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

Adult-onset asthma morbidity and related economic costs in middle age due to intentional chronic absenteeism in high school: An epidemiologic study using the national longitudinal survey of youth 1979 data

OBJECTIVE

Many authors examined the individual and societal impact of school absenteeism. Nevertheless, no empirical study has looked at the potential direct correlation between deliberate school absences and chronic illnesses in mid-adulthood. Our goal is to investigate any potential direct links between purposeful school absences and adult-onset asthma in middle age, as well as measure any associated costs of asthma.

METHODS

Data were sourced from the National Longitudinal Survey of Youth 1979, a nationally representative survey. The outcome measure was self-reported asthma in mid-adulthood. School records of absenteeism from grades nine through twelve were the key explanatory variables. Logistic regressions were performed with controls for demographic, economic and health variables. Predicted probabilities from the regressions were used to quantify costs of adult-onset asthma in middle age due to intentional high school absenteeism.

RESULTS

More years of chronic absenteeism in high school were associated with higher risk of adult-onset asthma in middle age. Four years of chronic absenteeism in high school during the late 1970s through the early 1980s could potentially have incurred between $817 million to $1 billion of asthma related costs in 2002, when these students were in their mid-adulthood. These potential asthma related costs due to high school absenteeism are sizeable considering that this high school cohort only accounted for six percent of the U.S. population.

CONCLUSIONS

Reducing high school absenteeism could lower the incidence of adult-onset asthma in middle age, and its associated future economic burden.

Widespread occurrence of pesticides in low-income housing

BACKGROUND

Low socioeconomic status (SES) residents living in social housing, which is subsidized by government or government-funded agencies, may have higher exposures to pesticides used in indoor residences since pesticides are applied due to structural deficiencies, poor maintenance, etc. OBJECTIVE: To estimate exposure of residents in low-SES social housing built in the 1970s to legacy and current-use pesticides and to investigate factors related to exposures.

METHODS

Twenty-eight particle-phase pesticides were measured in the indoor air of 46 units in seven low-income social housing, multi-unit residential buildings (MURBs) in Toronto, Canada using portable air cleaners deployed for 1 week in 2017. Pesticides analyzed were legacy and current use in the classes: organochlorines, organophosphates, pyrethroids, and strobilurins.

RESULTS

At least one pesticide was detected in 89% of the units with detection frequencies (DF) for individual pesticides of up to 50%, including legacy organochlorines and current-use pesticides. Current-use pyrethroids had the highest DF and concentrations, with the highest particle-phase concentration for pyrethrin I at 32,000 pg/m3. Heptachlor, restricted for use in Canada in 1985, had the highest estimated maximum total air (particle plus gas phase) concentration of 443,000 pg/m3. Heptachlor, lindane, endosulfan I, chlorothalonil, allethrin, and permethrin (except in one study) had higher concentrations than those measured in low-income residences reported elsewhere. In addition to the intentional use of pesticides to control pests and their use in building materials and paints, tobacco smoking was significantly correlated with the concentrations of five pesticides used on tobacco crops. The distribution of pesticides with high DF in individual buildings suggested that pest eradication programs by the building management and/or pesticide use by residents were the major sources of measured pesticides.

IMPACT

Low-income social housing fills a much-needed demand, but the residences are prone to pest infestation and hence pesticide use. We found exposure to at least 1 of 28 particle-phase pesticides in 89% of all 46 units tested, with the highest DF and concentrations for current-use pyrethroids and long-banned organochlorines (e.g., DDT, heptachlor) due to very high persistence indoors. Also measured were several pesticides not registered for use indoors, e.g., strobilurins used to treat building materials and pesticides used on tobacco crops. These results, which are the first Canadian data for most pesticides indoors, show widespread exposure to numerous pesticides.

Shifting the paradigm: highlights from 2022 demonstrate broad public health impacts of applied urban entomology

In 2022, the dramatic reduction of applied and extension urban entomology positions was highlighted and widely discussed by seasoned and nascent urban entomologists alike. In fact, many urban entomologists are calling for a "paradigm shift" within the discipline given the reduction in niche urban entomology-specific positions. Specifically, many individuals are insisting that movement toward a framework where urban entomologists address complex, cross-disciplinary issues and advocate for research funding through science policy is critical for the endurance of the discipline. In this new model, the purpose of urban entomology does not necessarily change, but rather expands to attack questions that may be of interest to the broader scientific community. In addition, this paradigm shift would necessitate increased engagement of urban entomologists with bureaucratic and administrative agencies to communicate the importance of urban pest management, especially in a landscape where funding opportunities and endowments have been reduced, reallocated, or eliminated. To reflect the ongoing transformation within the field of urban entomology, the objectives of this review were to highlight papers published in 2022 that exemplify the broader impacts of urban entomological studies and urban pest management. Studies with ties to global public health and Entomological Society of America science policy initiatives are highlighted to encourage urban entomologists to consider the far-reaching influence of their research.

Environmental allergen reduction in asthma management: an overview

Asthma is a prevalent non-communicable disease that affects both children and adults. Many patients with severe, uncontrolled asthma could not achieve total control despite using anti-asthmatic drugs. There is increasing evidence that allergy to environmental allergens, including both indoor and outdoor allergens, is associated with asthma symptoms and severe asthma. Frequently reported sensitized allergens were dust mites, cockroaches, grass pollens, molds, pets, and rodents in allergic asthma patients, although the patterns of widespread allergens differed from each country. Allergen avoidance is the cornerstone of asthma management, especially in sensitized subjects. This review summarizes environmental allergen avoidance and clarifies their effects on asthma control. Despite contrasting results about the impact of allergen exposure reduction on asthma control, several studies supported the beneficial effects of reducing asthma-related symptoms or risk of exacerbations as a nondrug therapy. Identifying environmental allergens is helpful for asthma patients, and further studies on clinically effective avoidance methods are required.

Impacts of Bioassay Type on Insecticide Resistance Assessment in the German Cockroach (Blattodea: Ectobiidae)

The German cockroach, Blattella germanica (L.), is one of the most critical urban pests globally due to the health risks it imposes on people, such as asthma. Insecticides are known to manage large cockroach population sizes, but the rapid rate at which they develop resistance is a continuing problem. Dealing with insecticide resistance can be expensive and time-consuming for both the consumer and the pest management professional (PMP) applying the treatment. Each cockroach population is unique because different strains have different insecticide susceptibilities, so resistance profiles must be considered. This study addressed the above issue in a controlled laboratory setting. Cockroach strains from Indianapolis, Indiana, Danville, Illinois, and Baltimore, Maryland, USA were used. Four insecticide active ingredients (AIs) most used by consumers and PMPs were selected for testing in vial bioassays to establish resistance profiles. Next, no-choice and choice feeding assays with four currently registered bait products were performed to assess the impacts of competing food and circadian rhythms on bait resistance levels. The results indicate that emamectin benzoate (Optigard) was the most effective AI in causing the highest mortality in all strains in vial and no-choice bioassays; whereas, the other AIs and products were more impacted by resistance. The results acquired from these studies can help develop rapid tests for use by PMPs based on the no-choice feeding assay while also adding more information supporting current resistance and cross-resistance evolution theories.

