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Cited by 315Allergic Rhinitis and SensitizationAsthma and respiratory diseasesIndoor Air Quality and Microbial Exposure

House dust mite and cockroach exposure are strong risk factors for positive allergy skin test responses in the Childhood Asthma Management Program

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Huss, Karen, Adkinson, N.Franklin, Eggleston, Peyton A., Dawson, Christopher, Van Natta, Mark L., Hamilton, Robert G.·2001·Journal of Allergy and Clinical Immunology
DOI 10.1067/mai.2001.111146
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Abstract

Background Children with asthma have a high prevalence of environmental allergies, especially to indoor allergens. The relationships of exposure to indoor allergens (dust mites, cat, dog, cockroach, and molds) and other host factors to allergy sensitization have not been evaluated simultaneously in a large cohort.Objectives We studied 1041 children aged 5 to 12 years with mild-to-moderate asthma to determine risk factors associated with having positive allergy skin test responses to indoor allergens. Also, we described, compared, and contrasted 6 allergens in the home environments of these children from 8 North American cities.Methods Data were used from baseline visits of the Childhood Asthma Management Program. Patients' sensitivities to house dust mites (Dermatophagoides farinae and Dermatophagoides pteronyssinus), cats, dogs, cockroaches, and molds were examined for relationships to demographic variables, home dust allergen exposures, number of other positive allergy skin test responses, total serum IgE levels, and smoking in the home.Results San Diego (78.5%) and Toronto (59.3%) had the topmost percentages of homes with moderate-to-high house dust mite levels. Boston (21.5%), St Louis (16.3%), and Baltimore (13.4%) had the highest percentages of homes with detectable levels of cockroach allergen. For house dust mites, the higher the level of allergen exposure, the more likely patients were to have positive allergy skin test responses, with relative odds of 9.0 (95% confidence interval, 5.4-15.1) for those exposed to high mite levels (>10.0 microg/g dust) relative to those unexposed. Even exposure to low levels of mite allergen (0.020-2.0 microg/g) was found to be a significant risk factor for sensitization. For cockroach allergen, those with detectable home exposure were more likely to have positive skin test responses (relative odds, 2.2; 95% confidence interval, 1.3-3.8) than those with undetectable exposure. In contrast, levels of exposure to cat, dog, and mold allergens were not related to sensitization rates. For cat allergen, this may reflect lower rates of cat ownership among highly sensitized subjects. Furthermore, the number of allergy skin test responses that were positive, excluding the test for the outcome of interest for each model, and total serum IgE levels were strong independent predictors of sensitization.Conclusions Levels of exposure determined by house dust analysis are important determinants of sensitization for dust mite and cockroach allergen. This relationship was not demonstrable for cat, dog, or mold allergens, possibly because of confounding factors. For all allergens studied, the degree of atopy, determined by the total number of positive skin test responses or by total serum IgE levels, is an important contributing risk factor for sensitization.

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Crossref · 10.1067/mai.2001.111146

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  • Dust mite allergens occur in fecal particles 10-40 microns in size and are present at high concentrations in settled dust.

    “Dust mite allergens are found in fecal particles measuring 10–40 microns and are present in high concentrations within settled dust (48).”

    From Indoor Allergen Interventions in Homes and Schools for Managing Asthma (2025) · cites this paper as [48]

    The House dust specimen collection section reports mite allergens in vacuumed household dust, and Geography of house dust allergen levels reports high or moderate levels in some homes. Neither section describes fecal particles or gives a particle size of 10–40 microns; the paper also does not characterize concentrations in settled dust as uniformly high. (LLM, conf=0.85)

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  • Der p 1 and Der f 1 are the most important dust mite species affecting people worldwide.

    “Dermatophagoides pteronyssinus (Der p 1) and D. farinae (Der f 1) are the most significant dust mite species affecting individuals worldwide (33,48).”

