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Van Horne YO, Farzan SF, Razafy M, Johnston JE. Respiratory and allergic health effects in children living near agriculture: A review. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 832:155009. [PMID: 35381238 PMCID: PMC9167771 DOI: 10.1016/j.scitotenv.2022.155009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 03/08/2022] [Accepted: 03/30/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Exposure to pesticides and agricultural burning are likely to co-occur in agricultural communities, but these exposures have remained distinct bodies of research. We reviewed epidemiological studies to identify the respiratory health effects of children exposed to pesticides and agricultural burning through a systematic evaluation of peer-reviewed publications of children living in industrial agricultural areas. METHODS Two academic search databases (PubMed and Scopus) were queried for all available studies published in English before May 31st, 2021. The initial search combining both exposure metrics (pesticides and agricultural burning) yielded zero publications and thus the queries were performed and presented separately. RESULTS Studies were categorized based on main exposure of interest (i.e., pesticides or agricultural burning) and by respiratory health outcome assessment (i.e., self-reported asthma, acute respiratory symptoms, and lung function measurements). In total we identified 25 studies that focused on pesticide exposures and children's respiratory health, and 12 studies that focused on exposure to agricultural burning and children's respiratory health. A majority of the pesticide studies (18/25) reported a positive association between exposure to pesticides and adverse childhood respiratory health effects. Similarly, most (11/12) of the agricultural burning studies also reported a positive association between exposure to agricultural burning and adverse respiratory health effects. CONCLUSION The most frequently studied health outcomes in these publications were acute respiratory symptoms (n = 11 pesticides, n = 3 agricultural burning), followed by asthma (n = 9 pesticides, n = 3 agricultural burning), and lung function measurements (n = 5 pesticides, n = 6 agricultural burning). Although health outcome assessment differed between pesticide studies and agricultural burning studies, similar adverse respiratory health effects were observed across the majority of studies.
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Affiliation(s)
- Yoshira Ornelas Van Horne
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, 2001 N. Soto Street, Los Angeles, CA 90032, USA.
| | - Shohreh F Farzan
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, 2001 N. Soto Street, Los Angeles, CA 90032, USA
| | - Mitiasoa Razafy
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, 2001 N. Soto Street, Los Angeles, CA 90032, USA
| | - Jill E Johnston
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, 2001 N. Soto Street, Los Angeles, CA 90032, USA
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Indoor Microbial Exposures and Chronic Lung Disease: From Microbial Toxins to the Microbiome. Clin Chest Med 2021; 41:777-796. [PMID: 33153695 DOI: 10.1016/j.ccm.2020.08.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Effects of environmental microbial exposures on human health have long been of interest. Microbes were historically assumed to be harmful, but data have suggested that microbial exposures can modulate the immune system. We focus on the effects of indoor environmental microbial exposure on chronic lung diseases. We found contradictory data in bacterial studies using endotoxin as a surrogate for bacterial exposure. Contradictory data also exist in studies of fungal exposure. Many factors may modulate the effect of environmental microbial exposures on lung health, including coexposures. Future studies need to clarify which method of assessing environmental microbial exposures is most relevant.
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3
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Wu T, Fu M, Valkonen M, Täubel M, Xu Y, Boor BE. Particle Resuspension Dynamics in the Infant Near-Floor Microenvironment. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2021; 55:1864-1875. [PMID: 33450149 DOI: 10.1021/acs.est.0c06157] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Carpet dust contains microbial and chemical material that can impact early childhood health. Infants may be exposed to greater quantities of resuspended dust, given their close proximity to floor surfaces. Chamber experiments with a robotic infant were integrated with a material balance model to provide new fundamental insights into the size-dependency of infant crawling-induced particle resuspension and exposure. The robotic infant was exposed to resuspended particle concentrations from 105 to 106 m-3 in the near-floor (NF) microzone during crawling, with concentrations generally decreasing following vacuum cleaning of the carpets. A pronounced vertical variation in particle concentrations was observed between the NF microzone and bulk air. Resuspension fractions for crawling are similar to those for adult walking, with values ranging from 10-6 to 10-1 and increasing with particle size. Meaningful amounts of dust are resuspended during crawling, with emission rates of 0.1 to 2 × 104 μg h-1. Size-resolved inhalation intake fractions ranged from 5 to 8 × 103 inhaled particles per million resuspended particles, demonstrating that a significant fraction of resuspended particles can be inhaled. A new exposure metric, the dust-to-breathing zone transport efficiency, was introduced to characterize the overall probability of a settled particle being resuspended and delivered to the respiratory airways. Values ranged from less than 0.1 to over 200 inhaled particles per million settled particles, increased with particle size, and varied by over 2 orders of magnitude among 12 carpet types.
