Academic journal article Environmental Health Perspectives

Indoor Environmental Exposures for Children with Asthma Enrolled in the Heal Study, Post-Katrina New Orleans

Academic journal article Environmental Health Perspectives

Indoor Environmental Exposures for Children with Asthma Enrolled in the Heal Study, Post-Katrina New Orleans

Article excerpt

BACKGROUND: Rain and flooding from Hurricane Katrina resulted in widespread growth of mold and bacteria and production of allergens in New Orleans, Louisiana, which may have led to increased exposures and morbidity in children with asthma.

OBJECTIVES: The goal of the Head-off Environmental Asthma in Louisiana (HEAL) study was to characterize post-Katrina exposures to mold and allergens in children with asthma.

METHODS: The homes of 182 children with asthma in New Orleans and surrounding parishes were evaluated by visual inspection, temperature and moisture measurements, and air and dust sampling. Air was collected using vacuum-pump spore traps and analyzed for > 30 mold taxa using bright field microscopy. Dust was collected from the children's beds and bedroom floors and analyzed for mouse (Mus m 1), dust mite (Der p 1), cockroach (Bla g 1), and mold (Alternaria mix) allergens using ELISA.

RESULTS: More than half (62%) of the children were living in homes that had been damaged by rain, flooding, or both. Geometric mean indoor and outdoor airborne mold levels were 501 and 3,958 spores/[m.sup.3], respectively. Alternaria antigen was detected in dust from 98% of homes, with 58% having concentrations > 10 [micro]g/g. Mus m 1, Der p 1, and Bla g 1 were detected in 60%, 35%, and 20% of homes, respectively, at low mean concentrations.

CONCLUSIONS: Except for Alternaria antigen in dust, concentrations of airborne mold (ratio of indoor to outdoor mold) and dust allergens in the homes of HEAL children were lower than measurements found in other studies, possibly because of extensive post-Katrina mold remediation and renovations, or because children moved into cleaner homes upon returning to New Orleans.

KEY WORDS: allergens, asthma, endotoxin, environmental remediation, glucan, Hurricane Katrina, mold. Environ Health Perspect 120:1600-1606 (2012). http://dx.doi.org/10.1289/ehp.1104840 [Online 15 August 2012]

On 29 August 2005, Hurricane Katrina struck the Gulf Coast, devastating much of the area in its path. The next day, many of the levees in Orleans Parish were breached, and 80% of the parish flooded; water levels rose to 20 feet in some areas (Kates et al. 2006). In addition, high winds caused roof damage, resulting in further water intrusion and moisture. The wet conditions provided an ideal environment for mold and bacterial growth in the city of New Orleans and surrounding parishes (NOLA). These organisms and their by-products (glucans, endotoxins) and allergens that are associated with moist environments (e.g., dust mite, cockroach) can exacerbate childhood asthma and allergies (Clark et al. 2004; Fisk et al. 2007; Jaakkola et al. 2005; Rosenbaum et al. 2010; Rosenstreich et al. 1997). However, the levels at which health effects occur and the factors associated with individual susceptibility to these outcomes are not well characterized (Brandt et al. 2006; Horner et al. 2008).

Several months after Katrina, many homes exhibited visible mold growth. In one study, 46% of 112 homes representing a random cross-section of homes in several NOLA parishes had visible mold growth (Ratard et al. 2006). In other studies, indoor airborne mold concentrations were higher than outdoor concentrations (Rao et al. 2007; Solomon et al. 2006). Indoor airborne mold concentrations were especially high in homes that had flooded (Chew et al. 2006), sometimes as much as five times higher than in homes that had not flooded (p < 0.05) (Solomon et al. 2006). The high mold concentrations were a concern for children with asthma returning to NOLA because associations between mold and asthma, wheeze, and other respiratory symptoms have been observed in other studies (Clark et al. 2004; Fisk et al. 2007; Jaakkola et al. 2005; Rockwell 2005; Rosenbaum et al. 2010). High concentrations of airborne endotoxin (Rao et al. 2007; Solomon et al. 2006) and glucan (Rao et al. 2007) were also reported in these post-Katrina studies at levels previously associated with respiratory pathology and decreased lung function (Douwes et al. …

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