Academic journal article Environmental Health Perspectives

Dust Weight and Asthma Prevalence in the National Survey of Lead and Allergens in Housing (NSLAH)

Academic journal article Environmental Health Perspectives

Dust Weight and Asthma Prevalence in the National Survey of Lead and Allergens in Housing (NSLAH)

Article excerpt

BACKGROUND: Settled dust has been used in studies to assess exposures to allergens and other biologically active components, but it has not been considered in the aggregate in relation to respiratory health outcomes in the general population.

OBJECTIVE: We addressed whether total house dust weight, an index of total dust exposure, was associated with respiratory health outcomes in the National Survey of Lead and Allergens in Housing (1998-1999) (NSLAH).

METHODS: NSLAH was a cross-sectional survey designed to represent permanently occupied housing units in the United States. In each household, a questionnaire was administered and settled dust was vacuumed from five locations. Linear regression models were used to identify predictors of dust weight; logistic regression models were used to examine the relationship between dust weight and asthma and wheeze.

RESULTS: Dust weight samples were available for 829 households, and survey information was available for 2,456 participants (children and adults). Lower income, older homes, household pets, having a smoker in the house, and less frequent cleaning predicted higher dust weight levels in U.S. households. Higher levels of dust weight were associated with greater odds of current asthma and wheeze. The strongest associations were seen for wheeze [adjusted odds ratio (OR) = 1.99; 95% confidence interval (CI), 1.21-3.28 for bedroom bed dust; OR = 2.81; 95% CI, 1.52-5.21 for upholstery dust). These associations persisted when adjusting for allergen and endotoxin exposures.

CONCLUSIONS: Dust weight, an index of total dust exposure in the home, may contribute to respiratory outcomes independently of the exposure to specific components.

KEY WORDS: allergens, cross-sectional, environmental, house dust, respiratory. Environ Health Perspect 115:215-220 (2007). doi:10.1289/ehp.9412 available via http://dx.doi.org/ [Online 7 November 2006]

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Since house dust was recognized as a common respiratory allergen in the early 20th century, research has focused on identifying the specific causes of its allergenicity. Early hypotheses made distinctions between settled house dust and "street dust," proposing that decayed cotton "linters" and "kapok fibers" from household furnishings and carpets were the allergenic agents in house dust [described by Sanghvi et al. (1958)]. Later, experiments suggested that allergic reactions were caused by a biological interaction between kapok fibers and the mold extracted from them, but not by either agent alone [described by Jaggi and Viswanathan (1965)]. Refinement of laboratory extraction and purification techniques led to the identification of several active protein fractions of house dust (Versie et al. 1966). Finally, the discovery of Dermatophagoides pteranyssinus, the "house dust mite" (HDM), by Voorhorst et al. (1964) resulted in a pause in the search for the putative agent and accelerated research into the distribution and characteristics of this arthropod and its fragments. During this flurry of descriptive research, one author described the discovery of HDM as a "new and refreshing idea" (Unger 1967), and another described the search for the allergenic agent as "tantalizing and, until recently, frustrating" (Mitchell et al. 1969).

The discovery of HDM did not cause research into the allergenic properties of house dust to cease completely, however, because people continued to react to dust, even when it did not contain dust mites (Kern 1970). Furthermore, other allergenic agents, such as cockroach, pollen, and fungi, were identified in dust (Bernton and Brown 1970; Sinha et al. 1970). Over the past 35 years, many specific allergenic proteins were identified, and methods to quantify their concentrations were developed. The proposed increase in asthma, allergic sensitization, and allergic diseases since 1980 has renewed the "tantalizing" aspect of the search for specific household exposures associated with the etiology and exacerbation of these diseases, albeit with an emphasis on the biologically relevant concentrations of allergens, in addition to the allergens themselves. …

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