Family history, dust mite exposure in early childhood, and risk for pediatric atopy and asthma.
BACKGROUND
Dust mite allergen exposure is considered a major determinant of sensitization to these allergens during childhood and a risk factor for pediatric asthma.


OBJECTIVE
By using a birth cohort in a setting with a substantial burden of dust mite allergen, we evaluated exposure and risk for outcomes related to allergy and asthma.


METHODS
We collected dust from the bedrooms of 428 children born from 1987 to 1989 and measured Der f 1 and Der p 1 (microg/g dust, combined). Follow-up at 6 to 7 years of age included clinical examination, skin prick testing, specific serum IgE measurement, and methacholine challenge.


RESULTS
No overall association was evident for any outcome except bronchial hyperresponsiveness (adjusted odds ratio [OR], 0.62; 95% CI, 0.38-1.00; P <.050; and OR, 0.53; CI, 0.27-1.04; P <.065 for dust mite allergen levels > or =2 microg/g and >10 microg/g, respectively). With a parental history of allergy and asthma, there was an association between a positive dust mite skin test (OR, 2.09; CI, 0.93-4.73; P <.076) and dust mite allergen level >10 microg/g. The inverse was true for children without a parental history. Dust mite exposure of >10 microg/g was associated with a decreased risk of current atopic asthma among children with a parental history (OR, 0.39; CI, 0.05-3.13; P <.376), but with increased risk if without a parental history (OR, 1.52; CI, 0.22-10.6; P <.673).


CONCLUSIONS
Parental history is an important independent variable in the relationship between early dust mite exposure and atopic outcomes. Increased exposure during infancy is associated with a higher risk for sensitization in the presence of a positive parental history, but is protective among children of parents without a history of atopic disease.
Cole Johnson
Christine
C
Department of Biostatistics and Research Epidemiology, Henry Ford Health System, Wayne State University, Detroit, MI 48202,USA. cjohnso1@hfhs.org
Ownby
Dennis R
DR
Havstad
Suzanne L
SL
Peterson
Edward L
EL
D039741:Antigens, Dermatophagoides / Q000276:immunology*; D060829:Arthropod Proteins; D001249:Asthma / Q000209:etiology / Q000276:immunology*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003546:Cysteine Endopeptidases; D004781:Environmental Exposure / Q000009:adverse effects*; D005190:Family; D005260:Female; D006798:Housing; D006801:Humans; D006967:Hypersensitivity / Q000209:etiology / Q000276:immunology*; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008487:Medical History Taking; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies; D039981:Pyroglyphidae / Q000276:immunology; D012307:Risk Factors
D039741:Antigens, Dermatophagoides; D060829:Arthropod Proteins; D003546:Cysteine Endopeptidases; C451159:Dermatophagoides farinae antigen f 1; C451162:Dermatophagoides pteronyssinus antigen p 1