Importance of the personal endotoxin cloud in school-age children with asthma.
BACKGROUND
A number of studies have observed associations between the amount of endotoxin in urban dust and chronic asthma severity, but a direct relationship between personal exposure to household endotoxin and acute asthma worsening has not yet been defined.


OBJECTIVE
We sought to investigate the relationship between day-to-day changes in personal endotoxin exposure and asthma severity.


METHODS
In the winter and spring of 1999 through 2000, endotoxin exposures were monitored in asthmatic schoolchildren by using portable, as opposed to stationary, monitors designed to measure inhalable and respirable particulate matter less than or equal to 2.5 and 10 microm in diameter. Children were followed with daily measurements of FEV(1) and asthma symptoms.


RESULTS
Over a 24-hour period, median daily personal endotoxin exposures ranged from 0.08 EU/m(3) (measured at a particulate matter size range </=2.5 microm in diameter) to 0.37 EU/m(3) (measured at a particulate matter size range </=10 microm in diameter). Personal exposures were significantly (P < .001) higher than endotoxin measurements from either indoor or outdoor stationary monitors. Moreover, individual exposures did not correlate with stationary measurements, suggesting that exposures derived from sources in close proximity to the children's personal activities might be better correlated with disease severity. Increases in personal endotoxin exposures were associated with decreased FEV(1) values and increased symptoms.


CONCLUSIONS
These findings demonstrate the importance of using personal monitoring to both measure and correlate endotoxin exposure with asthma severity.
Rabinovitch
Nathan
N
Department of Pediatrics, National Jewish Medical and Research Center, 1400 Jackson St, Denver, CO 80206, USA. rabinovitchn@njc.org
Liu
Andrew H
AH
Zhang
Lening
L
Rodes
Charles E
CE
Foarde
Karin
K
Dutton
Steven J
SJ
Murphy
James R
JR
Gelfand
Erwin W
EW
D000393:Air Pollutants; D001249:Asthma / Q000503:physiopathology*; D002648:Child; D004731:Endotoxins / Q000032:analysis*; D004784:Environmental Monitoring; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D008297:Male; D010550:Personal Space; D012574:Schools; D012720:Severity of Illness Index
D000393:Air Pollutants; D004731:Endotoxins