Abatement of cockroach allergens (Bla g 1 and Bla g 2) in low-income, urban housing
Open accessAbstract
Background In the first 6 months of this previously published, randomized trial, the combined intervention of occupant education, insecticide bait application, and professional cleaning significantly reduced cockroach numbers and Bla g 1 allergen levels in inner-city homes.Objective This continuation study investigated whether the cockroach allergen reductions achieved by month 6 could be maintained through month 12 with insecticide application alone.Methods Because we had agreed to place insecticide bait in control homes at the conclusion of the first study, intervention and control homes were treated with insecticide bait at months 6 and 9. No other intervention was conducted in either arm. Vacuumed dust and swab samples were collected at month 12. Twenty-one of the 31 original homes completed the 12-month study.Results Among the original intervention homes, Bla g 1 concentrations remained essentially unchanged from months 6 to 12. However, among the crossed-over control homes, the geometric mean Bla g 1 concentrations (Units per gram of dust) decreased from 287 to 14.4 for kitchen floors (95% reduction), from 28.8 to 5.6 for living room floors/sofas (81% reduction), from 26.7 to 4.7 for bedroom floors (82% reduction), and from 7.2 to 2.4 for beds (67% reduction). At month 12, Bla g 1 concentrations did not significantly differ between intervention and crossed-over control homes (P >.64 at each location). Similar results were seen for the allergen Bla g 2.Conclusions Reductions in cockroach allergen concentrations achieved through the combined intervention of occupant education, insecticide application, and professional cleaning can be maintained with continued cockroach control. Surprisingly, and in contrast to other studies, insecticide application alone significantly lowered allergen concentrations in the crossed-over control homes. This unexpected result is being tested further in another randomized trial.
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Integrated home management consisting of professional cleaning, education, and pest control is not economically sustainable.
“As the expense of integrated home management consisting of professional cleaning, education, and pest control is not economically sustainable, investigations are focused on assessing the efficacy of single interventions, such as extermination alone, to assess possible cost benefits.1135,1143”
From International Consensus Statement on Allergy and Rhinology: Allergic Rhinitis (2018) · cites this paper as [1135]
The Discussion (page unavailable) says the comprehensive intervention costs much more than extermination alone and calls for testing whether extermination alone can reduce allergens. It does not say that the combined approach is economically unsustainable; that conclusion is stronger than the source supports. (LLM, conf=0.88)
Experimental — accuracy not yet measuredProfessional pest control was the most effective treatment for eliminating cockroach infestation and reducing allergen load.
“The most effective treatment for eliminating infestation and reducing allergen load was professional pest control.1135”
From International Consensus Statement on Allergy and Rhinology: Allergic Rhinitis (2018) · cites this paper as [1135]
The Results (page not provided) report that entomologist-guided insecticide bait treatment reduced cockroach trap counts and allergen loads in the crossed-over control homes. But the paper does not establish professional pest control as the most effective treatment or show complete elimination of infestation; the Discussion says the effectiveness of commercial exterminators remained to be determined. (LLM, conf=0.87)
Experimental — accuracy not yet measuredMost studies of cockroach home interventions included one or more interventions aimed at reducing cockroach counts and Bla g 1 and Bla g 2 allergen levels; few focused on eliminating multiple allergens.
“Most studies included 1 or more interventions aimed at reducing cockroach counts and allergen (Bla g 1 and Bla g 2) levels1133-1140; however, a few focused on eliminating multiple allergens (eg, HDM, cockroach, rodent, cat, dog).1141,1142”
From International Consensus Statement on Allergy and Rhinology: Allergic Rhinitis (2018) · cites this paper as [1135]
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- Authors
- Arbes, S. J., Sever, M., Mehta, J., Gore, J. C., Schal, C., Vaughn, B., Mitchell, H., & Zeldin, D. C.
- Affiliations
- National Institutes of Health (US)
- North Carolina State University (US)
- Rho (United States) (US)
- Venue
- Journal of Allergy and Clinical Immunology
- Publisher
- Elsevier BV
- Published
- 2004-01
- Volume
- 113
- Issue
- 1
- Pages
- 109-114
- ISSN
- 0091-6749 (ISSN-L)
- OpenAlex
- W2048482724
- Cited by
- 96
- References
- 8
- Citations by year
- 2026: 5 · 2025: 5 · 2024: 1 · 2023: 2 · 2022: 4 · 2021: 2 · 2020: 2 · 2019: 2 · 2018: 5 · 2017: 6 · 2016: 2 · 2015: 1 · 2014: 2 · 2013: 7 · 2012: 6
- FWCI
- 6.28
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Allergy and Clinical Immunology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- North Carolina State University
- National Institute of Environmental Health Sciences
- National Institute on Minority Health and Health Disparities
- NHLBI Division of Intramural Research
- Topics
- Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Indoor Air Quality and Microbial Exposure
- Health Sciences › Medicine › Immunology and Allergy › Allergic Rhinitis and Sensitization
- Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Insects and Parasite Interactions
- Keywords
- cockroach allergens, Bla g 1, Bla g 2, cockroach control, insecticide baits, professional cleaning, house dust, indoor allergen exposure
- MeSH terms
- Allergens, Animals, Clinical Trials as Topic, Cockroaches, Follow-Up Studies, Housing, Humans, Insect Control, Insecticides, North Carolina, Osmolar Concentration, Patient Education as Topic, Poverty Areas, Urban Population, Aspartic Acid Endopeptidases, Cross-Over Studies, Antigens, Plant
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