Microbe-mediated activation of indoxacarb in German cockroach (Blattella germanica L.)

The German cockroach (Blattella germanica L.) is a major urban pest worldwide and is notorious for its ability to detoxify and resist insecticides. German cockroaches have generalist feeding habits that expose them to a range of potential hazardous substances and host a wide variety of unique microbial species, which may potentially facilitate unique detoxification capabilities. Since field German cockroach populations are routinely exposed to both bait and spray insecticide treatments, we hypothesized whether these unique gut microbes might play roles in toxicological processes of the host insect. The goals of this research were to understand the metabolic processes inside the German cockroach gut after treatment with kanamycin, a broad-ranging antibiotic, and indoxacarb, an oxadiazine pro-insecticide used in cockroach bait products. In these experiments, two resistant cockroach strains were obtained from field populations in Danville, IL and compared to a susceptible laboratory strain that had no previous exposure to insecticides (J-wax). Roaches provided kanamycin-infused water had lower median mortality to indoxacarb compared to the control treatment in feeding bioassays regardless of strain, but in vial (surface contact) bioassays, only susceptible cockroaches experienced a shift in mortality apparently due to their greater susceptibility. When frass extracts of indoxacarb-fed cockroaches were analyzed, less of the active, hydrolytic metabolite DCJW (N-decarbomethoxyllated JW062) was produced relative to the parent compound indoxacarb with the antibiotic KAN. This result was further corroborated by hydrolase activity assays of whole homogenized cockroach guts. Taken together these results provide novel evidence of microbe-mediated pro-insecticide activation in the cockroach gut.

Population Structure of German Cockroaches (Blattodea: Ectobiidae) in an Urban Environment Based on Single Nucleotide Polymorphisms

German cockroaches (Blattella germanica L.) harbor and disperse medically important pathogens and are a source of allergens that impact human health and wellbeing. Management of this pest requires an understanding of their distribution and dispersal. In this study, we collected German cockroaches from three apartment buildings in New Jersey, USA. We identified single-nucleotide polymorphisms (SNPs) from DNA extractions using next generation sequencing. We analyzed the SNPs and characterized cockroach population genetic structure using Fst, principal component, phylogenetic, and STRUCTURE analyses. We found significant differences in German cockroach population structure among the buildings. Within buildings, we found variable population structure that may be evidence for multiple colonization events. This study shows that SNPs derived from next generation sequencing provide a powerful tool for analyzing the genetic population structure of these medically important pests.

Prevalence of Cockroaches, Bed Bugs, and House Mice in Low-Income Housing and Evaluation of Baits for Monitoring House Mouse Infestations

Pests are frequently found in homes, especially in apartment buildings in low-income communities. We investigated the prevalence and patterns of pest infestations in low-income communities in four cities (Jersey City, Linden, Paterson, Trenton) in New Jersey, USA. Resident interviews, visual inspections, and the placement of monitors were used to identify pest infestations. A total of 1,753 apartments from 19 buildings or building complexes were accessed. The infestation rates of cockroaches, bed bugs (Cimex lectularius L.), and house mice (Mus musculus domesticus Schwarz and Schwarz) were 37, 9, and 20%, respectively. Among apartments with cockroaches, 97.8, 2.5, and 0.8% had German cockroach [Blattella germanica (L.)], American cockroach [Periplaneta americana (L.)], and Oriental cockroach (Blatta orientalis L.), respectively. The percentage of residents who were aware of the presence of cockroaches, bed bugs, and house mice was 70.8, 55.3, and 56.8%, respectively. The prevalence of pest infestation was associated with resident ethnicity and gender. Among 856 interview responses, 78% implemented methods themselves to control pests in their homes in the past six months. Chocolate spread detected 99% of house mouse infestations and was much more sensitive than three commercial blank baits. Significant differences were also observed in the feeding preference of the three commercial blank baits.

Using Integrated City Data and Machine Learning to Identify and Intervene Early on Housing-Related Public Health Problems

CONTEXT

Housing is more than a physical structure-it has a profound impact on health. Enforcing housing codes is a primary strategy for breaking the link between poor housing and poor health.

OBJECTIVE

The objective of this study was to determine whether machine learning algorithms can identify properties with housing code violations at a higher rate than inspector-informed prioritization. We also show how city data can be used to describe the prevalence and location of housing-related health risks, which can inform public health policy and programs.

SETTING

This study took place in Chelsea, Massachusetts, a demographically diverse, densely populated, low-income city near Boston.

DESIGN

Using data from 1611 proactively inspected properties, representative of the city's housing stock, we developed machine learning models to predict the probability that a given property would have (1) any housing code violation, (2) a set of high-risk health violations, and (3) a specific violation with a high risk to health and safety (overcrowding). We generated predicted probabilities of each outcome for all residential properties in the city (N = 5989).

RESULTS

Housing code violations were present in 54% of inspected properties, 85% of which were classified as high-risk health violations. We predict that if the city were to use integrated city data and machine learning to identify at-risk properties, it could achieve a 1.8-fold increase in the number of inspections that identify code violations as compared with current practices.

CONCLUSION

Given the strong connection between housing and health, reducing public health risk at more properties-without the need for additional inspection resources-represents an opportunity for significant public health gains. Integrated city data and machine learning can be used to describe the prevalence and location of housing-related health problems and make housing code enforcement more efficient, effective, and equitable in responding to public health threats.

The Spatial Distribution of the House Mouse, Mus musculus domesticus, in Multi-Family Dwellings

The house mouse, Mus musculus domesticus, creates significant public health risks for residents in low-income multi-family dwellings (MFDs). This study was designed to evaluate the spatial distribution of house mice in MFDs. Four low-income high-rise apartment buildings in three cities in New Jersey were selected for building-wide monitoring on two occasions with approximately one year between the monitoring events. The presence of a house mouse infestation was determined by placing mouse bait stations with three different non-toxic baits for a one-week period in all accessible units as well as common areas. Permutation tests were conducted to evaluate house mouse infestation spatial patterns. All four analyzed buildings exhibited a significant correlation between apartments with house mouse infestations and whether they share a common wall or ceiling/floor at both sampling periods except one building during the second inspection, which contained a high number of isolated apartments. Foraging ranges, speed of locomotion, and dispersal behavior of house mice are relatively larger, faster, and more common, respectively, compared to common urban arthropod pests. This could lead to the conclusion that house mice are as likely to infest non-neighboring apartments as those that share a wall or floor/ceiling. However, these results demonstrate that house mouse infestations tend to occur among apartments that share common walls or ceilings/floors. This spatial distribution pattern can be utilized in rodent management plans to improve the efficiency of house mouse management programs in MFDs.

Differential microbial responses to antibiotic treatments by insecticide-resistant and susceptible cockroach strains (Blattella germanica L.)