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Affiliation(s)
- Tianren Wu
- Lyles School of Civil Engineering, Purdue University, West Lafayette, Indiana 47907, United States
- Ray W. Herrick Laboratories, Center for High Performance Buildings, Purdue University, West Lafayette, Indiana 47907, United States
| | - Manjie Fu
- Ray W. Herrick Laboratories, Center for High Performance Buildings, Purdue University, West Lafayette, Indiana 47907, United States
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, Indiana 47907, United States
| | - Maria Valkonen
- Environmental Health Unit, Finnish Institute for Health and Welfare, Kuopio 70701, Finland
| | - Martin Täubel
- Environmental Health Unit, Finnish Institute for Health and Welfare, Kuopio 70701, Finland
| | - Ying Xu
- Department of Building Science, Tsinghua University, Beijing 100084, China
| | - Brandon E Boor
- Lyles School of Civil Engineering, Purdue University, West Lafayette, Indiana 47907, United States
- Ray W. Herrick Laboratories, Center for High Performance Buildings, Purdue University, West Lafayette, Indiana 47907, United States
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Vlaski E, Stavrikj K, Kimovska M, Cholakovska VC, Lawson JA. Divergent trends in the prevalence of asthma-like symptoms and asthma in a developing country: three repeated surveys between 2002 and 2016. Allergol Immunopathol (Madr) 2020; 48:475-483. [PMID: 32284265 DOI: 10.1016/j.aller.2019.11.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 10/22/2019] [Accepted: 11/12/2019] [Indexed: 12/14/2022]
Abstract
INTRODUCTION AND OBJECTIVES There have been differences in temporal trends of asthma prevalence by geographic region and economic prosperity. The aim of this study was to assess temporal trends in asthma prevalence among young adolescents in Skopje, Republic of North Macedonia as a developing country with a low asthma prevalence. SUBJECTS AND METHODS Data were obtained from three cross-sectional surveys (2002, 2006, and 2016) of adolescents (12-15 years) from randomly selected schools in Skopje. Trends in the prevalence of asthma and asthma-like symptoms were investigated descriptively and using multiple logistic regression to adjust for potential confounding factors. RESULTS The prevalence of asthma increased, although the changes were not statistically significant (2002: 1.7%; 2006: 2.0%; 2016: 2.8%; p=0.075). Statistically significant (p<0.05) reductions in wheeze prevalence over time (2002, 2006, 2016) were observed for current wheeze (8.8%, 7.2%, 5.5%), exercise-induced wheeze (14.2%, 7.9%, 1.9%), and night dry cough (16.5%, 13.5%, 9.6%). After adjustment for potential confounding factors, there was an increase in asthma likelihood by year compared to 2002 (2006: OR=1.22, 95%CI=0.67-2.22; 2016: OR=2.45, 95%CI=1.24-4.84). In the adjusted analyses, associations between year and the asthma-like symptoms confirmed the descriptive results, except for current wheeze, where statistical significance disappeared. CONCLUSIONS Divergent trends in prevalence with a decrease in asthma-like symptoms and an increase in physician-diagnosed asthma in Skopje during a period of 14 years were established. Improved asthma labelling and effective preventative treatment of symptoms may explain some of these changes, although changes in environment and lifestyle could not be ruled out.
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Affiliation(s)
- E Vlaski
- Department of Pulmonology and Allergology, University Children's Clinic, Skopje, Republic of North Macedonia.
