Lack of association between indoor allergen sensitization and asthma morbidity in inner-city adults.
BACKGROUND
Sensitivity and exposure to indoor allergens is associated with increased asthma morbidity in inner-city children. However, it is unknown whether sensitization is associated with worse asthma in adults.


OBJECTIVE
To evaluate the relationship between sensitization and asthma morbidity in urban adults.


METHODS
We prospectively studied 245 adults with persistent asthma recruited from an inner-city clinic. Sensitization to indoor allergens was evaluated by specific IgE antibodies measured at enrollment. Data on asthma control, asthma-related emergency department visits, hospitalizations, and oral steroid use were collected at baseline and at 1-month and 3-month follow-up contacts. Univariate, stratified, and multiple regression analyses were used to compare asthma morbidity in sensitized and nonsensitized patients after controlling for self-reported exposure and other potential confounders.


RESULTS
The study cohort consisted predominantly of low income, minority patients with high rates of resource utilization. The prevalences of sensitization to cockroach, dust mite, cat, mold, and mouse were 60%, 43%, 41%, 21%, and 14%. On univariate analyses, patients sensitized to each allergen did not have worse asthma control or higher resource utilization compared with nonsensitized individuals. Stratified and multivariate analyses also showed no association between sensitization and several measures of asthma morbidity even after controlling for self-reported exposure to indoor allergens and other potential confounders.


CONCLUSIONS
Sensitization to indoor allergens does not appear to be associated with increased asthma morbidity in inner-city adults.


CONCLUSIONS
These findings suggest that efforts to improve asthma control among urban populations should focus on other modifiable risk factors for morbidity.
Wisnivesky
Juan P
JP
Division of General Internal Medicine, Critical Care and Sleep Medicine, Department of Medicine, Mount Sinai School of Medicine, New York, NY 10029, USA. juan.wisnivesky@mssm.edu
Sampson
Hugh
H
Berns
Stephen
S
Kattan
Meyer
M
Halm
Ethan A
EA
D000328:Adult; D016902:Air Pollution, Indoor; D000485:Allergens / Q000276:immunology*; D001249:Asthma / Q000453:epidemiology* / Q000276:immunology / Q000628:therapy; D004781:Environmental Exposure; D005260:Female; D006295:Health Resources / Q000706:statistics & numerical data; D006801:Humans; D007073:Immunoglobulin E / Q000276:immunology; D008297:Male; D009017:Morbidity; D011446:Prospective Studies; D014504:Urban Health
D000485:Allergens; D007073:Immunoglobulin E