Results of the National Cooperative Inner-City Asthma Study (NCICAS) environmental intervention to reduce cockroach allergen exposure in innercity homes

Peter J. Gergen, Kathleen M. Mortimer, Peyton A. Eggleston, David Rosenstreich, Herman Mitchell, Dennis Ownby, Meyer Kattan, Dean Baker, Elizabeth C. Wright, Raymond Slavin, Floyd Malveaux

Research output: Contribution to journalArticle

153 Scopus citations

Abstract

Background: Cockroach allergen is important in asthma. Practical methods to reduce exposure are needed. Objective: We sought to evaluate the effectiveness of house cleaning and professional extermination on lowering cockroach antigen levels in inner-city dwellings. Methods: As part of the National Cooperative Inner-City Asthma Study intervention, 265 of 331 families with asthmatic children who had positive skin test responses to cockroach allergen consented to a professional home extermination with 2 applications of a cockroach insecticide (Abamectin, Avert) combined with directed education on cockroach allergen removal. On a random subset of 48 homes undergoing cockroach extermination in the intervention group, Bla g 1 was measured in settled dust from the kitchen, bedroom, and TV/living room. The first sample was collected 1 week before extermination, with additional samples after the exterminations at approximately 2, 6, and 12 months after the first sample. Self-reported problems with cockroaches were collected at baseline and after 12 months of follow-up in both the intervention and control group. Results: The geometric mean kitchen level of Bla g 1 decreased at 2 months (33.6 U/g) relative to preextermination levels (68.7 U/g, P < .05). The percent of kitchens with over 8 U/g of Bla g 1 followed a similar pattern, but only the decrease from preextermination to 6-month levels was significant (86.8% vs 64.3%, P < .05). By the 12-month visit, the allergen burden had returned to or exceeded baseline levels. Except for an increase in the bedroom at 2 months (8.9 U/g vs 11.1 U/g, P < .05), no other significant change was seen. Only about 50% of the families followed the cleaning instructions; no greater effect was found in these homes. Self-reported problems with cockroaches showed no difference between the intervention and control group after 1 year of follow-up. Conclusions: Despite a significant, but short-lived, decrease the cockroach allergen burden remained well above levels pre-viously found to be clinically significant.

Original languageEnglish (US)
Pages (from-to)501-506
Number of pages6
JournalJournal of Allergy and Clinical Immunology
Volume103
Issue number3 II
DOIs
StatePublished - 1999

Keywords

  • Bla g 1
  • Cockroach
  • Intervention

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology

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    Gergen, P. J., Mortimer, K. M., Eggleston, P. A., Rosenstreich, D., Mitchell, H., Ownby, D., Kattan, M., Baker, D., Wright, E. C., Slavin, R., & Malveaux, F. (1999). Results of the National Cooperative Inner-City Asthma Study (NCICAS) environmental intervention to reduce cockroach allergen exposure in innercity homes. Journal of Allergy and Clinical Immunology, 103(3 II), 501-506. https://doi.org/10.1016/s0091-6749(99)70477-x