The German cockroach (Blattella germanica L.) is a major urban pest worldwide and is known for its ability to resist insecticides. Past research has shown that gut bacteria in other insects can metabolize xenobiotics, allowing the host to develop resistance. The research presented here determined differences in gut microbial composition between insecticide-resistant and susceptible German cockroaches and compared microbiome changes with antibiotic treatment. Cockroaches received either control diet or diet plus kanamycin (KAN) to quantify shifts in microbial composition. Additionally, both resistant and susceptible strains were challenged with diets containing the insecticides abamectin and fipronil in the presence and absence of antibiotic. In both strains, KAN treatment reduced feeding, leading to higher doses of abamectin and fipronil being tolerated. However, LC50 resistance ratios between resistant and susceptible strains decreased by half with KAN treatment, suggesting gut bacteria mediate resistance. Next, whole guts were isolated, bacterial DNA extracted, and 16S MiSeq was performed. Unlike most bacterial taxa, Stenotrophomonas increased in abundance in only the kanamycin-treated resistant strain and was the most indicative genus in classifying between control and kanamycin-treated cockroach guts. These findings provide unique insights into how the gut microbiome responds to stress and disturbance, and important new insights into microbiome-mediated insecticide resistance.

Further Inspection: Integrating Housing Code Enforcement and Social Services to Improve Community Health

As a result of working inside homes, city housing inspectors witness hidden and serious threats to public health. However, systems to respond to the range of problems they encounter are lacking. In this study, we describe the impact and enabling environment for integrating a novel Social Service Referral Program within the Inspectional Services Department in Chelsea, MA. To evaluate the first eight months of the program, we used a mixed-methods approach combining quantitative data from 15 referrals and qualitative interviews with six key informants (inspectors, a case manager, and city leadership). The most common services provided to residents referred by inspectors were for fuel, food, and rent assistance; healthcare; hoarding; and homelessness prevention. Half of referred residents were not receiving other social services. Inspectors reported increased work efficiency and reduced psychological burden because of the program. Interviewees described how quality of life improved not only for referred residents but also for the surrounding neighborhood. A simple referral process that made inspectors' jobs easier and a trusted, well-connected service provider funded to carry out the work facilitated the program's uptake and impact. Housing inspectors' encounters with residents present a unique opportunity to expand the public health impact of housing code enforcement.

Laboratory and Field Evaluations of Food-Based Attractants for Monitoring German Cockroaches

Sticky traps are standard tools for monitoring German cockroaches (Blattella germanica L.); however, because they lack an attractant, their ability to catch cockroaches is by chance and largely dependent upon the location of placement and length of time they are left in place. Currently, highly effective and economical cockroach attractants are not available. Food-based attractants have the potential to be employed in sticky traps and enhance their effectiveness on trapping German cockroaches. We conducted laboratory and field experiments to evaluate the effectiveness of novel food-based attractants. Laboratory results showed that sticky traps containing the following attractants: apple oil, blueberry oil, orange oil, or their combination, fish oil, peanut butter, Roach lure tablet, and bacon extract had significantly higher trap catch compared to those traps that do not contain an attractant. Apple plus blueberry oil mixture and Roach lure tablet enhanced the trap catch by ≥ 103%, and bacon extract enhanced the trap catch by 92% in the field assays. Apple plus blueberry oil mixture and Roach lure tablet were the most promising attractants based on laboratory and field experiments. Apple plus blueberry oil mixture aged for 2 wk was as attractive to German cockroaches as fresh mixture.

Material Hardship and Indoor Allergen Exposure among Low-Income, Urban, Minority Children with Persistent Asthma

Traditional measures of socioeconomic status (SES) are associated with asthma morbidity, but their specific contributions are unclear. Increased exposure to indoor allergens among low SES children is an important consideration. Material hardship, a concept describing poor access to basic goods and services, may explain the relationship between low SES and indoor allergen exposure, and thereby, the increased risk of asthma morbidity. We sought to (i) describe the specific hardships experienced by low-Income, urban, minority children with asthma and indoor allergen sensitization and (ii) determine if material hardship is associated with indoor allergen exposure in this population. We conducted a cross-sectional analysis of children undergoing the baseline assessment for a clinical trial of home environmental modification. Participants were scored in five domains of material hardship. Domain scores were assigned based on caregiver responses to a questionnaire and were summed to generate a total material hardship score. Linear regression was used to examine the relationship between material hardship scores and bedroom floor concentrations of five common indoor allergens. Participants experienced high levels of material hardship in each of the five domains, with 33% not having access to a car, 35% not being able to pay utility bills, and 28% not being able to pay rent in the past year. Each one-point increase in material hardship was associated with an increase in cockroach allergen of 16.2% (95% CI 9.4%, 24.6%) and an increase in mouse allergen of 9.4% (95% CI 1.0%, 18.5%). After adjusting for traditional measures of SES, including household income, health insurance type, caregiver education, and caregiver employment status, the association between material hardship and cockroach allergen, but not mouse allergen, remained. These data suggest that a significant proportion of families of low-income, minority children with asthma may experience material hardship, and that they may be at greater risk of cockroach allergen exposure than their peers with similar income, but without material hardship.

Monitoring and Controlling House Mouse, Mus musculus domesticus, Infestations in Low-Income Multi-Family Dwellings

The house mouse, Mus musculus domesticus, is a common pest in multi-family residential apartment buildings. This study was designed to gain insights into residents' impressions of house mice, develop more effective house mouse detection methods, and evaluate the effectiveness of building-wide house mouse management programs. Two high-rise apartment buildings in New Jersey were selected for this study during 2019-2020. Bait stations with three different non-toxic baits were used to detect house mouse activity. Two rodenticides (FirstStrike^®-0.0025% difethialone and Contrac^®-0.005% bromadiolone) were applied by researchers over a 63-day period and pest control operations were then returned to pest control contractors for rodent management. There were significant differences in the consumption rates of non-toxic baits and two toxic baits tested. A novel non-toxic bait, chocolate spread, was much more sensitive than the two commercial non-toxic baits for detecting mouse activity. The house mouse management programs resulted in an average 87% reduction in the number of infested apartments after three months. At 12 months, the number of infestations decreased by 94% in one building, but increased by 26% in the second building. Sustainable control of house mouse infestations requires the use of effective monitoring strategies and control programs coupled with preventative measures.

Screening of the Repellent Activity of 12 Essential Oils Against Adult German Cockroach (Dictyoptera: Blattellidae): Preparation of a Sustained Release Repellent Agent of Binary Oil-γ-CD and its Repellency in a Small Container

Cockroaches are important sanitary pests and very difficult to control worldwide. With public concern about traditional insecticides, cockroach control agents should be environmentally friendly, highly efficient, and economical. In this article, 12 essential oils were screened to test their repellent effect against Blattella germanica. To develop essential oils as repellent agents, the oils were further examined in binary synergistic combinations. Ilex chinensis Sims (Sapindales: Aquifoliaceae) oil, Lavandula spp (Tubiflorae: Labiatae) oil, and Elsholtzia ciliata (Thunb.) Hyland (Tubiflorae: Labiatae) oil showed excellent repellent activities with lower RD50 (repellency dose for 50% of treated adults) values of 218.634, 154.590, and 223.989 µg/cm2, respectively, compared to those of other oils and the positive control. The I. chinensis oil and E. ciliata oil (weight ratio of 1:1.41) combination also displayed a remarkable synergistic effect against B. germanica. Their cotoxicity coefficient was 214.4. The major chemical constituents in E. ciliata and I. chinensis oils were respectively 3,7-dimethyl-1, 6-octadien-3-ol and methyl salicylate. The binary oil mixtures were formulated as a sustained release agent with γ-CD. The optimal preparation should be an 8:1 ratio of γ-CD to oils, with a 1 h stirring time, 50°C stirring temperature, and 1:12 ratio of γ-CD to ddH2O. The results of this study suggest that sustained release of binary oil-γ-CD exhibited a prolonged repellent activity (10 h) against B. germanica. This sustained-release agent could be further investigated and developed as a novel repellent preparation.