| | - K Stavrikj
- Department of Immunology, University Children's Clinic, Skopje, Republic of North Macedonia
| | - M Kimovska
- Intensive Care Unit, University Children's Clinic, Skopje, Republic of North Macedonia
| | - V C Cholakovska
- Department of Pulmonology and Allergology, University Children's Clinic, Skopje, Republic of North Macedonia
| | - J A Lawson
- Department of Medicine and Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Canada
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Gehring U, Wijga AH, Koppelman GH, Vonk JM, Smit HA, Brunekreef B. House dust endotoxin, asthma and allergic sensitization through childhood into adolescence. Clin Exp Allergy 2020; 50:1055-1064. [PMID: 32640057 PMCID: PMC7540017 DOI: 10.1111/cea.13705] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 04/28/2020] [Accepted: 07/02/2020] [Indexed: 12/17/2022]
Abstract
Background House dust endotoxin may have beneficial effects on allergic sensitization and asthma in children. Evidence is scarce for adolescents and most studies so far have been cross‐sectional and limited to a single exposure measurement. Objective We assessed associations of house dust endotoxin with asthma and allergic sensitization from birth to age 17 years longitudinally taking into account exposure early in life and at primary school age. Methods We used data of 854 participants of the prospective Dutch PIAMA birth cohort study with house dust endotoxin measurements at 3 months and/or 5‐6 years and data on asthma and/or allergic sensitization from at least one of 11 follow‐ups until age 17. We assessed overall and age‐specific associations of the prevalence of asthma and sensitization with mattress and living room floor dust concentrations (per gram of dust) and loads (per m2 of sampling surface). Results Higher living room floor dust endotoxin concentrations at 3 months were associated with lower odds of asthma until age 4 [odds ratio (95% confidence interval) ranging from 0.70 (0.51‐0.97) at age 1 to 0.76 (0.57‐1.00) at age 3 per interquartile range increase], but not thereafter in children of allergic mothers. Higher living room floor dust endotoxin at 5‐6 years was associated with higher odds of sensitization at 8‐16 years [eg odds ratio (95% confidence interval) 1.70 (1.17‐2.47) per interquartile range increase in endotoxin load]. Conclusions and clinical relevance House dust endotoxin may have beneficial effects on asthma in preschool children of allergic mothers, which do not persist into adolescence. Beneficial associations with allergic sensitization could not be confirmed.
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Affiliation(s)
- Ulrike Gehring
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Alet H Wijga
- Center for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Gerard H Koppelman
- Department of Pediatric Pulmonology, Beatrix Children's Hospital, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,Groningen Research Institute for Asthma and COPD, University of Groningen, Groningen, The Netherlands
| | - Judith M Vonk
- Groningen Research Institute for Asthma and COPD, University of Groningen, Groningen, The Netherlands.,Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Henriëtte A Smit
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands
| | - Bert Brunekreef
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands.,Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands
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Tsuang A, Grishin A, Grishina G, Do AN, Sordillo J, Chew GL, Bunyavanich S. Endotoxin, food allergen sensitization, and food allergy: A complementary epidemiologic and experimental study. Allergy 2020; 75:625-635. [PMID: 31535385 DOI: 10.1111/all.14054] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 08/02/2019] [Accepted: 08/09/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Household endotoxin levels have been variably associated with risk for asthma and atopy. METHODS We studied participants from the 2005-2006 National Health and Nutrition Examination Survey (NHANES, n = 6963), a large cohort representative of the US population (aged 1-84 years). We built logistic regression models to test for associations between house dust endotoxin and sensitization to specific foods (milk, egg, and peanut). To experimentally explore the detected epidemiologic associations, peripheral blood mononuclear cells (PBMCs) were collected from 21 children (aged 1-19 years) mono-food allergic (ie, sensitized and clinically reactive) to milk, egg, or peanut and nonallergic controls for stimulation with endotoxin and secreted cytokine measurement. For each food allergy, linear mixed-effects models were built to test the association between endotoxin stimulation and cytokine level. RESULTS Among NHANES subjects, the geometric mean household endotoxin level was 15.5 EU/mg (GSE 0.5). Prevalence of food allergen sensitization (sIgE ≥ 0.35 kUA /L) varied by food: milk 5.7%, egg 4.0%, and peanut 7.9%. In models adjusted for potential confounders (age, race, country of birth, total people per household, US region, and history of wheezing in the past year), household endotoxin level was associated with sensitization to milk (OR 1.7, 95% CI 1.2-2.1) and egg (OR 1.4, 95% CI 1.01-1.9), but not peanut (OR 0.98, 95% CI 0.8-1.2). Interferon-γ levels of endotoxin-stimulated PBMCs from children allergic to milk or egg, but not peanut, were significantly lower compared to controls in linear mixed-effects models adjusted for repeated measures, experimental variables, age, and inter-individual variability (P-values .007, .018, and .058, respectively). CONCLUSION Higher household endotoxin is associated with increased odds of milk and egg sensitization. Altered cytokine responsiveness to endotoxin is also observed in PBMCs from individuals with milk and egg allergy.
