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Abatement of cockroach allergen (Bla g 1) in low-income, urban housing: A randomized controlled trial.

AbstractBACKGROUND:
Clinically relevant reductions in exposure to cockroach allergen, an important risk factor for asthma in inner-city households, have proven difficult to achieve in intervention trials.
OBJECTIVE:
This study investigated a method for the abatement of cockroach allergen in low-income, urban homes. The goal was to reduce mean Bla g 1 concentrations below the previously proposed thresholds for allergic sensitization and asthma morbidity.
METHODS:
A prerandomized, nonmasked trial with 16 intervention and 15 control homes was conducted. Study inclusion was based on 50 to 500 cockroaches trapped in a 3-day period. The interventions consisted of occupant education, placement of insecticide bait, and professional cleaning. Vacuumed dust and multiple swab samples were collected at 0, 1, 2, 4, and 6 months in intervention homes and at 0 and 6 months in control homes. Room maps containing cockroach and allergen data were used to guide and monitor the interventions.
RESULTS:
From 0 to 6 months among intervention homes, geometric mean Bla g 1 concentrations (U/g dust) decreased from 633 to 24 on kitchen floors (96% reduction), from 25 to 4.3 on living room floors/sofas (83% reduction), from 46 to 7.3 on bedroom floors (84% reduction), and from 6.1 to 1.0 in bedroom beds (84% reduction). These reductions, with the exception of that on the bedroom floor (P =.06), were statistically significant relative to changes in control homes.
CONCLUSIONS:
Substantial reductions in cockroach allergen levels can be achieved in inner-city homes. In this study, allergen levels were reduced below the sensitization threshold (2 U/g) in beds, arguably the most relevant site for exposure, and below the asthma morbidity threshold (8 U/g) on bedroom floors and living room floors/sofas. The level on kitchen floors, although reduced 96%, remained above the asthma morbidity threshold. Future studies will test the intervention's effectiveness in asthma prevention trials.
AuthorsSamuel J Arbes Jr, Michelle Sever, Janet Archer, Elizabeth H Long, J Chad Gore, Coby Schal, Michelle Walter, Betsy Nuebler, Ben Vaughn, Herman Mitchell, Eric Liu, Nicholas Collette, Peter Adler, Megan Sandel, Darryl C Zeldin
JournalThe Journal of allergy and clinical immunology (J Allergy Clin Immunol) Vol. 112 Issue 2 Pg. 339-45 (Aug 2003) ISSN: 0091-6749 [Print] United States
PMID12897740 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, P.H.S.)
Chemical References
  • Allergens
  • Antigens, Plant
  • Insecticides
  • allergen Bla g 1
Topics
  • Allergens (analysis, immunology)
  • Antigens, Plant
  • Differential Threshold
  • Household Work
  • Housing
  • Humans
  • Immunization
  • Insect Control
  • Insecticides (pharmacology)
  • Osmolar Concentration
  • Patient Education as Topic
  • Poverty Areas
  • Urban Population

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