Home Indoor Pollutant Exposures among Inner-City Children With and Without Asthma (original) (raw)

Abstract

Asthma is common among children in the United States, especially those who are racial/ethnic minorities living in inner cities (Centers for Disease Control and Prevention 2004). Although definitive causes of asthma remain to be discovered, substantial evidence points to environmental exposures, which may in turn interact with individual genetic susceptibility-a phenomenon often called gene-environment interaction. Some evidence points to the heritability of asthma, because it occurs more commonly in children whose parents have asthma and in affected twins (Laitinen et al. 1998). Because not all cases of asthma arise in people with affected first-degree relatives, however, it leaves open the possibility that asthma results from high exposure to environmental factors. Evidence to support asthma causation through high exposure alone can come from studies that compare the environment of people with and without asthma. Environmental studies of inner-city children are especially important for understanding asthma disparities among African Americans. Asthma prevalence is 39% higher among African Americans than whites, and African Americans are more likely than whites to live in urban areas (86% vs. 70% of the respective populations), areas which are at high risk for air pollution (American Lung Association 2005). Indeed, 65% of African Americans live in counties that failed to meet at least one of the U.S. Environmental Protection Agency's (EPA) outdoor air quality standards (American Lung Association 2005). The home indoor environment is especially relevant for studying inner-city childhood asthma, because some pollutants, such as ambient particulate matter (PM), penetrate from the outside, and some are generated and remain indoors, such as particles and gases from smoking, heating, cooking, and cleaning (Abt et al. 2000; Howard-Reed et al. 2000; Long et al. 2000; National Research Council and Committee on Research Priorities for Airborne Particulate Matter 2004; Rea et al. 2001; Vette et al. 2001). Remarkably, a previously published study from the Center for Childhood Asthma in the Urban Environment, conducted in older children from inner-city Baltimore (90% African American), has already shown that children are exposed to concentrations of indoor PM that are three times the concentrations found in outdoor air (Breysse et al. 2005). Such concentrations would frequently exceed the outdoor limits set by the U.S. EPA (Breysse et al. 2005). Furthermore, the indoor environment may be especially critical to study because Americans, including preschool children, spend the vast majority of time indoors. Studies are urgently needed to determine the causes of the asthma epidemic, and in response to this need, there has been support for research from the U.S. federal government to uncover the role of environmental exposures in the etiology and prevention of prevalent disorders, such as asthma, in children (National Institute of Environmental Health Sciences 2003). To address this issue, the Johns Hopkins Center for Childhood Asthma in the Urban Environment conducted a study to determine whether indoor home environmental pollutants are greater in homes of preschool children with asthma compared with homes of children without asthma. Methods Study population. We recruited children 2-6 years of age who resided in urban area of Baltimore, Maryland, defined by 9 contiguous zip codes. Children with and without asthma were identified using a two-stage screening method. All children who were patients of health systems that provide care to most East Baltimore residents were identified from billing records. If the child had had a health care encounter for asthma [International Classification of Diseases, 9th Revision (ICD-9) code 493.x (World Health Organization 1975)] in the previous 12 months, he or she was considered a potential asthma subject. Asthma status was confirmed, for the purposes of this study, if the primary caregiver also reported that the child met both of the following criteria: a) doctor-diagnosed asthma

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References (47)

  1. Abt E, Suh HH, Allen G, Koutrakis P. 2000. Characterization of indoor particle sources: a study conducted in the metro- politan Boston area. Environ Health Perspect 108:35-44.
  2. American Lung Association. 2005. Lung Disease Data in Culturally Diverse Communities: 2005. New York:American Lung Association.
  3. Baker D, Henderson J. 1999. Differences between infants and adults in the social aetiology of wheeze. The ALSPAC Study Team. Avon Longitudinal Study of Pregnancy and Childhood. J Epidemiol Community Health 53:636-642.
  4. Breysse PN, Buckley TJ, Williams D, Beck CM, Jo SJ, Merriman B, et al. 2005. Indoor exposures to air pollutants and allergens in the homes of asthmatic children in inner- city Baltimore. Environ Res 98:167-176.
  5. Bruce N, Perez-Padilla R, Albalak R. 2000. Indoor air pollution in developing countries: a major environmental and public health challenge. Bull WHO 78:1078-1092.
  6. Butland BK, Strachan DP, Anderson HR. 1997. The home envi- ronment and asthma symptoms in childhood: two popula- tion based case-control studies 13 years apart. Thorax 52:618-624.
  7. Centers for Disease Control and Prevention. 2004. FASTATS: Asthma. Atlanta, GA:Centers for Disease Control and Prevention. Available: http://www.cdc.gov/nchs/fastats/ asthma.htm [accessed 21 January 2005].
