title: Indoor particulate matter increases asthma morbidity in children with non-atopic and atopic asthma.
abstract: BACKGROUND
  Compared with atopic asthma, fewer environmental modifications are recommended for non-atopic asthma in children.
  
  
  OBJECTIVE
  To better understand the role of indoor pollutants in provoking non-atopic asthma, we investigated the effect of in-home particulate matter on asthma symptoms among non-atopic and atopic children living in inner-city Baltimore.
  
  
  METHODS
  A cohort of 150 children ages 2 to 6 years with asthma underwent home environmental monitoring for 3-day intervals at baseline, 3, and 6 months. Children were classified as non-atopic if they were skin test negative to a panel of 14 aeroallergens. Caregivers completed questionnaires assessing symptoms and rescue medication use. Longitudinal data analysis included regression models with generalized estimating equations.
  
  
  RESULTS
  Children were primarily African American from lower socioeconomic backgrounds and spent most of their time in the home. Thirty-one percent were non-atopic, and 69% were atopic. Among non-atopic and atopic children, increased in-home fine (PM2.5) and coarse (PM2.5-10) particle concentrations were associated with significant increases in asthma symptoms and rescue medication use ranging from 7% (95% confidence interval [CI], 0-15) to 14% (95% CI, 1-27) per 10 μg/m(3) increase in particle concentration after adjustment for confounders.
  
  
  CONCLUSIONS
  In-home particles similarly cause increased symptoms of asthma in non-atopic and atopic children. Environmental control strategies that reduce particle concentrations may prove to be an effective means of improving asthma outcomes, especially for non-atopic asthma, for which there are few environmental control practice recommendations.
authors: Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205, USA. Mmccor16@jhmi.edu
authors: Meredith C
authors: MC
authors: McCormack
authors: Patrick N
authors: PN
authors: Breysse
authors: Elizabeth C
authors: EC
authors: Matsui
authors: Nadia N
authors: NN
authors: Hansel
authors: Roger D
authors: RD
authors: Peng
authors: Jean
authors: J
authors: Curtin-Brosnan
authors: D'Ann L
authors: DL
authors: Williams
authors: Marsha
authors: M
authors: Wills-Karp
authors: Gregory B
authors: GB
authors: Diette
mesh_terms: D016902:Air Pollution, Indoor / Q000009:adverse effects*; D000485:Allergens / Q000009:adverse effects* / Q000276:immunology; D001249:Asthma / Q000276:immunology / Q000503:physiopathology*; D015142:Baltimore; D002675:Child, Preschool; D015331:Cohort Studies; D004784:Environmental Monitoring / Q000379:methods; D006801:Humans; D008137:Longitudinal Studies; D015999:Multivariate Analysis; D010316:Particle Size; D012882:Skin Tests; D012923:Social Class
chemical_list: D000485:Allergens