Survey of pest infestation, asthma, and allergy in low-income housing

Are neighborhood-level characteristics associated with indoor allergens in the household?

BACKGROUND

Individual home characteristics have been associated with indoor allergen exposure; however, the influence of neighborhood-level characteristics has not been well studied. We defined neighborhoods as community districts determined by the New York City Department of City Planning.

OBJECTIVE

We examined the relationship between neighborhood-level characteristics and the presence of dust mite (Der f 1), cat (Fel d 1), cockroach (Bla g 2), and mouse (MUP) allergens in the household.

METHODS

Using data from the Puerto Rican Asthma Project, a birth cohort of Puerto Rican children at risk of allergic sensitization (n = 261), we examined associations between neighborhood characteristics (percent tree canopy, asthma hospitalizations per 1,000 children, roadway length within 100 meters of buildings, serious housing code violations per 1000 rental units, poverty rates, and felony crime rates), and the presence of indoor allergens. Allergen cutpoints were used for categorical analyses and defined as follows: dust mite: >0.25 microg/g; cat: >1 microg/g; cockroach: >1 U/g; mouse: >1.6 microg/g.

RESULTS

Serious housing code violations were statistically significantly positively associated with dust mite, cat, and mouse allergens (continuous variables), adjusting for mother's income and education, and all neighborhood-level characteristics. In multivariable logistic regression analyses, medium levels of housing code violations were associated with higher dust mite and cat allergens (1.81, 95%CI: 1.08, 3.03 and 3.10, 95%CI: 1.22, 7.92, respectively). A high level of serious housing code violations was associated with higher mouse allergen (2.04, 95%CI: 1.15, 3.62). A medium level of housing code violations was associated with higher cockroach allergen (3.30, 95%CI: 1.11, 9.78).

CONCLUSIONS

Neighborhood-level characteristics, specifically housing code violations, appear to be related to indoor allergens, which may have implications for future research explorations and policy decisions.

German cockroach allergen levels in North Carolina schools: comparison of integrated pest management and conventional cockroach control

Cockroach suppression is fundamental to cockroach allergen mitigation in infested homes. The effects of various cockroach control strategies on cockroach populations and allergen concentration have not been examined in schools. This study was conducted to compare the effectiveness of integrated pest management (IPM) and conventional pest control in controlling German cockroach (Blattella germanica L.) infestations and concentrations of the cockroach allergen Bla g 1 in public school buildings. Two school districts included six schools that used conventional pest control and one district included seven schools that used IPM to control pests. Cockroach traps were deployed to assess the level of infestation, settled dust samples were collected in food service areas, classrooms, and other school areas, and the Bla g 1 allergen was quantified by ELISA. Both cockroach counts and Bla g 1 concentrations were dependent on the pest control approach, with highly significant differences between IPM-treated schools and conventionally treated schools in both the cockroach mean trap counts (0 versus 82.6 +/- 17.3 cockroaches/trap/wk, respectively) and in the amount of Bla g 1 in dust samples (2.8 +/- 0.3 versus 30.6 +/- 3.4 U/g dust). Cockroaches and Bla g 1 were primarily associated with food preparation and food service areas and much less with classrooms and offices. Our data extend recent findings from studies in homes, showing that cockroach allergens can be reduced by cockroach elimination alone or by integrating several tactics including education, cleaning, and pest control. IPM is not only effective at controlling cockroaches but also can lead to long-term reductions in cockroach allergen concentrations, resulting in a healthier environment for students and school personnel.

Asthma morbidity in adult Chicago public housing residents

BACKGROUND

Residents of public housing can experience socioeconomic disadvantages, inadequate access to health care, and particularly substandard indoor air quality due to inadequate building maintenance.

OBJECTIVE

This study investigates demographic, medical management, severity, and household factors associated with asthma-related emergency department visits and hospitalizations.

METHODS

A total of 103 adult participants with asthma from four Chicago housing developments completed surveys and underwent household inspections.

RESULTS

Using stepwise multivariate logistic regression, we identified independent predictors of asthma-related emergency department visits: asthma controller medication use, not keeping an asthma-related doctor's appointment, and frequent nocturnal wheeze episodes. Using stepwise multivariate logistic regression, we identified independent predictors of asthma-related hospitalizations: peeling paint, plaster, or wallpaper, environmental tobacco smoke, written action plan for an asthma-related doctor or emergency department visit, and frequent nocturnal wheeze episodes.

CONCLUSIONS

In multivariate models, factors related to clinical severity and asthma management were related to both emergency department visits and hospitalizations while household conditions were related only to hospitalizations. Interventions to address both asthma management and household environmental triggers may be needed to reduce asthma morbidity in low-income populations.