  8. Chapman MD, Aalberse RC, Brown MJ, Platts-Mills TA. 1988. Monoclonal antibodies to the major feline allergen Fel d I. II. Single step affinity purification of Fel d I, N-terminal sequence analysis, and development of a sensitive two- site immunoassay to assess Fel d I exposure. J Immunol 140:812-818.
  9. Dennekamp M, Howarth S, Dick CA, Cherrie JW, Donaldson K, Seaton A. 2001. Ultrafine particles and nitrogen oxides generated by gas and electric cooking. Occup Environ Med 58:511-516.
  10. Eggleston PA, Butz AM, Rand C, Curtin-Brosnan J, Kanchanaraksa S, Breysse P, et al. 2005. Home environ- mental interventions in inner-city asthma: a randomized controlled clinical trial. Ann Allergy Asthma Immunol 95:518-524.
  11. Eggleston PA, Rosenstreich D, Lynn H, Gergen P, Baker D, Kattan M, et al. 1998. Relationship of indoor allergen expo- sure to skin test sensitivity in inner-city children with asthma. J Allergy Clin Immunol 102:563-570.
  12. Ehrlich RI, Du TD, Jordaan E, Volmink JA, Weinberg EG, Zwarenstein M. 1995. Prevalence and reliability of asthma symptoms in primary school children in Cape Town. Int J Epidemiol 24:1138-1145.
  13. Gold DR. 2000. Environmental tobacco smoke, indoor allergens, and childhood asthma. Environ Health Perspect 108(suppl 4):643-651.
  14. Howard-Reed C, Rea AW, Zufall MJ, Burke JM, Williams RW, Suggs JC, et al. 2000. Use of a continuous nephelometer to measure personal exposure to particles during the U.S. Environmental Protection Agency Baltimore and Fresno Panel studies. J Air Waste Manag Assoc 50:1125-1132.
  15. Janssen NA, Hoek G, Harssema H, Brunekreef B. 1997. Childhood exposure to PM 10 : relation between personal, classroom, and outdoor concentrations. Occup Environ Med 54:888-894.
  16. Koppelman GH. 2006. Gene by environment interaction in asthma. Curr Allergy Asthma Rep 6:103-111.
  17. Koutrakis P, Wolfson JM, Bunyaviroch A, Froehlich SE, Kirano K, Mulik JD. 1993. Measurement of ambient ozone using a nitrite-coated filter. Anal Chem 65[3], 209-214.
  18. Laitinen T, Rasanen M, Kaprio J, Koskenvuo M, Laitinen LA. 1998. Importance of genetic factors in adolescent asthma: a population-based twin-family study. Am J Respir Crit Care Med 157:1073-1078.
  19. Lioy PJ, Waldman JM, Buckley TJ, Butler J, Pietarinen C. 1990. The personal, indoor and outdoor concentrations of PM-10 measured in an industrial community during the winter. Atmos Environ 24B:57-66.
  20. Liu LJ, Slaughter JC, Larson TV. 2002. Comparison of light scat- tering devices and impactors for particulate measure- ments in indoor, outdoor, and personal environments. Environ Sci Technol 36:2977-2986.
  21. Long CM, Suh HH, Kobzik L, Catalano PJ, Ning YY, Koutrakis P. 2001. A pilot investigation of the relative toxicity of indoor and outdoor fine particles: in vitro effects of endotoxin and other particulate properties. Environ Health Perspect 109:1019-1026.
  22. Long CM, Suh HH, Koutrakis P. 2000. Characterization of indoor particle sources using continuous mass and size monitors. J Air Waste Manag Assoc 50:1236-1250.
  23. McConnell R, Berhane K, Yao L, Jerrett M, Lurmann F, Gilliland F, et al. 2006. Traffic, susceptibility, and childhood asthma. Environ Health Perspect 114:766-772.
  24. Merchant JA, Naleway AL, Svendsen ER, Kelly KM, Burmeister LF, Stromquist AM, et al. 2005. Asthma and farm exposures in a cohort of rural Iowa children. Environ Health Perspect 113:350-356.
  25. Mitchell H, Senturia Y, Gergen P, Baker D, Joseph C, Niff- Mortimer K, et al. 1997. Design and methods of the National Cooperative Inner-City Asthma Study. Pediatr Pulmonol 24:237-252.
  26. Morgan WJ, Crain EF, Gruchalla RS, O'Connor GT, Kattan M, Evans R III, et al. 2004. Results of a home-based environmental intervention among urban children with asthma. N Engl J Med 351:1068-1080.