Quantifying the Efficacy of an Assessment-Based Pest Management (APM) Program for German Cockroach (L.) (Blattodea: Blattellidae) Control in Low-Income Public Housing Units

Over the last several decades, low-income public housing facilities have been known to be infested with particularly large German cockroach populations. These populations persist even though the housing pest control contracts often require, and pay for, IPM practices to be used in their facilities. When Virginia Tech researchers began reviewing public housing contracts in Virginia and North Carolina, it was easy to see why these 'IPM programs' were not successful. Many of these 'low-bidder' contracts do not allow the technician enough time in each apartment to assess the size of the pest population. In addition, these pest management contracts did not require German cockroach population monitoring, even though all IPM programs are based on assessments of the pest population. There was a clear need for an effective, easy to apply cockroach management program in U.S. public housing authorities. This study determined the long-term efficacy of an Assessment-based Pest Management (APM) program for German cockroach control in U.S. public housing facilities. Specifically, we evaluated an APM program where the residents were not asked to clean or prepare for treatment, and where overnight cockroach trap counts were used to determine the volume of gel bait that would be applied. The APM baiting program was conducted for 15 mo in three housing authorities. In all three housing authorities, cockroach populations in test units were typically reduced by >90%. German cockroach infestations were even eliminated from 49 of the 65 (75%) test units during this study.

Changes in Indoor Insecticide Residue Levels after Adopting an Integrated Pest Management Program to Control German Cockroach Infestations in an Apartment Building

Insecticide use in homes leads to human exposure to insecticide residues that persist in the environment. Integrated pest management (IPM) programs have been known to be more environmentally friendly for managing German cockroach (Blattella germanica L.) infestations, but their effect on indoor insecticide residue levels are not well understood. An IPM program consisting of applying cockroach gel baits and placing insect sticky traps as the primary treatment methods were implemented. Floor wipe samples were collected from the bedroom and kitchen floors of 69 apartments with German cockroach infestations at 0 months and again at 12 months from 49 of the 69 apartments sampled at 0 months. Levels of 18 insecticide residues were measured. The mean insecticide residue concentration per apartment decreased by 74% after 12 months. The number of insecticides detected per apartment decreased from 2.5 ± 0.2 to 1.5 ± 0.2 (mean ± standard error). Indoxacarb residue was only detected in two apartments at 12 months despite the fact that an average of 32 ± 4 g 0.6% indoxacarb gel bait was applied per apartment. IPM implementation can result in significant reduction in the insecticide residue concentrations and number of detected insecticides in floor dust samples.

Inner-City Asthma in Children

Asthma in inner-city children is often severe and difficult to control. Residence in poor and urban areas confers increased asthma morbidity even after adjusting for ethnicity, age, and gender. Higher exposure to household pests, such as cockroaches and mice, pollutants and tobacco smoke exposure, poverty, material hardship, poor-quality housing, differences in health care quality, medication compliance, and heath care access also contribute to increased asthma morbidity in this population. Since 1991, the National Institutes of Allergy and Infectious Diseases established research networks: the National Cooperative Inner-City Asthma Study (NCICAS), the Inner-City Asthma Study (ICAS), and the Inner-City Asthma Consortium (ICAC), to improve care for this at risk population. The most striking finding of the NCICAS is the link between asthma morbidity and the high incidence of allergen sensitization and exposure, particularly cockroach. The follow-up ICAS confirmed that reductions in household cockroach and dust mite were associated with reduction in the inner-city asthma morbidity. The ICAC studies have identified that omalizumab lowered fall inner-city asthma exacerbation rate; however, the relationship between inner-city asthma vs immune system dysfunction, respiratory tract infections, prenatal environment, and inner-city environment is still being investigated. Although challenging, certain interventions for inner-city asthma children have shown promising results. These interventions include family-based interventions such as partnering families with asthma-trained social workers, providing guidelines driven asthma care as well as assured access to controller medication, home-based interventions aim at elimination of indoor allergens and tobacco smoke exposure, school-based asthma programs, and computer/web-based asthma programs.

Housing Quality and Mental Health: the Association between Pest Infestation and Depressive Symptoms among Public Housing Residents

Housing quality, which includes structural and environmental risks, has been associated with multiple physical health outcomes including injury and asthma. Cockroach and mouse infestations can be prime manifestations of diminished housing quality. While the respiratory health effects of pest infestation are well documented, little is known about the association between infestation and mental health outcomes. To address this gap in knowledge and given the potential to intervene to reduce pest infestation, we assessed the association between household pest infestation and symptoms of depression among public housing residents. We conducted a cross-sectional study in 16 Boston Housing Authority (BHA) developments from 2012 to 2014 in Boston, Massachusetts. Household units were randomly selected and one adult (n = 461) from each unit was surveyed about depressive symptoms using the Center for Epidemiologic Study-Depression (CES-D) Scale, and about pest infestation and management practices. In addition, a home inspection for pests was performed. General linear models were used to model the association between pest infestation and high depressive symptoms. After adjusting for important covariates, individuals who lived in homes with current cockroach infestation had almost three times the odds of experiencing high depressive symptoms (adjusted OR = 2.9, 95% CI 1.9-4.4) than those without infestation. Dual infestation (cockroach and mouse) was associated with over five times the odds (adjusted odds = 5.1, 95% CI 3.0-8.5) of experiencing high depressive symptoms. Using a robust measure of cockroach and mouse infestation, and a validated depression screener, we identified associations between current infestation and depressive symptoms. Although the temporal directionality of this association remains uncertain, these findings suggest that the health impact of poor housing conditions extend beyond physical health to include mental health. The study adds important information to the growing body of evidence that housing contributes to population health and improvements in population health may not be possible without addressing deficiencies in the housing infrastructure.

Bedroom Allergen Exposure Beyond House Dust Mites

PURPOSE OF REVIEW

The review provides insight into recent findings on bedroom allergen exposures, primarily focusing on pet, pest, and fungal exposures.

RECENT FINDINGS

Large-scale studies and improved exposure assessment technologies, including measurement of airborne allergens and of multiple allergens simultaneously, have extended our understanding of indoor allergen exposures and their impact on allergic disease. Practical, streamlined methods for exposure reduction have shown promise in some settings, and potential protective effects of early-life exposures have been further elucidated through the investigation of specific bacterial taxa. Advances in molecular allergology have yielded novel data on sensitization profiles and cross-reactivity. The role of indoor allergen exposures in allergic disease is complex and remains incompletely understood. Advancing our knowledge of various co-exposures, including the environmental and host microbiome, that interact with allergens in early life will be crucial for the development of efficacious interventions to reduce the substantial economic and social burden of allergic diseases including asthma.

