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. 1995 Nov;73(5):408–412. doi: 10.1136/adc.73.5.408

Indoor environmental risk factors in young asthmatics: a case-control study.

A Lindfors 1, M Wickman 1, G Hedlin 1, G Pershagen 1, H Rietz 1, S L Nordvall 1
PMCID: PMC1511369  PMID: 8554356

Abstract

One hundred and ninety three children with asthma and 318 controls aged 1-4 years were evaluated for atopic heredity and exposure to possible indoor risk factors for asthma-for example exposure to furred pets, tobacco smoke, and home dampness. A subgroup of cases were classified as cat and/or dog allergic on the basis of skin prick tests. Heredity for asthma was a significant risk factor (odds ratio (OR) 3.0, confidence interval (CI) 2.1 to 4.6). Environmental tobacco smoke was associated with an excess risk for asthma (OR 1.7, CI 1.1 to 2.3) and signs of home dampness tended to increase this risk (OR 1.3, CI 0.9 to 2.0). High dose exposure to cat and/or dog resulted in an increased risk only in asthma cases sensitised to cat and/or dog (OR 2.7, CI 1.0 to 7.3). A combination of high dose exposure to cat and/or dog, environmental tobacco smoke and damp housing was associated with an OR of 8.0 (CI 1.9 to 34.1). Raised indoor humidity has been shown to reflect low air exchange, which may also lead to increased doses of inhaled aeroallergens and tobacco smoke, and contribute to the interaction between the three risk factors.