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Affiliation(s)
- Angela Tsuang
- Division of Allergy & Immunology Department of Pediatrics Icahn School of Medicine at Mount Sinai New York NY USA
| | - Alexander Grishin
- Division of Allergy & Immunology Department of Pediatrics Icahn School of Medicine at Mount Sinai New York NY USA
| | - Galina Grishina
- Division of Allergy & Immunology Department of Pediatrics Icahn School of Medicine at Mount Sinai New York NY USA
| | - Anh N. Do
- Department of Genetics & Genomic Sciences Icahn School of Medicine at Mount Sinai New York NY USA
| | - Joanne Sordillo
- Department of Population Medicine Harvard Medical School and Harvard Pilgrim Health Care Institute Boston MA USA
| | - Ginger L. Chew
- Department of Environmental Health Sciences Mailman School of Public Health Columbia University New York NY USA
| | - Supinda Bunyavanich
- Division of Allergy & Immunology Department of Pediatrics Icahn School of Medicine at Mount Sinai New York NY USA
- Department of Genetics & Genomic Sciences Icahn School of Medicine at Mount Sinai New York NY USA
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7
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Oluwole O, Rennie DC, Afanasieva A, Lawson JA. Personal and early life factors associated with new-onset asthma, remission, and persistence of asthma in a 2-year follow-up of schoolchildren. J Asthma 2020; 58:488-496. [PMID: 31906746 DOI: 10.1080/02770903.2019.1709865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVE The natural course of childhood asthma, after its onset, is characterized by periods of persistence, relapse and remission. To investigate personal and early life factors associated with new-onset asthma, persistence and remission among children. METHODS The study was conducted in the province of Saskatchewan, Canada. Children in grades Kindergarten to Grade 8 (ages 5-14 years) participated in a cross-sectional study in 2013. In 2015, we approached those who gave consent in 2013 to be re-contacted, creating a prospective cohort. Data were collected using questionnaires in both years. Participants in 2013 who also had data in 2015 (25%: n = 324/1,348) had their asthma status reclassified and longitudinal descriptors were applied: "no asthma", "new-onset asthma", "persistent" or "remission". Personal and early life factors associations with asthma outcomes in 2015 were evaluated. RESULTS Among those without asthma in 2013 (n = 245), the incidence of new-onset asthma in 2015 was 7.2%. Among those with asthma in 2013 (n = 79), 47.1% had remission and 52.9% had persistent asthma in 2015. Parental history of asthma (adjusted odds ratio (aOR): 4.99; 95% confidence interval (CI): 1.88-28.27), early life respiratory infection (aOR: 1.92; 95%CI: 1.47-7.88), early life allergy [aOR: 6.39; 95%CI: 1.34-30.58) and early life infection (aOR: 4.99; 95%CI: 1.19-20.93) were associated with new onset asthma. Similarly, while parental history of asthma (aOR: 1.13; 95%CI: 0.29-4.34), early life respiratory infection (aOR: 2.71; 95%CI: 0.70-10.45), and early life ear infection (aOR: 1.34; 95%CI: 0.36-5.05) were also positively association with persistent asthma, the associations were not statistically significant. CONCLUSION Parental history of asthma, early life respiratory infection and allergy might not only influence the onset of childhood asthma but also be associated with asthma persistence.
