believed to play important roles in the etiology of asthma; however, the levels of these allergens have never been assessed in a representative sample of US homes. Objective-The objective of this study was to estimate and characterize exposures to Can f 1 (dog allergen) and Fel d 1 (cat allergen) in US homes. Methods-Data were obtained from the National Survey of Lead and Allergens in Housing, a nationally representative survey of 831 US homes. Vacuumed-collected dust samples from the bed, bedroom floor, living room floor, and living room sofa were analyzed for concentrations of Can f 1 and Fel d 1 (micrograms of allergen per gram of dust). Results-Although a dog or cat had lived in only 49.1% of homes in the previous 6 months, Can f 1 and Fel d 1 were detected in 100% and 99.9% of homes, respectively. Averaged over the sampled sites, geometric mean concentrations (µg/g) were 4.69 for Can f 1 and 4.73 for Fel d 1. Among homes with an indoor dog and cat, respectively, geometric mean concentrations were 69 for Can f 1 and 200 for Fel d 1. Among homes without the indoor pet, geometric mean concentrations were above 1.0. The independent predictors of elevated concentrations in homes without pets were all demographic variables that were also linked to a higher prevalence of pet ownership. Conclusions-Can f 1 and Fel d 1 are universally present in US homes. Levels that have been associated with an increased risk of allergic sensitization were found even in homes without pets. Because of the transportability of these allergens on clothing, elevated levels in homes without
Allergens on desktop surfaces in preschools and elementary schools of urban children with asthma
Allergy, 2014
Desktop dust has been studied as a source of food allergen, but not as a source of potential aeroallergen exposure. Thirty-six wiped samples from desktop surfaces were collected from preschools and schools. Samples were analyzed for detectable levels of common aeroallergens including Alternaria, cockroach, dog, dust mite, cat, mouse, and rat allergens by immunoassay. Mouse allergen was the most prevalent, detectable in 97.2% of samples. Cat allergen was detectable in 80.6% of samples, and dog allergen was detectable in 77.8% of samples. Other allergens were not as prevalent. Mouse was the only allergen that was highly correlated with settled floor dust collected from the same rooms (r = 0.721, P < 0.001). This is the first study to detect aeroallergens on desktop surfaces by using moist wipes. Allergens for mouse, cat, and dog were highly detectable in wipes with mouse desktop surface levels correlating with levels in vacuumed floor dust.
The Journal of Allergy and Clinical Immunology: In Practice, 2018
Learning objectives: 1. To describe the evidence accumulated related to indoor environmental control interventions and asthma. 2. To describe findings from recent trials of home-based environmental interventions. 3. To describe the patient populations most likely to benefit from homebased environmental control interventions. Recognition of Commercial Support: This CME has not received external commercial support. Disclosure of Relevant Financial Relationships with Commercial Interests: E. C. Matsui has received research support from the National Institutes of Health; has received travel support from JAMA; and has received in kind donations of supplies for environmental intervention studies from CleanBrands, LLC and RabbitAir. S. K. Ahluwalia declares no relevant conflicts of interest. M. Schatz disclosed no relevant financial relationships.