title: Endotoxin exposure, wheezing, and rash in infancy in a New Zealand birth cohort.
abstract: 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.
authors.affiliation: Wellington Asthma Research Group, Department of Medicine, Wellington South, New Zealand. gilju567@student.otago.ac.nz
authors.forename: Julie
authors.initials: J
authors.lastname: Gillespie
authors.forename: Kristin
authors.initials: K
authors.lastname: Wickens
authors.forename: Rob
authors.initials: R
authors.lastname: Siebers
authors.forename: Philippa
authors.initials: P
authors.lastname: Howden-Chapman
authors.forename: Ian
authors.initials: I
authors.lastname: Town
authors.forename: Michael
authors.initials: M
authors.lastname: Epton
authors.forename: Penny
authors.initials: P
authors.lastname: Fitzharris
authors.forename: David
authors.initials: D
authors.lastname: Fishwick
authors.forename: Julian
authors.initials: J
authors.lastname: Crane
mesh_terms: 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
chemical_list: D004391:Dust; D004731:Endotoxins