Established and Emerging Environmental Contributors to Disparities in Asthma and Chronic Obstructive Pulmonary Disease

PURPOSE OF REVIEW

Multiple respiratory diseases, including asthma and chronic obstructive pulmonary disease (COPD), display significant socioeconomic and racial/ethnic disparities. The objective of this review is to evaluate the evidence supporting a link between disproportionate environmental exposures and these health disparities.

RECENT FINDINGS

Studies suggest that various co-occurring factors related to the home environment, neighborhood environment, non-modifiable individual factors, and individual behaviors and attributes can increase or modify the risk of adverse respiratory outcomes among socioeconomically-disadvantaged and racially/ethnically diverse populations. Pollutants in the home environment, including particulate matter, nitrogen dioxide, and pesticides, are elevated among lower socioeconomic status populations and have been implicated in the development or exacerbation of respiratory-related conditions. Neighborhood crime and green space are socioeconomically patterned and linked with asthma outcomes through psychosocial pathways. Non-modifiable individual factors such as genetic predisposition cannot explain environmental health disparities but can increase susceptibility to air pollution and other stressors. Individual behaviors and attributes, including obesity and physical activity, contribute to worse outcomes among those with asthma or COPD.

SUMMARY

The root causes of these multifactorial exposures are complex, but many likely stem from economic forces and racial/ethnic and economic segregation that influence the home environment, neighborhood environment, and access to healthy foods and consumer products. Critical research needs include investigations that characterize exposure to and health implications of numerous stressors simultaneously, both to guard against potential confounding in epidemiological investigations and to consider the cumulative impact of multiple elevated environmental exposures and sociodemographic stressors on health disparities.

Efficacy of sanitation and sanitary factors against the German cockroach (Blattella germanica) infestation and effectiveness of educational programs on sanitation in Iran

Background: Sanitation and educational programmes as tactics of the biorational control programme to affect bait performance against German cockroaches have been reported, but these are limited to discussion on the effect of these factors alone. Objective: Investigate the effectiveness of sanitation and related factors on German cockroaches (Blattella germanica) in Iran. Methods: Sticky traps were used to monitor cockroach infestations at three residential buildings comprising of 150 apartment units in the southwest part of Iran. Educational programmes using pamphlets, posters, and lectures to describe the importance of sanitation, exclusion, and low toxic control in biorational control approach was performed in the intervention groups of the surveyed residential buildings. The cockroach index and sanitation rate tables were tools to evaluate the infestation and sanitation. A questionnaire was distributed to collect information on unsanitary factors and occupants’ attitudes towards sanitation. Results: There was a significant correlation between infestation and poor sanitation. Furthermore, there was significant correlation between infestation and sanitation in a biorational system. The effectiveness of a comprehensive educational program on the improvement of unsanitary factors such as “dirty and cluttered”, “unwashed dishes left at night” and “leftover foods exposed at places” or “food debris” was significant as it reduced upon cockroach infestation. Other relevant effects were also taken into consideration. Conclusion: Sanitation has positive impact in reduction of German cockroach infestation.

Pest Prevalence and Evaluation of Community-Wide Integrated Pest Management for Reducing Cockroach Infestations and Indoor Insecticide Residues

Pest infestations in residential buildings are common, but community-wide pest survey data are lacking. Frequent insecticide applications for controlling indoor pests leave insecticide residues and pose potential health risks to residents. In this study, a community-wide pest survey was carried out in a housing complex consisting of 258 units in 40 buildings in New Brunswick, New Jersey. It was immediately followed by implementation of an integrated pest management (IPM) program in all the cockroach-infested apartments and two bed bug apartments with the goal of eliminating pest infestations, reducing pyrethroid residues, and increasing resident satisfaction with pest control services. The IPM-treated apartments were revisited and treated biweekly or monthly for 7 mo. Initial inspection found the top three pests and their infestation rates to be as follows: German cockroaches (Blattella germanica L. [Blattodea: Blattellidae]), 28%; rodents, 11%; and bed bugs (Cimex lectularius L. [Hemiptera: Cimicidae]), 8%. Floor wipe samples were collected in the kitchens and bedrooms of 20 apartments for pyrethroid residue analysis before the IPM implementation; 17 of the 20 apartments were resampled again at 7 mo. The IPM program reduced cockroach counts per apartment by 88% at 7 wk after initial treatment. At 7 mo, 85% of the cockroach infestations found in the initial survey were eliminated. The average number of pyrethroids detected decreased significantly from 6 ± 1 (mean ± SEM) and 5 ± 1 to 2 ± 1 and 3 ± 1 in the kitchens and bedrooms, respectively. The average concentrations of targeted pyrethroids residue also decreased significantly in the kitchens and bedrooms.

Exoskeletons and economics: indoor arthropod diversity increases in affluent neighbourhoods

In urban ecosystems, socioeconomics contribute to patterns of biodiversity. The ‘luxury effect’, in which wealthier neighbourhoods are more biologically diverse, has been observed for plants, birds, bats and lizards. Here, we used data from a survey of indoor arthropod diversity (defined throughout as family-level richness) from 50 urban houses and found that house size, surrounding vegetation, as well as mean neighbourhood income best predict the number of kinds of arthropods found indoors. Our finding, that homes in wealthier neighbourhoods host higher indoor arthropod diversity (consisting of primarily non-pest species), shows that the luxury effect can extend to the indoor environment. The effect of mean neighbourhood income on indoor arthropod diversity was particularly strong for individual houses that lacked high surrounding vegetation ground cover, suggesting that neighbourhood dynamics can compensate for local choices of homeowners. Our work suggests that the management of neighbourhoods and cities can have effects on biodiversity that can extend from trees and birds all the way to the arthropod life in bedrooms and basements.

Development of Diagnostic Insecticide Concentrations and Assessment of Insecticide Susceptibility in German Cockroach (Dictyoptera: Blattellidae) Field Strains Collected From Public Housing

Insecticide resistance in German cockroaches (Blattella germanica (L.)) has been a barrier to effective control since its first documentation in the 1950s. A necessary first step toward managing resistance is to understand insecticide susceptibility profiles in field-collected strains so that active ingredients (AIs) with lowest resistance levels can be identified. As a first step in this study, diagnostic concentrations (DCs) were determined for 14 insecticide AIs based on lethal concentrations that killed 99% or 90% of the individuals from a susceptible lab strain (JWax-S). Next, cockroaches were collected from two low-income multifamily housing complexes in Danville, IL, and Indianapolis, IN, and used to establish laboratory strains. These strains were screened against the 14 AI-DCs in vial bioassays, and susceptibility profiles were determined by comparing percent mortalities between the field strains relative to the JWax-S strain. Results revealed lowest resistance of field strains to boric acid, abamectin, dinotefuran, clothianidin, thiamethoxam, and chlorfenapyr. For the AIs hydramethylnon and imidacloprid, field strains did not display survivorship different than the lab strain, but >90% mortality was never achieved. Lastly, both field strains displayed resistance to indoxacarb, fipronil, acetamiprid, beta-cyfluthrin, bifenthrin, and lambda-cyhalothrin, but at varying levels. These results satisfy two objectives. First, baseline monitoring DCs were established for 14 insecticides presently registered for use against cockroaches, which represents a useful resource. Second, our findings reveal insecticide AIs with lowest resistance levels for use in forthcoming field studies that will investigate impacts of different insecticide deployment strategies on resistance management and evolution in cockroach field populations.

