Endotoxin exposure, wheezing, and rash in infancy in a New Zealand birth cohort.
BACKGROUND
Wheezing in infancy is common and is associated with small lungs, viral respiratory tract infection, and environmental tobacco smoke exposure. Recently, increased levels of endotoxin in the domestic environment have also been associated with infant wheezing, particularly among infants with a family history of atopic disease.


OBJECTIVE
To explore associations between exposure to endotoxin at 3 months of age and reported symptoms of wheezing, rhinitis, itchy scaly rash, and atopy at 15 months in a birth cohort of 881 New Zealand children.


METHODS
Using standardized methods, a 1-m(2) site from the bedroom floors of the 3-month-old infants was sampled and analyzed for endotoxin.


RESULTS
Wheezing was significantly associated with higher endotoxin levels (odds ratio [OR], 1.54; 95% CI, 1.03-2.30), particularly among infants with a parental history of allergic disease (OR, 1.67; 95% CI, 1.07-2.60). Higher endotoxin concentrations were also strongly associated with recurrent itchy rashes (OR, 1.87; 95% CI, 1.14-3.05), particularly among infants who were atopic (OR, 4.64; 95% CI, 1.56-13.77) or had a parental history of allergic disease (OR, 2.10; 95% CI, 1.22-3.61).


CONCLUSIONS
Domestic endotoxin was associated with reported airway and skin symptoms in this large group of New Zealand infants. The role of endotoxin in the development of respiratory and skin disease in infancy deserves further study.


CONCLUSIONS
Reducing domestic endotoxin exposure might reduce infant wheezing and atopic dermatitis, but the long-term benefits of this remain unclear.
Gillespie
Julie
J
Wellington Asthma Research Group, Department of Medicine, Wellington South, New Zealand. gilju567@student.otago.ac.nz
Wickens
Kristin
K
Siebers
Rob
R
Howden-Chapman
Philippa
P
Town
Ian
I
Epton
Michael
M
Fitzharris
Penny
P
Fishwick
David
D
Crane
Julian
J
D015331:Cohort Studies; D004391:Dust / Q000032:analysis; D004731:Endotoxins / Q000032:analysis*; D004781:Environmental Exposure / Q000032:analysis*; D005076:Exanthema / Q000453:epidemiology*; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000453:epidemiology; D007223:Infant; D009520:New Zealand / Q000453:epidemiology; D015995:Prevalence; D011446:Prospective Studies; D012135:Respiratory Sounds; D012307:Risk Factors; D011795:Surveys and Questionnaires
D004391:Dust; D004731:Endotoxins