Environmental exposures and exhaled nitric oxide in children with asthma.
OBJECTIVE
To evaluate the relation of environmental factors with exhaled nitric oxide (FENO) concentrations among asthmatic children.


METHODS
Cross-sectional analysis of 170 tobacco smoke-exposed children, ages 6 to 12 years, who have doctor-diagnosed asthma using measures of FENO, medication use, and exposures to settled indoor allergens and tobacco smoke.


RESULTS
In multivariable analysis, child's age, uncarpeted flooring, not owning a cat, higher income, dust mite exposure, and being sensitized to any allergens were associated with higher FENO concentrations. Children who were sensitized to indoor allergens had an adjusted geometric mean FENO of 15.4 ppb (95% CI, 13.1, 18.2) compared with 10 ppb (95% CI, 8.2, 12.2) for unsensitized children. There was no statistically significant association of serum cotinine, hair cotinine, or reported corticosteroid therapy with FENO.


CONCLUSIONS
FENO is higher among children who are sensitized to indoor allergens and exposed to dust mites. The results hold promise for the use of FENO as a tool to manage childhood asthma by using both pharmacologic and environmental treatments.
Spanier
Adam J
AJ
Cincinnati Children's Environmental Health Center, Division of General and Community Pediatrics, and the Division of Allergy and Clinical Immunology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA. adam.spanier@cchmc.org
Hornung
Richard
R
Lierl
Michelle
M
Lanphear
Bruce P
BP
D016902:Air Pollution, Indoor / Q000009:adverse effects; D000485:Allergens / Q000009:adverse effects; D000818:Animals; D039741:Antigens, Dermatophagoides / Q000009:adverse effects; D001249:Asthma / Q000453:epidemiology / Q000378:metabolism / Q000503:physiopathology*; D002415:Cats / Q000276:immunology; D002648:Child; D003430:Cross-Sectional Studies; D003710:Demography; D004285:Dogs / Q000276:immunology; D004781:Environmental Exposure / Q000009:adverse effects*; D045853:Exhalation; D006801:Humans; D009569:Nitric Oxide / Q000032:analysis / Q000378:metabolism*; D014028:Tobacco Smoke Pollution / Q000009:adverse effects
D000485:Allergens; D039741:Antigens, Dermatophagoides; D014028:Tobacco Smoke Pollution; D009569:Nitric Oxide