Infestation of cockroaches (Insecta: Blattaria) in the human dwelling environments: A systematic review and meta-analysis

Periplaneta americana, Blatta orientalis, Blattella germanica and Supella longipalpa are the most common worldwide cockroaches that mentioned in the "22 common pest" or "22 dirty" species named as "group I". They are able to infest any type of buildings. A meta-analysis review was conducted between January 2015 and July 2016 on any literature published about infestation of cockroaches. Scientific reports and papers about infestation of cockroaches and relevant topics were collected from various specific scientific websites such as PubMed, Web of Science, ScienceDirect, Springer, Elsevier, Scopus, and Google Scholar. About 271 scientific reports and papers were collected and after a preliminary review, 63 were selected to become part of the detailed synthesis review and meta-analysis. Results showed that the global world mean infestation trend of cockroaches, and B. germanica and P. americana cockroach species ranged 49.0-55.0, 40.0-70.0 and 60.0-70.0%, respectively suggests that their infestation trend are increasing. The global world mean infestation of cockroaches, and B. germanica and P. americana cockroach species were 52.3, 55.2 and 65.4, respectively. There was a significant difference between the global world mean infestation of cockroaches and P. americana cockroach species (P=0.019). The global mean infestation trend of cockroaches in the human dwelling environments and world ranged 55.0-65.0 and 50.0-70.0%, respectively suggests that their infestation trend are increasing. The global world mean infestation of cockroaches in the human dwelling environments and world were 60.4 and 57.7%, respectively. Although some factors affect the infestation of cockroaches and the sanitation and quality structure of the buildings are also being improved. While as present study reveal that the globally the world infestation trend of cockroaches are being increased and recent studies also indicate that the prevalence of asthma has increased dramatically over the decades suggest that infestation of cockroaches can directly affect the development of asthma.

Integrated Pest Management Intervention in Child Care Centers Improves Knowledge, Pest Control, and Practices

INTRODUCTION

To reduce young children's exposure to pests and pesticides, an integrated pest management (IPM) intervention was provided for child care center staff.

METHODS

The 7-month IPM education and consultation intervention was conducted by trained nurse child care health consultants in 44 child care centers in California. IPM knowledge surveys were completed by child care staff, objective IPM assessments were completed by research assistants pre- and postintervention, and activity logs were completed by the nurses.

RESULTS

There were significant increases in IPM knowledge for the child care staff who attended workshops. There were reductions in the prevalence of pests and increases in IPM practices at the postintervention compared with the preintervention time point. The nurses consulted an average of 5.4 hours per center.

DISCUSSION

A nurse-led IPM intervention in child care centers can reduce exposure to harmful substances for young children attending child care centers.

Detection of allergen sources in the homes of sensitized children

OBJECTIVE

To identify the presence of environmental factors linked to the onset of allergies and asthma in the homes of children participating in an early detection program that were identified with sensitivity to common allergens in the region of Sonora, Mexico.

METHODS

A walkthrough assessment was carried out in the homes of sensitized children; the research tools were the questionnaire and environmental checklist proposed by the Lowell Healthy Homes Program of the University of Massachusetts-Lowell.

RESULTS

The results showed the presence of environmental allergen sources, to which most of the children in the study are sensitized, as well as the environmental conditions and habits that determine the quality of the indoor air of the households, were both related to triggering allergies and asthma in this population. A statistically significant association was found between the visual observation of dust inside homes and the sensitivity of children to dust mites.

CONCLUSIONS

Dust found inside the home was the most relevant environmental factor related to positive cases of IgE in children. Early detection of allergies in children in the study and the methodology used in this investigation provided a useful framework for the design of plans and intervention alternatives in these homes to prevent the development of allergies and asthma panorama. These plans should be designed with a multidisciplinary approach to impact social, environmental and economic benefits in the family, improving the living conditions of the study population and contributing to the sustainable development goals of the United Nations for 2030.

Housing need in Canada: Healthy lives start at home

Housing affects the health of children and youth. One-third of households in Canada live in substandard conditions or in housing need. The present statement reviews the literature documenting the impacts of housing on personal health and the health care system. Types of housing need are defined, including unsuitable or crowded housing, unaffordable housing and inadequate housing, or housing in need of major repairs. The health effects of each type of housing need, as well as of unsafe neighbourhoods, infestations and other environmental exposures are outlined. Paediatricians and other physicians caring for children need to understand the housing status of patients to fully determine their health issues and ability to access and engage in health care. Recommendations and sample tools to assess and address housing need at the patient, family, community and policy levels are described. Canada is the only G8 country without a national housing strategy. Recommendations also include advocating for enhanced action at all levels of government and for housing-supportive policies, including a national housing strategy.

The insecticidal effect of diatomaceous earth against adults and nymphs of Blattella germanica

OBJECTIVE

To evaluate the insecticidal effect of diatomaceous earth (DE) against adults and nymphs of Blattella germanica.

METHODS

This cross sectional study has been done on the laboratory strain of German cockroaches. Two stages, nymph and adult, were exposed to six dose rates of the DE, 2.5, 5, 10, 15, 20 and 25 g/m(2), at 24, 48 and 72 h exposure period. Mortality (number of dead cockroaches) was assessed after 24 h. Other exposed specimens were transferred to the beakers contained food and water for counting the retard mortality rate after 1 week.

RESULTS

Increasing in dose rates of DE increased mortality rate, so that the lowest and highest mortality rates were observed in 2.5 and 25 g/m(2), respectively. The results of the statistical analysis showed no significant difference in the lethality of 50% of DE plus water on the German cockroach nymphs.

CONCLUSIONS

Due to the resistance of German cockroach against organochloride, organophosphorus, carbamate and pyrethriodes insecticides, it is suggested to use DE for insect's control.

Environmental remediation in the treatment of allergy and asthma: latest updates

In the modern era, the prevalence of asthma and allergies are increasing. It has been speculated that environmental exposures are contributing to this rise. Several studies demonstrate that common indoor allergen exposures exacerbate asthma. Minimizing exposure to allergens and remediating the environment play a critical role in the treatment of asthma and allergies. The most effective environmental control measures are tailored multifaceted interventions which include education, thorough cleaning, using high-efficiency particulate air (HEPA) filters, integrated pest management, and maintenance of these practices.

