Dataset Information

Sensitization and Exposure to Pets: The Effect on Asthma Morbidity in the US Population.

ABSTRACT: BACKGROUND:Although pets are found in more than 50% of US homes, the effect of pet allergen exposure on asthma morbidity in the US population is not well documented. OBJECTIVE:To determine the effect of dog and cat allergen exposures on asthma morbidity in the US population. METHODS:The National Health and Nutrition Examination Survey is a representative sample of civilian US population. Data on asthma, dog and cat allergen levels in bedroom dust, as well as specific IgE to dog and cat were analyzed for all participants 6 years or older. RESULTS:Pets are common in the United States, with more that 50% of households having a dog or a cat or both. The prevalence of allergic sensitization in the National Health and Nutrition Examination Survey population was similar for dog and cat, with both being approximately 12%. Among those who were sensitized, exposure to elevated levels of pet allergens was associated with an increased prevalence of asthma and asthma attacks. Indeed, 44.2% of the asthma attacks were attributable to exposure to high levels of dog allergen in the bedroom among patients with asthma sensitive to dog and 30.3% were attributable to cat allergen exposure among the comparable cat-sensitive and exposed group. Projecting these results to the US population indicates more than 1 million increased asthma attacks each year for the dog-sensitive and exposed group and more than 500,000 increased asthma attacks for the cat-sensitive and exposed population of patients with asthma. CONCLUSIONS:Exposure to elevated levels of dog and cat allergens among those sensitized individuals with asthma is associated with excess asthma attacks. Reducing pet allergen exposures has the potential for a significant decrease in asthma morbidity.

SUBMITTER: Gergen PJ

PROVIDER: S-EPMC5756688 | biostudies-literature | 2018 Jan - Feb

REPOSITORIES: biostudies-literature

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Sensitization and Exposure to Pets: The Effect on Asthma Morbidity in the US Population.

Gergen Peter J PJ Mitchell Herman E HE Calatroni Agustin A Sever Michelle L ML Cohn Richard D RD Salo Pӓivi M PM Thorne Peter S PS Zeldin Darryl C DC

The journal of allergy and clinical immunology. In practice 20170708 1

<h4>Background</h4>Although pets are found in more than 50% of US homes, the effect of pet allergen exposure on asthma morbidity in the US population is not well documented.<h4>Objective</h4>To determine the effect of dog and cat allergen exposures on asthma morbidity in the US population.<h4>Methods</h4>The National Health and Nutrition Examination Survey is a representative sample of civilian US population. Data on asthma, dog and cat allergen levels in bedroom dust, as well as specific IgE to ...[more]

PMID: 28694047

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Project description:Environmental tobacco smoke (ETS) exposure is associated with poor asthma outcomes in children. However, little is known about natural changes in ETS exposure over time in children with asthma and how these changes may affect health-care utilization. This article documents the relationship between changes in ETS exposure and childhood asthma morbidity among children enrolled in a clinical trial of supervised asthma therapy.Data for this analysis come from a large randomized clinical trial of supervised asthma therapy in which 290 children with persistent asthma were randomized to receive either usual care or supervised asthma therapy. No smoking cessation counseling or ETS exposure education was provided to caregivers; however, children were given 20 min of asthma education, which incorporated discussion of the avoidance of asthma triggers, including ETS. Asthma morbidity and ETS exposure data were collected from caregivers via telephone interviews at baseline and at the 1-year follow-up.At baseline, 28% of caregivers reported ETS exposure in the home and 19% reported exposure outside of the primary household only. Among children whose ETS exposure decreased from baseline, fewer hospitalizations (p = 0.034) and emergency department (ED) visits (p < or = 0.001) were reported in the 12 months prior to the second interview compared to the 12 months prior to the first interview. Additionally, these children were 48% less likely (p = 0.042) to experience an episode of poor asthma control (EPAC).This is the first study to demonstrate an association between ETS exposure reduction and fewer EPACs, respiratory-related ED visits, and hospitalizations. These findings emphasize the importance of ETS exposure reduction as a mechanism to improve asthma control and morbidity. Potential policy implications include supporting ETS reductions and smoking cessation interventions for parents and caregivers of children with asthma. Research to identify the most cost-effective strategy is warranted.

Project description:ImportanceHome aeroallergen exposure is associated with increased asthma morbidity in children, yet little is known about the contribution of school aeroallergen exposures to such morbidity.ObjectiveTo evaluate the effect of school-specific aeroallergen exposures on asthma morbidity among students, adjusting for home exposures.Design, setting, and participantsThe School Inner-City Asthma Study was a prospective cohort study evaluating 284 students aged 4 to 13 years with asthma who were enrolled from 37 inner-city elementary schools in the northeastern United States between March 1, 2008, and August 31, 2013. Enrolled students underwent baseline clinical evaluations before the school year started and were then observed clinically for 1 year. During that same school year, classroom and home dust samples linked to the students were collected and analyzed for common indoor aeroallergens. Associations between school aeroallergen exposure and asthma outcomes during the school year were assessed, adjusting for home exposures.ExposuresIndoor aeroallergens, including rat, mouse, cockroach, cat, dog, and dust mites, measured in dust samples collected from inner-city schools.Main outcomes and measuresThe primary outcome was maximum days in the past 2 weeks with asthma symptoms. Secondary outcomes included well-established markers of asthma morbidity, including asthma-associated health care use and lung function, measured by forced expiratory volume in 1 second.ResultsAmong 284 students (median age, 8 years [interquartile range, 6-9 years]; 148 boys and 136 girls), exposure to mouse allergen was detected in 441 (99.5%) of 443 school dust samples, cat allergen in 420 samples (94.8%), and dog allergen in 366 samples (82.6%). Levels of mouse allergen in schools were significantly higher than in students' homes (median settled dust level, 0.90 vs 0.14 µg/g; P < .001). Exposure to higher levels of mouse allergen in school (comparing 75th with 25th percentile) was associated with increased odds of having an asthma symptom day (odds ratio, 1.27; 95% CI, 1.05-1.54; P = .02) and 4.0 percentage points lower predicted forced expiratory volume in 1 second (95% CI, -6.6 to -1.5; P = .002). This effect was independent of allergic sensitization. None of the other indoor aeroallergens were associated with worsening asthma outcomes.Conclusions and relevanceIn this study of inner-city students with asthma, exposure to mouse allergen in schools was associated with increased asthma symptoms and decreased lung function. These findings demonstrate that the school environment is an important contributor to childhood asthma morbidity. Future school-based environmental interventions may be beneficial for this important public health problem.

Dataset Information

Sensitization and Exposure to Pets: The Effect on Asthma Morbidity in the US Population.

Publications

Sensitization and Exposure to Pets: The Effect on Asthma Morbidity in the US Population.

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