title: Association of pediatric asthma severity with exposure to common household dust allergens.
abstract: BACKGROUND
  Reducing exposure to household dust inhalant allergens has been proposed as one strategy to reduce asthma.
  
  
  OBJECTIVE
  To examine the dose-response relationships and health impact of five common household dust allergens on disease severity, quantified using both symptom frequency and medication use, in atopic and non-atopic asthmatic children.
  
  
  METHODS
  Asthmatic children (N=300) aged 4-12 years were followed for 1 year. Household dust samples from two indoor locations were analyzed for allergens including dust mite (Der p 1, Der f 1), cat (Fel d 1), dog (Can f 1), cockroach (Bla g 1). Daily symptoms and medication use were collected in monthly telephone interviews. Annual disease severity was examined in models including allergens, specific IgE sensitivity and adjusted for age, gender, atopy, ethnicity, and mother's education.
  
  
  RESULTS
  Der p 1 house dust mite allergen concentration of 2.0 microg/g or more from the main room and the child's bed was related to increased asthma severity independent of allergic status (respectively, OR 2.93, 95% CI 1.37, 6.30 for 2.0-10.0 microg/g and OR 2.55 95% CI 1.13, 5.73 for 10.0 microg/g). Higher pet allergen levels were associated with greater asthma severity, but only for those sensitized (cat OR 2.41 95% CI 1.19, 4.89; dog OR 2.06 95% CI 1.01, 4.22).
  
  
  CONCLUSIONS
  Higher levels of Der p 1 and pet allergens were associated with asthma severity, but Der p 1 remained an independent risk factor after accounting for pet allergens and regardless of Der p 1 specific IgE status.
authors.affiliation: Yale Center for Perinatal, Pediatric and Environmental Epidemiology, Department of Epidemiology and Public Health, Yale University School of Medicine, One Church Street, 6th Floor, New Haven, CT 06510, USA. janneane.gent@yale.edu
authors.forename: Janneane F
authors.initials: JF
authors.lastname: Gent
authors.forename: Kathleen
authors.initials: K
authors.lastname: Belanger
authors.forename: Elizabeth W
authors.initials: EW
authors.lastname: Triche
authors.forename: Michael B
authors.initials: MB
authors.lastname: Bracken
authors.forename: William S
authors.initials: WS
authors.lastname: Beckett
authors.forename: Brian P
authors.initials: BP
authors.lastname: Leaderer
mesh_terms: D016902:Air Pollution, Indoor / Q000009:adverse effects* / Q000032:analysis; D000485:Allergens / Q000009:adverse effects* / Q000032:analysis / Q000276:immunology; D000818:Animals; D000829:Animals, Domestic / Q000276:immunology; D001249:Asthma / Q000175:diagnosis / Q000209:etiology* / Q000276:immunology; D002648:Child; D004305:Dose-Response Relationship, Drug; D004391:Dust / Q000032:analysis* / Q000276:immunology; D005260:Female; D006798:Housing / Q000592:standards*; D006801:Humans; D008297:Male; D039981:Pyroglyphidae / Q000276:immunology; D012720:Severity of Illness Index
chemical_list: D000485:Allergens; D004391:Dust