Extermination strategies reported in the NYC Health and Nutrition Examination Survey, 2004: prevalence and predictors

It is likely that household extermination is a major source of pesticide exposure for urban residents. Little is known about the predictors of residential pest control strategies in urban areas, and greater knowledge of these may help identify who is at risk for higher pesticide exposure. Study data is from the 2004 NYC Health and Nutrition Examination Surveys, a cross-sectional, population-based study using a three-stage sampling scheme. Logistic regression was used to identify predictors of pesticide use overall, and of application strategy: (1) consumer-applied pesticides only, (2) use of a professional exterminator only, or (3) use of both. Consumer-applied extermination was more prevalent than professional or both professional and consumer (39.9% versus 27.8% and 15.9%, respectively, and non-exclusively). In multivariate models among those who used any extermination, consumer application was associated with age 60 years+, being black or Asian, and being widowed, divorced, or single. Lower income households were more likely to use both strategies, and less likely to use professional extermination only. Urban residents may benefit from targeted education on how and when to self-apply pesticides, and on best-practice pest control to avoid unnecessary pesticide exposure. Higher prevalence of consumer-applied and conjoint consumer and professionally applied extermination in low-income households may reflect both economic determinants of first recourse and higher neighborhood infestation levels.

Sensitization to rodents (mouse/rat) in urban atopic populations without occupational exposure living in Campania district (Southern Italy): a multicenter study

BACKGROUND

Up to now very few data on allergic sensitization to rodent allergens in Western Europe and Italy are available, and there are no information at district level.The aim of this report was to investigate clinical significance and characteristics of allergic sensitization to mouse/rat (M/Rt) allergens in atopic subjects living in Campania district (Southern Italy).

METHODS

Allergists from the whole Campania district were required to report the results of skin prick tests of at least 100 consecutive subjects. In 1,477 consecutive outpatients, we selected all subjects with an immediate skin reaction to M/Rt dander. Clinical history including a careful evaluation of the modality of exposure and the results of skin-prick tests (SPTs) were recorded.

RESULTS

Fifty seven patients were sensitized to M/Rt dander (5.78%). Two patients were mono-sensitized. Fourteen patients reported indoor conditions suggesting presence of rodents allergens at home. All patients exhibited low-moderate degree of SPT positivity to M/Rt. High frequency of concomitant allergic sensitization to dust mites was found.

CONCLUSIONS

Our results suggest that the role of allergic sensitization to rodents is not negligible in atopic subjects without occupational exposure living in Campania district area; these values are higher in comparison to those previously found in Naples area. Highly atopic individuals should be tested by SPTs/evaluation of serum specific IgE to rodents in the case they should begin an occupational exposure to M/Rt or keep these animals as pets.

Respiratory health in home and leisure pursuits

Many home-based and leisure activities can generate hazardous respirable exposures. Routine domestic activities and a variety of hobbies, avocations, and leisure pursuits have been associated with a spectrum of respiratory tract disorders. Indoor environments present a special risk for high-intensity exposures and adverse health effects. There are important knowledge gaps regarding the prevalence of specific health hazards within and across communities, exposure-response effects, population and individual susceptibilities, best management strategies, the adverse health effects of mixed exposures, and long-term clinical outcomes following exposures. The home environment presents special health risks that should be part of the health assessment.

Household pesticide contamination from indoor pest control applications in urban low-income public housing dwellings: a community-based participatory research

We designed this community-based participatory research (CBPR) project aiming to generate evidence-based research results to encourage residents living in urban low-income public housing dwellings engaging in a community-wide integrated pest management (IPM) program with the intention to improve their health and quality of life, as well as household conditions. We enrolled 20 families and their children in this study in which we utilized environmental exposure assessment (surface wipe and indoor air) tools to quantitatively assessing residential pesticide exposure in young children before the implementation of an IPM program. We analyzed those samples for 19 organophosphate (OP) and pyrethroid pesticides. The most commonly detected pesticides were pyrethroids, particularly permethrin and cypermethrin with average concentrations of 2.47 and 3.87 μg/m(2), respectively. In many dwellings, we detected OPs, which are no longer available on the market; however, their levels are significantly lower than those of pyrethroids. None of the 20 families was free from pesticide contamination in their households, and pesticides were commonly detected in living room and children's bedroom. The correlation among household hygienic conditions, the sighting of live pests/pest debris, and the degree of indoor pesticide contamination highlights the failure of conventional chemical-based applications for pest controls. The results from the current study, as well as other recent studies, conducted in low-income public housing, child care centers, and randomly selected homes in the U.S. should accentuate the need for alternative pest management programs that incorporate safer and more sustainable protocols for pest controls.

Impact of environmental controls on childhood asthma

Exposure to allergens early in life can lead to sensitization and the development of childhood asthma. It is thought that increased exposure with the advent of modern housing is likely contributing to the rise in prevalence of childhood asthma during the past few decades. The progression from allergen exposure to sensitization and asthma development has been noted with respect to dust mites, pets, cockroach, mouse, mold, tobacco smoke, endotoxin, and air pollution, although some have found a protective effect with pet and endotoxin exposure. Recent studies have shown that allergen remediation may be beneficial in reducing asthma morbidity and development, although there is also some evidence to the contrary. Examples of allergen remediation that have been studied include the use of dust mite-impermeable covers, high-efficiency particulate air filtration, integrated pest management, home repairs, ventilation improvement, and pet removal. Several multifaceted, randomized controlled trials have shown that reducing multiple early allergen exposures with environmental controls is associated with a decreased risk of asthma.

Indoor environment and children's health: recent developments in chemical, biological, physical and social aspects

Much research is being carried out into indoor exposure to harmful agents. This review focused on the impact on children's health, taking a broad approach to the indoor environment and including chemical, microbial, physical and social aspects. Papers published from 2006 onwards were reviewed, with regards to scientific context. Most of publications dealt with chemical exposure. Apart from the ongoing issue of combustion by-products, most of these papers concerned semi volatile organic compounds (such as phthalates). These may be associated with neurotoxic, reprotoxic or respiratory effects and may, therefore, be of particular interest so far as children are concerned. In a lesser extent, volatile organic compounds (such as aldehydes) that have mainly respiratory effects are still studied. Assessing exposure to metals is still of concern, with increasing interest in bioaccessibility. Most of the papers on microbial exposure focused on respiratory tract infections, especially asthma linked to allergens and bio-aerosols. Physical exposure includes noise and electromagnetic fields, and articles dealt with the auditory and non auditory effects of noise. Articles on radiofrequency electromagnetic fields mainly concerned questions about non-thermal effects and papers on extremely low-frequency magnetic fields focused on the characterization of exposure. The impact of the indoor environment on children's health cannot be assessed merely by considering the effect of these different types of exposure: this review highlights new findings and also discusses the interactions between agents in indoor environments and also with social aspects.

Bla g 1 allergen levels in Zagreb area household dust

Cockroach allergy is a health problem in many parts of the world. In urban environments, indoor exposure to cockroach allergens involves a risk of asthma. The aim of this study was to measure the mass fraction of Bla g 1, a major allergen of the German cockroach (Blatella germanica) in 30 house samples, collected at random from Zagreb area households, Croatia. Dust samples were collected on cellulose filters by vacuuming living rooms floors. After extraction, Bla g 1 was detected using the commercial enzyme-linked immunosorbent assay (ELISA). Only four of the thirty households had detectable Bla g 1 levels, and only in one was its concentration higher than 2.0 U g(-1), the threshold associated with sensitisation. The Bla g 1 ELISA proved highly sensitive, with the detection limit of 0.12 U g(-1). The within- and between-assay imprecision was 8.9 % and 14.4 %, respectively, and accuracy 85 % to 120 %. Low Bla g 1 levels in the household dust support previously reported low prevalence of skin sensitisation to B. germanica among Zagreb residents. Further monitoring should reveal if there are differences in cockroach allergen exposure and sensitisation between households from other geographic areas in Croatia.