    From Indoor Allergen Interventions in Homes and Schools for Managing Asthma (2025) · cites this paper as [48]

    The House dust specimen collection section identifies Der p 1 and Der f 1 as major mite allergens, and Geography of house dust allergen levels reports where the corresponding mites prevailed across the study’s eight sites (page numbers unavailable). The paper does not establish that these are the most significant dust mite species worldwide; Der p 1 and Der f 1 are allergen names, not species names. (LLM, conf=0.86)

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  • The main indoor reservoirs for dust mites are mattresses, pillows, upholstered furniture, carpets, and stuffed toys.

    “Their primary reservoirs within homes include mattresses, pillows, upholstered furniture, carpets, and stuffed toys (48).”

    From Indoor Allergen Interventions in Homes and Schools for Managing Asthma (2025) · cites this paper as [48]

    The House dust specimen collection section describes sampling mattresses, carpets, and upholstered furniture for mite allergens; the Discussion also mentions mattress and pillow encasings. The paper does not identify these as the primary reservoirs or include stuffed toys in that list, and it does not assess the listed items separately. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

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Cites

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1 of the 30 references couldn’t be matched to a known paper.

Research works printed but not linked: 4

  1. [15]15. Childhood Asthma Management Program Research Group. The Child- hood Asthma Management Program (CAMP): design, rationale, and methods. Control Clin Trials 1999;20:91-120.
  2. [16]16. Chapman MD, Smith AM, Slunt JB, Vailes LD, Arruda LK. Immuno- chemical and molecular method for defining and measuring indoor aller- gens: in dust and air. Pediatr Allergy Immunol 1995;6:8-12.
  3. [17]17. Hamilton RG, Chapman MD, Platts-Mills TAE, Adkinson NF Jr. House dust aeroallergen measurements in clinical practice: a guide to allergen free home and work environments. Immunol Allergy Prac 1992;14:96-112.
  4. [21]21. SAS Institute Inc. SAS/STAT user's guide, version 6.12. Fourth ed. Vol. 1-2. Cary (NC): SAS Institute, Inc; 1989.

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Authors
Huss, K., Adkinson, N. F., Eggleston, P. A., Dawson, C., Van Natta, M. L., & Hamilton, R. G.
Affiliations
Johns Hopkins University (US)
ORCID
Hamilton, Robert G.
Venue
Journal of Allergy and Clinical Immunology
Publisher
Elsevier BV
Published
2001-01
Volume
107
Issue
1
Pages
48-54
ISSN
0091-6749 (ISSN-L)
DOI
10.1067/mai.2001.111146
OpenAlex
W2082906220
Cited by
315
References
30
Citations by year
2026: 1 · 2025: 6 · 2024: 4 · 2023: 4 · 2022: 2 · 2021: 7 · 2020: 3 · 2019: 10 · 2018: 8 · 2017: 13 · 2016: 11 · 2015: 16 · 2014: 20 · 2013: 9 · 2012: 14
FWCI
8.98
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Allergy and Clinical Immunology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Immunology and Allergy › Allergic Rhinitis and Sensitization
  • Health Sciences › Medicine › Physiology › Asthma and respiratory diseases
  • Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Indoor Air Quality and Microbial Exposure
Keywords
house dust mite allergy, cockroach allergens, indoor allergens, allergen sensitization, childhood asthma, Dermatophagoides farinae, Dermatophagoides pteronyssinus, cat allergen, dog allergen, mold allergens, serum IgE, household smoking, risk factors, Childhood Asthma Management Program, cross-reactivity
MeSH terms
Allergens, Animals, Asthma, Cats, Child, Child, Preschool, Cockroaches, Cross-Sectional Studies, Dogs, Dose-Response Relationship, Immunologic, Dust, Female, Humans, Hypersensitivity, Immediate, Immunoglobulin E, Male, Mites, Risk Factors, Skin Tests, Air Pollution, Indoor

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