TY - JOUR
T1 - Indoor environmental exposures and obstructive lung disease phenotypes among children with asthma living in poor urban neighborhoods
AU - Grant, Torie
AU - Lilley, Travis
AU - McCormack, Meredith C.
AU - Rathouz, Paul J.
AU - Peng, Roger
AU - Keet, Corinne A.
AU - Rule, Ana
AU - Davis, Meghan
AU - Balcer-Whaley, Susan
AU - Newman, Michelle
AU - Matsui, Elizabeth C.
N1 - Publisher Copyright:
© 2022 American Academy of Allergy, Asthma & Immunology
PY - 2023/3
Y1 - 2023/3
N2 - Background: Air trapping is an obstructive phenotype that has been associated with more severe and unstable asthma in children. Air trapping has been defined using pre- and postbronchodilator spirometry. The causes of air trapping are not completely understood. It is possible that environmental exposures could be implicated in air trapping in children with asthma. Objective: We investigated the association between indoor exposures and air trapping in urban children with asthma. Methods: Children with asthma aged 5 to 17 years living in Baltimore and enrolled onto the Environmental Control as Add-on Therapy for Childhood Asthma study were evaluated for air trapping using spirometry. Aeroallergen sensitization was assessed at baseline, and spirometry was performed at 0, 3, and 6 months. Air trapping was defined as an FVC z score of less than −1.64 or a change in FVC with bronchodilation of ≥10% predicted. Logistic normal random effects models were used to evaluate associations of air trapping and indoor exposures. Results: Airborne and bedroom floor mouse allergen concentrations were associated with air trapping but not airflow limitation (odds ratio 1.19, 95% confidence interval 1.02-1.37, P = .02 per 2-fold increase in airborne mouse allergen; odds ratio 1.23, 95% confidence interval 1.07-1.41, P = .003 per 2-fold increase in bedroom floor mouse allergen). Other indoor exposures (cockroach, cat, dog, dust mite, particulate matter, and nicotine) were not associated with air trapping or airflow limitation. Conclusion: Mouse allergen exposure, but not other indoor exposure, was associated with air trapping in urban children with asthma.
AB - Background: Air trapping is an obstructive phenotype that has been associated with more severe and unstable asthma in children. Air trapping has been defined using pre- and postbronchodilator spirometry. The causes of air trapping are not completely understood. It is possible that environmental exposures could be implicated in air trapping in children with asthma. Objective: We investigated the association between indoor exposures and air trapping in urban children with asthma. Methods: Children with asthma aged 5 to 17 years living in Baltimore and enrolled onto the Environmental Control as Add-on Therapy for Childhood Asthma study were evaluated for air trapping using spirometry. Aeroallergen sensitization was assessed at baseline, and spirometry was performed at 0, 3, and 6 months. Air trapping was defined as an FVC z score of less than −1.64 or a change in FVC with bronchodilation of ≥10% predicted. Logistic normal random effects models were used to evaluate associations of air trapping and indoor exposures. Results: Airborne and bedroom floor mouse allergen concentrations were associated with air trapping but not airflow limitation (odds ratio 1.19, 95% confidence interval 1.02-1.37, P = .02 per 2-fold increase in airborne mouse allergen; odds ratio 1.23, 95% confidence interval 1.07-1.41, P = .003 per 2-fold increase in bedroom floor mouse allergen). Other indoor exposures (cockroach, cat, dog, dust mite, particulate matter, and nicotine) were not associated with air trapping or airflow limitation. Conclusion: Mouse allergen exposure, but not other indoor exposure, was associated with air trapping in urban children with asthma.
KW - Pediatric asthma
KW - air trapping
KW - indoor environmental exposures
KW - mouse allergen exposure
KW - urban asthma
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U2 - 10.1016/j.jaci.2022.08.032
DO - 10.1016/j.jaci.2022.08.032
M3 - Article
C2 - 36395986
AN - SCOPUS:85144446886
SN - 0091-6749
VL - 151
SP - 716-722.e8
JO - Journal of Allergy and Clinical Immunology
JF - Journal of Allergy and Clinical Immunology
IS - 3
ER -