Knowledge and practices of in-home pesticide use: a community survey in Uganda

Many communities in low-income countries use in-home pesticides for the control of pests. Such use is often inadequately controlled. In this study, 100 households in Kireka ward, Wakiso district in Uganda were involved in a cross-sectional survey to assess pests, knowledge, and use patterns of pesticides. A structured pretested questionnaire was administered via personal interviews, and observational checklists were used. Mosquitoes were the most prevalent pests (83%), followed by cockroaches (69%) and rats (52%). Pesticides were the most preferred method for pest control (98%), with insecticide spray being the most common form of application (71.4%). Pesticide application was inappropriately done in many households mainly due to inadequate knowledge on use. Only 48% of the respondents read manufacturer's instructions for use. Information on what pesticide to use was obtained from friends (53.1%), points of sales (48%). Educational interventions particularly at points of sale would be a critical avenue for promoting safe use of pesticides in households.

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

Building-level characteristics are structural factors largely beyond the control of those who live in them. We explored whether building-level characteristics and indoor allergens in the household are related. We examined the relationship between building-level characteristics and indoor allergens: dust mite, cat, cockroach, and mouse. Building-level characteristics measured were presence of pests (seeing cockroaches and rodents), building type (public housing, buildings zoned commercially and residentially, and building size), and building condition (building age and violations). Allergen cutpoints were used for categorical analyses and defined as follows: dust mite: >0.25 μg/g; cat: >1 μg/g; cockroach: >1 U/g; mouse: >1.6 μg/g. In fully adjusted linear analyses, neither dust mite nor cat allergen were statistically significantly associated with any building-level characteristics. Cockroach allergen was associated with the presence of cockroaches (2.07; 95% CI, 1.23, 3.49) and living in public housing (2.14; 95% CI, 1.07, 4.31). Mouse allergen was associated with the presence of rodents (1.70; 95% CI, 1.29, 2.23), and building size: living in a low-rise (<8 floors; 0.60; 95% CI, 0.42, 0.87) or high-rise (8 + floors; 0.50; 95% CI, 0.29, 0.88; compared with house/duplex). In fully adjusted logistic analyses, cat allergen was statistically significantly associated with living in a high-rise (6.29; 95% CI, 1.51, 26.21; compared with a house/duplex). Mouse allergen was associated with living in public housing (6.20; 95% CI, 1.01, 37.95) and building size: living in a low-rise (0.16; 95% CI, 0.05, 0.52) or high-rise (0.06; 95% CI, 0.01, 0.50; compared with a house/duplex). Issues concerning building size and public housing may be particularly critical factors in reducing asthma morbidity. We suggest that future research explore the possible improvement of these factors through changes to building code and violations adherence, design standards, and incentives for landlords.

Methodological lessons and pilot data on the effect of proximity of homes and schools to highways on pediatric asthma and lung function

PURPOSE

Numerous studies have found that either living or attending school near highways or exposure to pollutants associated with heavy motor vehicle traffic are associated with a high prevalence of asthma and reduced lung function. Yet, few investigations have assessed school and home exposure in the same study.

METHODS

We recruited children aged 5-19 years from a pediatric clinic in an urban center (Boston Chinatown) for many of whom housing and school were located immediately adjacent to two major highways. A questionnaire was used to assess self-report of diagnosis of asthma and the proximity of schools and homes to highways, as well as basic demographic information. Spirometric lung function data were obtained and reviewed by a pediatric pulmonologist blinded to survey responses. During this review, we excluded lung function tests of low quality.

RESULTS

The analyses did not demonstrate any associations or mean differences between near-highway exposure at school, at home, or both with diagnosed asthma (p>0.10, n=124). For the lung function data (n=87), neither direct measures (FEV1, FVC, and FEF(25-75)) nor ratio measures (FEV1/FVC and FEF(25-75)/FVC) had a significant association with near-highway exposure (p>0.10). Certain predisposing factors, such as diagnosed allergies and family history of asthma, were strongly associated with diagnosed asthma (p<0.05 and p=0.001, respectively), findings we have seen consistently in other work with children recruited from the same clinic. We also found that exposure to pests was significantly correlated with a smaller FEF(25-75)/FVC ratio (p=0.02).

CONCLUSIONS

Our findings suggest that either limitations in our study design restricted our ability to see the associations reported by others or that such associations do not exist in this population. One possibility is that in this community, with heavy street traffic and many street canyons, the gradient of exposure next to the highway is not very well delineated by simple proximity.

Double jeopardy: assessing the association between internal displacement, housing quality and chronic illness in a low-income neighborhood

Purpose

This study analyzed associations between war-related internal displacement, housing quality and the prevalence of chronic illness in Nabaa, a low-income neighborhood on the outskirts of Beirut, Lebanon.

Methods

A cross-sectional survey of sociodemographics, household characteristics and health conditions of the study population was carried out in 2002. Using a structured questionnaire, the research team surveyed 1,151 households representing 4,987 residents of all ages. The survey was administered to a proxy respondent from each household in face-to-face interviews. A multiple logistic regression model using the generalized estimation equation method was constructed to assess the simultaneous effect of displacement and housing quality on reported ill health, while adjusting for potential confounders.

Results

Housing quality and internal displacement were strongly associated with occurrences of chronic illness. The most vulnerable respondents were older residents, females and internally displaced people, who reported high rates of chronic illnesses. Residents with high levels of education were less likely to report a chronic illness than those that had elementary education or less.

Conclusion

Nabaa residents’ experience of poor health was associated with inadequate housing quality. Moreover, residents who have been displaced experience worse living conditions and were more likely to experience poor health than those who were not displaced. These results reveal a need for policies to improve housing quality and alleviate war-related consequences in low-income neighborhoods.

Pest and allergen exposure and abatement in inner-city asthma: a work group report of the American Academy of Allergy, Asthma & Immunology Indoor Allergy/Air Pollution Committee

Our work group report details the importance of pest allergen exposure in inner-city asthma. We will focus specifically on mouse and cockroach exposure. We will discuss how exposure to these pests is common in the inner city and what conditions exist in urban areas that might lead to increased exposure. We will discuss how exposure is associated with allergen sensitization and asthma morbidity. Finally, we will discuss different methods of intervention and the effectiveness of these tactics.

What can pest management learn from laboratory animal ethics?

There remains a lack of a clear overarching policy framework for decision-making in pest control programmes. In comparison, ethical principles have been extensively developed for scientific procedures, such as those underlying the UK's Animals (Scientific Procedures) Act 1986. This paper assesses the extent to which the principles and methodology underlying the act and secondary guidance could be used to provide principles of rodent management. Useful principles include that any programme has a legitimate purpose; that methods are used only if the harms are outweighed by the benefits; that harms are minimised by refinement, replacement and reduction and that there is personal responsibility. The usefulness and implications for pest control of each principle and the overall approach are discussed.