Asthma-related health status determinants of environmental control practices for inner-city preschool children.
BACKGROUND
Asthma guidelines recommend environmental control practices (ECPs) to improve asthma health. In the inner city, where asthma morbidity is high, it is not known whether children's health status affects the use of ECPs.


OBJECTIVE
To investigate health status determinants of ECPs in the homes of children with asthma.


METHODS
Caregivers of children aged 2 to 6 years with (n = 150) and without (n = 150) asthma completed a survey about ECPs. Atopic status was determined by means of skin prick testing.


RESULTS
Most ECPs were similarly practiced, regardless of whether the child had asthma. Only pet avoidance was more common in children with asthma (30% vs 19%). Asthma severity and recent acute health care visits for asthma were not associated with ECP use. Most ECPs were not linked to allergen sensitization (eg, mite and mouse), although cockroach-sensitized children were more likely to have cockroach control than nonsensitized individuals (65% vs 45%). Caregivers of asthmatic children with rhinitis were more likely than those without rhinitis to report ECPs, including pet avoidance (44% vs 15%), smoking avoidance (78% vs 53%), cockroach control (65% vs 42%), mouse control (78% vs 42%), air-conditioning (45% vs 24%), and allergyproof covers (7% vs 0%).


CONCLUSIONS
The presence of asthma, asthma severity, and allergen sensitization seem to have little relationship to ECP use in the homes of inner-city children. Rhinitis was consistently linked to ECPs, which suggests that caregivers may make changes in the home environment for upper airway but not lower airway symptoms.
Hansel
Nadia N
NN
Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland 21205, USA.
Eggleston
Peyton A
PA
Krishnan
Jerry A
JA
Curtin-Brosnan
Jean
J
Rand
Cynthia S
CS
Patino
Cecilia M
CM
Diette
Gregory B
GB
D016902:Air Pollution, Indoor / Q000009:adverse effects*; D000818:Animals; D001249:Asthma / Q000453:epidemiology / Q000517:prevention & control*; D017028:Caregivers; D002648:Child; D002675:Child, Preschool; D003058:Cockroaches / Q000276:immunology; D004781:Environmental Exposure / Q000009:adverse effects*; D005260:Female; D006796:Household Work; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000453:epidemiology / Q000517:prevention & control*; D008297:Male; D051379:Mice; D010571:Pest Control / Q000706:statistics & numerical data; D012111:Residence Characteristics; D012882:Skin Tests; D012907:Smoking / Q000009:adverse effects; D014504:Urban Health / Q000706:statistics & numerical data; D014505:Urban Population / Q000706:statistics & numerical data*