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House dust mite and cockroach exposure are strong risk factors for positive allergy skin test responses in the Childhood Asthma Management Program
Open accessAbstract
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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“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]
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“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]
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“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]
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Self-citation
Metadata
- 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)
- 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
- bronze
- doi.org
- Locations
- Journal of Allergy and Clinical Immunology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Immunology and Allergy › Allergic Rhinitis and Sensitization
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › 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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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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