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Further study needed on allergen concentrations, associated reactions
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ORLANDO, Fla. — High concentrations of mouse and cockroach allergen were frequently detected in the homes of rural pediatric asthmatics, according to a study presented here during the American Academy of Allergy, Asthma & Immunology 2012 Annual Meeting. But investigators hope that further research will help them determine the common characteristics that predict which homes will have the highest allergen counts.
Most studies of cockroach and mouse allergens are conducted in urban communities, but little is known about allergen concentrations in rural areas. Results of this study from the University of Arkansas for Medical Sciences (UAMS) show the presence of significant concentrations of cockroach and mouse allergen in homes in less-populated areas.
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Amáziah T. Coleman, MD, a resident physician in the department of pediatrics at the UAMS and the Arkansas Children’s Hospital, Little Rock, Ark., and colleagues examined the home environment of 95 asthmatic children (median age 9 years, 83% African-American) living in the rural areas of the Arkansas Delta region. As part of the study, each family completed a home environment questionnaire, home inspection, and settled dust analysis by the team of investigators. Bedroom and kitchen dust samples were analyzed for concentrations of cockroach and mouse allergens.
Evidence of cockroaches (27%), evidence of mice and/or rats (23%); wall-to-wall carpeting (62%); smokers (27%); and lack of mattress/pillow encasements (100%) were recorded in the homes of participants.
Allergen concentrations >1 U/g for German cockroach (Blattella germanica allergen 1 [Bla g 1]) were detected in 71% of kitchens and 23% of bedrooms; Blattella germanica allergen 2 (Bla g 2) >1 U/g was found in 69% of kitchens and 37% of bedrooms; and mouse allergen (Mus musculus [Mus m 1]) >1.6 mg/g was found in 43% of kitchens and 33% of bedrooms.
Most (78%) patients resided in single-family homes, which were more likely to have detectable levels of cockroach allergen compared with apartment buildings.
“We aren’t sure if that is because most apartment buildings have regular pest control service and maybe the single-family homes are not able to afford that service,” Coleman told Infectious Diseases in Children. “Another interesting finding of the study was that although we did see increased levels of mouse concentrations in the home, we couldn’t associate any home characteristics specifically associated with the increased levels.”
Evidence of cockroaches in any room (OR 7.27, 95% CI 1.39-71.08) and mildew on bedroom walls/windows (OR 4.71, 95% CI 1.06-20.22) were associated with Bla g 1 >1 U/g. Wall-to-wall bedroom carpeting was associated with Bla g 1< 1 U/g (OR 5 5.26, 95% CI 1.61-20). Similar associations were found for Bla g 2.
Coleman said that characteristics associated with elevated levels of cockroach were identified, some of which included evidence of cockroach, ie, live or dead roaches, or cockroach stains throughout the home. In contrast, while the investigators found increased levels of mouse concentrations in the home, they could not associate any home characteristics specifically associated with the increased levels, according to Coleman.
“This study will help us in the future to be able to education families about the ways to decrease levels of these allergens and to help improve total quality of life with asthma,” Coleman said, adding that future studies should establish clinically relevant associations that might place these rural asthmatic children at risk for poor clinical outcomes.
Disclosure: Funding for this research was provided by the Robert Wood Johnson Faculty Scholars Program and Arkansas Children's Hospital Research Institute.
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