Parent report of pests and pets and indoor allergen levels in inner-city homes.
BACKGROUND
Guidelines recommend allergen avoidance for patients with allergic asthma, but direct measurements of home allergen levels are not available to most physicians. Parent report of indoor allergen exposure is a potentially convenient and inexpensive surrogate measure of exposure, although validity of parent report to estimate indoor allergen levels is not well established.


OBJECTIVE
To determine if parent-reported pest and pet exposures can identify patients with clinically relevant allergen exposure.


METHODS
Parents of 300 inner-city children completed a survey about pests (cockroaches and mice) and furred pets (dogs and cats). Settled dust samples were obtained for Bla g 1, Mus m 1, Can f 1, and Fel d 1 from kitchens and bedrooms.


RESULTS
Parent reports were associated with clinically relevant levels of Bla g 1, Mus m 1, Can f 1, and Fel d 1 (P < .001 for all). For example, when parents reported cockroaches were present, 86% of homes had settled dust Bla g 1 levels of 1 U/g or higher, and when they reported mice were present, 90% had Mus m 1 levels greater than 500 ng/g. Report of pets was also predictive of clinically meaningful allergen levels. Parent-reported absence of pets provided assurance that allergen levels were below relevant thresholds (negative predictive value, 80%-98%). However, parent-reported absence of pests did not provide assurance of low levels of these allergens (negative predictive value, 38%-75%).


CONCLUSIONS
Since direct measurement of indoor allergens is not always feasible, especially in the inner city, parent report of pests and pets may be sufficient to recommend environmental control practices for sensitized children. Negative parent reports of pests are not sufficient evidence of low pest allergen exposure.
Curtin-Brosnan
Jean
J
Department of Pediatrics, School of Medicine, Johns Hopkins University, Baltimore, Maryland 21205, USA.
Matsui
Elizabeth C
EC
Breysse
Patrick
P
McCormack
Meredith C
MC
Hansel
Nadia N
NN
Tonorezos
Emily S
ES
Eggleston
Peyton A
PA
Williams
Dann L
DL
Diette
Gregory B
GB
D016902:Air Pollution, Indoor / Q000032:analysis*; D000485:Allergens / Q000032:analysis* / Q000276:immunology; D000818:Animals; D000829:Animals, Domestic; D052179:Antigens, Plant; D001249:Asthma / Q000209:etiology* / Q000276:immunology; D002648:Child; D002675:Child, Preschool; D003058:Cockroaches; D004391:Dust / Q000032:analysis; D005260:Female; D006023:Glycoproteins / Q000032:analysis; D006801:Humans; D008297:Male; D051379:Mice; D010290:Parents; D012111:Residence Characteristics; D014505:Urban Population
D000485:Allergens; D052179:Antigens, Plant; D004391:Dust; D006023:Glycoproteins; C105482:allergen Bla g 1; C091462:allergen Can f I; C059296:Fel d 1 protein, Felis domesticus