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Selected References

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  1. Aberg N. Asthma and allergic rhinitis in Swedish conscripts. Clin Exp Allergy. 1989 Jan;19(1):59–63. doi: 10.1111/j.1365-2222.1989.tb02345.x. [DOI] [PubMed] [Google Scholar]
  2. Andrae S., Axelson O., Björkstén B., Fredriksson M., Kjellman N. I. Symptoms of bronchial hyperreactivity and asthma in relation to environmental factors. Arch Dis Child. 1988 May;63(5):473–478. doi: 10.1136/adc.63.5.473. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Arshad S. H., Matthews S., Gant C., Hide D. W. Effect of allergen avoidance on development of allergic disorders in infancy. Lancet. 1992 Jun 20;339(8808):1493–1497. doi: 10.1016/0140-6736(92)91260-f. [DOI] [PubMed] [Google Scholar]
  4. Brunekreef B., Groot B., Hoek G. Pets, allergy and respiratory symptoms in children. Int J Epidemiol. 1992 Apr;21(2):338–342. doi: 10.1093/ije/21.2.338. [DOI] [PubMed] [Google Scholar]
  5. Burr M. L., Butland B. K., King S., Vaughan-Williams E. Changes in asthma prevalence: two surveys 15 years apart. Arch Dis Child. 1989 Oct;64(10):1452–1456. doi: 10.1136/adc.64.10.1452. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Chandra R. K., Hamed A. Cumulative incidence of atopic disorders in high risk infants fed whey hydrolysate, soy, and conventional cow milk formulas. Ann Allergy. 1991 Aug;67(2 Pt 1):129–132. [PubMed] [Google Scholar]
  7. Chandra R. K., Puri S., Hamed A. Influence of maternal diet during lactation and use of formula feeds on development of atopic eczema in high risk infants. BMJ. 1989 Jul 22;299(6693):228–230. doi: 10.1136/bmj.299.6693.228. [DOI] [PMC free article] [PubMed] [Google Scholar] [Retracted]
  8. Cockcroft D. W. Cigarette smoking, airway hyperresponsiveness, and asthma. Chest. 1988 Oct;94(4):675–676. doi: 10.1378/chest.94.4.675. [DOI] [PubMed] [Google Scholar]
  9. Croner S., Kjellman N. I. Natural history of bronchial asthma in childhood. A prospective study from birth up to 12-14 years of age. Allergy. 1992 Apr;47(2 Pt 2):150–157. doi: 10.1111/j.1398-9995.1992.tb00956.x. [DOI] [PubMed] [Google Scholar]
  10. Cullinan P., Taylor A. J. Asthma in children: environmental factors. BMJ. 1994 Jun 18;308(6944):1585–1586. doi: 10.1136/bmj.308.6944.1585. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Duff A. L., Pomeranz E. S., Gelber L. E., Price G. W., Farris H., Hayden F. G., Platts-Mills T. A., Heymann P. W. Risk factors for acute wheezing in infants and children: viruses, passive smoke, and IgE antibodies to inhalant allergens. Pediatrics. 1993 Oct;92(4):535–540. [PubMed] [Google Scholar]
  12. Dybendal T., Elsayed S. Dust from carpeted and smooth floors. VI. Allergens in homes compared with those in schools in Norway. Allergy. 1994 Apr;49(4):210–216. doi: 10.1111/j.1398-9995.1994.tb02651.x. [DOI] [PubMed] [Google Scholar]
  13. Foucard T. Allergy and allergy-like symptoms in 1,050 medical students. Allergy. 1991 Jan;46(1):20–26. doi: 10.1111/j.1398-9995.1991.tb00537.x. [DOI] [PubMed] [Google Scholar]
  14. Haahtela T., Lindholm H., Björkstén F., Koskenvuo K., Laitinen L. A. Prevalence of asthma in Finnish young men. BMJ. 1990 Aug 4;301(6746):266–268. doi: 10.1136/bmj.301.6746.266. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Hattevig G., Kjellman B., Sigurs N., Björkstén B., Kjellman N. I. Effect of maternal avoidance of eggs, cow's milk and fish during lactation upon allergic manifestations in infants. Clin Exp Allergy. 1989 Jan;19(1):27–32. doi: 10.1111/j.1365-2222.1989.tb02339.x. [DOI] [PubMed] [Google Scholar]
  16. Ishizaki T., Koizumi K., Ikemori R., Ishiyama Y., Kushibiki E. Studies of prevalence of Japanese cedar pollinosis among the residents in a densely cultivated area. Ann Allergy. 1987 Apr;58(4):265–270. [PubMed] [Google Scholar]
  17. Kagamimori S., Katoh T., Naruse Y., Watanabe M., Kasuya M., Shinkai J., Kawano S. The changing prevalence of respiratory symptoms in atopic children in response to air pollution. Clin Allergy. 1986 Jul;16(4):299–308. doi: 10.1111/j.1365-2222.1986.tb01961.x. [DOI] [PubMed] [Google Scholar]
  18. Luczynska C. M., Li Y., Chapman M. D., Platts-Mills T. A. Airborne concentrations and particle size distribution of allergen derived from domestic cats (Felis domesticus). Measurements using cascade impactor, liquid impinger, and a two-site monoclonal antibody assay for Fel d I. Am Rev Respir Dis. 1990 Feb;141(2):361–367. doi: 10.1164/ajrccm/141.2.361. [DOI] [PubMed] [Google Scholar]
  19. Munir A. K., Björkstén B., Einarsson R., Schou C., Ekstrand-Tobin A., Warner A., Kjellman N. I. Cat (Fel d I), dog (Can f I), and cockroach allergens in homes of asthmatic children from three climatic zones in Sweden. Allergy. 1994 Aug;49(7):508–516. doi: 10.1111/j.1398-9995.1994.tb01121.x. [DOI] [PubMed] [Google Scholar]