  27. National Institute of Environmental Health Sciences. 2003. Centers for Children's Environmental Health and Disease Prevention Research. Available: www.niehs.nih.gov/ translat/children/children.htm [accessed 28 January 2003].
  28. National Research Council and Committee on Research Priorities for Airborne Particulate Matter. 2004. Research Priorities for Airborne Particulate Matter: IV. Continuing Research Progress. Washington DC:National Academies Press.
  29. Ohman JL, Jr., Hagberg K, MacDonald MR, Jones RR Jr., Paigen BJ, Kacergis JB. 1994. Distribution of airborne mouse allergen in a major mouse breeding facility. J Allergy Clin Immunol 94:810-817.
  30. Ott W, Wallace L, Mage D. 2000. Predicting particulate (PM 10 ) personal exposure distributions using a random compo- nent superposition statistical model. J Air Waste Manag Assoc 50:1390-1406.
  31. Palmes ED, Gunnison AF, DiMattio J, Tomczyk C. 1976. Personal sampler for nitrogen dioxide. Am Ind Hyg Assoc J 37:570-577.
  32. Perry T, Matsui E, Merriman B, Duong T, Eggleston P. 2003. The prevalence of rat allergen in inner-city homes and its rela- tionship to sensitization and asthma morbidity. J Allergy Clin Immunol 112:346-352.
  33. Pilotto LS, Douglas RM, Attewell RG, Wilson SR. 1997. Respiratory effects associated with indoor nitrogen diox- ide exposure in children. Int J Epidemiol 26:788-796.
  34. Pollart SM, Smith TF, Morris EC, Gelber LE, Platts-Mills TA, Chapman MD. 1991. Environmental exposure to cockroach allergens: analysis with monoclonal antibody-based enzyme immunoassays. J Allergy Clin Immunol 87:505-510.
  35. Quintana PJ, Samimi BS, Kleinman MT, Liu LJ, Soto K, Warner GY, et al. 2000. Evaluation of a real-time passive personal particle monitor in fixed site residential indoor and ambi- ent measurements. J Expo Anal Environ Epidemiol 10:437-445.
  36. Rea AW, Zufall MJ, Williams RW, Sheldon L, Howard-Reed C. 2001. The influence of human activity patterns on personal PM exposure: a comparative analysis of filter-based and continuous particle measurements. J Air Waste Manag Assoc 51:1271-1279.
  37. Rios JL, Boechat JL, Sant'Anna CC, Franca AT. 2004. Atmospheric pollution and the prevalence of asthma: study among schoolchildren of 2 areas in Rio de Janeiro, Brazil. Ann Allergy Asthma Immunol 92:629-634.
  38. Tavernier G, Fletcher G, Gee I, Watson A, Blacklock G, Francis H, et al. 2006. IPEADAM study: indoor endotoxin exposure, family status, and some housing characteristics in English children. J Allergy Clin Immunol 117:656-662.
  39. U.S. EPA (U.S. Environmental Protection Agency). 1997. EPA's Revised Particulate Matter Standard. Available: http://www.epa.gov/ttn/oarpg/naaqsfin/pmfact.html [accessed 11 October 2007].
  40. Vette AF, Rea AW, Lawless PA, Rodes CE, Evans G, Highsmith VR, et al. 2001. Characterization of indoor-outdoor aerosol concentration relationships during the Fresno PM expo- sure studies. Aerosol Sci Technol 34:118-126.
  41. Wallace LA, Duan N, Ziegenfus R. 1994. Can long-term expo- sure distributions be predicted from short-term measure- ments? Risk Anal 14:75-85.
  42. Wood RA, Eggleston PA, Lind P, Ingemann L, Schwartz B, Graveson S, et al. 1988. Antigenic analysis of household dust samples. Am Rev Respir Dis 137:358-363.
  43. Wood RA, Eggleston PA, Rand C, Nixon WJ, Kanchanaraksa S. 2001. Cockroach allergen abatement with extermination and sodium hypochlorite cleaning in inner-city homes. Ann Allergy Asthma Immunol 87:60-64.
  44. World Health Organization. 1975. International Classification of Diseases, 9th Revision. Geneva:World Health Organization.
  45. Yang IA, Savarimuthu S, Kim ST, Holloway JW, Bell SC, Fong KM. 2007. Gene-environmental interaction in asthma. Curr Opin Allergy Clin Immunol 7:75-82.
  46. Zanobetti A, Schwartz J, Gold D. 2000. Are there sensitive sub- groups for the effects of airborne particles? Environ Health Perspect 108:841-845.
  47. Zejda JE, Kowalska M. 2003. Risk factors for asthma in school children-results of a seven-year follow-up. Cent Eur J Public Health 11:149-154.