  20. Munir A. K., Einarsson R., Schou C., Dreborg S. K. Allergens in school dust. I. The amount of the major cat (Fel d I) and dog (Can f I) allergens in dust from Swedish schools is high enough to probably cause perennial symptoms in most children with asthma who are sensitized to cat and dog. J Allergy Clin Immunol. 1993 May;91(5):1067–1074. doi: 10.1016/0091-6749(93)90221-z. [DOI] [PubMed] [Google Scholar]
  21. Murray A. B., Ferguson A. C., Morrison B. J. The frequency and severity of cat allergy vs. dog allergy in atopic children. J Allergy Clin Immunol. 1983 Aug;72(2):145–149. doi: 10.1016/0091-6749(83)90522-5. [DOI] [PubMed] [Google Scholar]
  22. Nordvall S. L., Eriksson M., Rylander E., Schwartz B. Sensitization of children in the Stockholm area to house dust mites. Acta Paediatr Scand. 1988 Sep;77(5):716–720. doi: 10.1111/j.1651-2227.1988.tb10736.x. [DOI] [PubMed] [Google Scholar]
  23. Platt S. D., Martin C. J., Hunt S. M., Lewis C. W. Damp housing, mould growth, and symptomatic health state. BMJ. 1989 Jun 24;298(6689):1673–1678. doi: 10.1136/bmj.298.6689.1673. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Popp W., Rauscher H., Sertl K., Wanke T., Zwick H. Risk factors for sensitization to furred pets. Allergy. 1990 Jan;45(1):75–79. doi: 10.1111/j.1398-9995.1990.tb01087.x. [DOI] [PubMed] [Google Scholar]
  25. Popp W., Zwick H., Steyrer K., Rauscher H., Wanke T. Sensitization to aeroallergens depends on environmental factors. Allergy. 1989 Nov;44(8):572–575. doi: 10.1111/j.1398-9995.1989.tb04202.x. [DOI] [PubMed] [Google Scholar]
  26. Robins J., Greenland S., Breslow N. E. A general estimator for the variance of the Mantel-Haenszel odds ratio. Am J Epidemiol. 1986 Nov;124(5):719–723. doi: 10.1093/oxfordjournals.aje.a114447. [DOI] [PubMed] [Google Scholar]
  27. Ronchetti R., Bonci E., Cutrera R., De Castro G., Indinnimeo L., Midulla F., Tancredi G., Martinez F. D. Enhanced allergic sensitisation related to parental smoking. Arch Dis Child. 1992 Apr;67(4):496–500. doi: 10.1136/adc.67.4.496. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. Roorda R. J., Gerritsen J., van Aalderen W. M., Knol K. Influence of a positive family history and associated allergic diseases on the natural course of asthma. Clin Exp Allergy. 1992 Jun;22(6):627–634. doi: 10.1111/j.1365-2222.1992.tb00179.x. [DOI] [PubMed] [Google Scholar]
  29. Rylander E., Pershagen G., Eriksson M., Nordvall L. Parental smoking and other risk factors for wheezing bronchitis in children. Eur J Epidemiol. 1993 Sep;9(5):517–526. doi: 10.1007/BF00209530. [DOI] [PubMed] [Google Scholar]
  30. Rylander E., Pershagen G., Eriksson M., Nordvall L. Parental smoking and other risk factors for wheezing bronchitis in children. Eur J Epidemiol. 1993 Sep;9(5):517–526. doi: 10.1007/BF00209530. [DOI] [PubMed] [Google Scholar]
  31. Rylander E., Pershagen G., Eriksson M., Nordvall L. Parental smoking and other risk factors for wheezing bronchitis in children. Eur J Epidemiol. 1993 Sep;9(5):517–526. doi: 10.1007/BF00209530. [DOI] [PubMed] [Google Scholar]
  32. Sears M. R., Herbison G. P., Holdaway M. D., Hewitt C. J., Flannery E. M., Silva P. A. The relative risks of sensitivity to grass pollen, house dust mite and cat dander in the development of childhood asthma. Clin Exp Allergy. 1989 Jul;19(4):419–424. doi: 10.1111/j.1365-2222.1989.tb02408.x. [DOI] [PubMed] [Google Scholar]
  33. Sporik R., Holgate S. T., Cogswell J. J. Natural history of asthma in childhood--a birth cohort study. Arch Dis Child. 1991 Sep;66(9):1050–1053. doi: 10.1136/adc.66.9.1050. [DOI] [PMC free article] [PubMed] [Google Scholar]
  34. Strachan D. P. Damp housing and childhood asthma: validation of reporting of symptoms. BMJ. 1988 Nov 12;297(6658):1223–1226. doi: 10.1136/bmj.297.6658.1223. [DOI] [PMC free article] [PubMed] [Google Scholar]
  35. Taylor B., Wadsworth J., Wadsworth M., Peckham C. Changes in the reported prevalence of childhood eczema since the 1939-45 war. Lancet. 1984 Dec 1;2(8414):1255–1257. doi: 10.1016/s0140-6736(84)92805-8. [DOI] [PubMed] [Google Scholar]
  36. Warner J. O., Price J. A. Aero-allergen avoidance in the prevention and treatment of asthma. Clin Exp Allergy. 1990 Sep;20 (Suppl 3):15–19. doi: 10.1111/j.1365-2222.1990.tb02465.x. [DOI] [PubMed] [Google Scholar]
  37. Wickman M., Emenius G., Egmar A. C., Axelsson G., Pershagen G. Reduced mite allergen levels in dwellings with mechanical exhaust and supply ventilation. Clin Exp Allergy. 1994 Feb;24(2):109–114. doi: 10.1111/j.1365-2222.1994.tb00205.x. [DOI] [PubMed] [Google Scholar]
  38. Wickman M., Nordvall S. L., Pershagen G., Sundell J., Schwartz B. House dust mite sensitization in children and residential characteristics in a temperate region. J Allergy Clin Immunol. 1991 Jul;88(1):89–95. doi: 10.1016/0091-6749(91)90305-8. [DOI] [PubMed] [Google Scholar]
  39. deShazo R. D., Nordberg J., Baser Y., Bozelka B., Weill H., Salvaggio J. Analysis of depressed cell-mediated immunity in asbestos workers. J Allergy Clin Immunol. 1983 Apr;71(4):418–424. doi: 10.1016/0091-6749(83)90072-6. [DOI] [PubMed] [Google Scholar]

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