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Affiliation(s)
- Oluwafemi Oluwole
- College of Nursing, University of Saskatchewan, Saskatoon, SK, Canada.,Canadian Centre for Health and Safety in Agriculture, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Donna C Rennie
- College of Nursing, University of Saskatchewan, Saskatoon, SK, Canada.,Canadian Centre for Health and Safety in Agriculture, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Anna Afanasieva
- Canadian Centre for Health and Safety in Agriculture, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Joshua A Lawson
- Canadian Centre for Health and Safety in Agriculture, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada.,Department of Medicine, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
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8
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Oluwole O, Rennie DC, Senthilselvan A, Dyck R, Afanasieva A, Kirychuk S, Katselis G, Lawson JA. The association between endotoxin in house dust with atopy and exercise-induced bronchospasm in children with asthma. ENVIRONMENTAL RESEARCH 2018; 164:302-309. [PMID: 29554621 DOI: 10.1016/j.envres.2018.03.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 03/05/2018] [Accepted: 03/07/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Studies have reported protective and adverse associations between microbial exposure and childhood asthma. However, among children with asthma the relationships between endotoxin and exercise-induced bronchospasm (EIB) is less clear. OBJECTIVE We investigated the association between exposure to endotoxin in house dust with atopy and EIB in children with asthma. METHODS A cross-sectional survey was conducted among schoolchildren (aged 7-17 years) in the province of Saskatchewan, Canada. A subpopulation with asthma (n = 116) were identified from 335 participants using a validated asthma algorithm. We determined atopy among the asthma subpopulation by skin prick testing (SPT) while EIB was evaluated using exercise challenge testing (ECT). Dust samples were collected from mattress and play area floors, and endotoxin was measured in dust extracts. Logistic regression analyses were used to explore associations between endotoxin with atopy and EIB. RESULTS Among the 116 children with asthma, 99 completed SPT and all had completed ECT. Of these, 71/99 (71.7%) were atopic and 26/116 (22.4%) had EIB. Exposure to high play area endotoxin concentration [adjusted odds ratio (aOR) = 0.15, 95% CI: 0.03-0.85] and load (aOR = 0.11, 95% CI: 0.02-0.73) were negatively associated with atopy. In contrast, EIB was positively associated with high mattress endotoxin concentration (aOR = 6.01, 95% CI: 1.20-30.13). CONCLUSION Indoor microbial endotoxin exposure has varied associations with atopy and exercise-induced bronchospasm among children with asthma.
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Affiliation(s)
- Oluwafemi Oluwole
- Department of Community Health and Epidemiology, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK, Canada S7N 2Z4; Canadian Centre for Health and Safety in Agriculture, College of Medicine, University of Saskatchewan, 104 Clinic Place, PO Box 23, Saskatoon, SK, Canada S7N 2Z4.
| | - Donna C Rennie
- Canadian Centre for Health and Safety in Agriculture, College of Medicine, University of Saskatchewan, 104 Clinic Place, PO Box 23, Saskatoon, SK, Canada S7N 2Z4; College of Nursing, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK, Canada S7N 2Z4.
| | | | - Roland Dyck
- Canadian Centre for Health and Safety in Agriculture, College of Medicine, University of Saskatchewan, 104 Clinic Place, PO Box 23, Saskatoon, SK, Canada S7N 2Z4; Department of Medicine, College of Medicine, University of Saskatchewan, 103 Hospital Drive, Saskatoon, SK, Canada S7N 0W8.
| | - Anna Afanasieva
- Canadian Centre for Health and Safety in Agriculture, College of Medicine, University of Saskatchewan, 104 Clinic Place, PO Box 23, Saskatoon, SK, Canada S7N 2Z4.
| | - Shelley Kirychuk
- Canadian Centre for Health and Safety in Agriculture, College of Medicine, University of Saskatchewan, 104 Clinic Place, PO Box 23, Saskatoon, SK, Canada S7N 2Z4; Department of Medicine, College of Medicine, University of Saskatchewan, 103 Hospital Drive, Saskatoon, SK, Canada S7N 0W8.
| | - George Katselis
- Canadian Centre for Health and Safety in Agriculture, College of Medicine, University of Saskatchewan, 104 Clinic Place, PO Box 23, Saskatoon, SK, Canada S7N 2Z4; Department of Medicine, College of Medicine, University of Saskatchewan, 103 Hospital Drive, Saskatoon, SK, Canada S7N 0W8.
| | - Joshua A Lawson
- Canadian Centre for Health and Safety in Agriculture, College of Medicine, University of Saskatchewan, 104 Clinic Place, PO Box 23, Saskatoon, SK, Canada S7N 2Z4; Department of Medicine, College of Medicine, University of Saskatchewan, 103 Hospital Drive, Saskatoon, SK, Canada S7N 0W8.
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Oluwole O, Rennie DC, Senthilselvan A, Dyck R, Afanasieva A, Kirychuk S, Katselis G, Lawson JA. The association between endotoxin and beta-(1 → 3)-D-glucan in house dust with asthma severity among schoolchildren. Respir Med 2018; 138:38-46. [PMID: 29724391 DOI: 10.1016/j.rmed.2018.03.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Accepted: 03/13/2018] [Indexed: 01/19/2023]
Abstract
BACKGROUND Asthma severity can be affected by microbial exposures. However, less is known about the specific indoor agents aggravating the disease in children. We examined the associations between indoor endotoxin and beta-(1 → 3)-D-glucan exposures and asthma severity in children with asthma. METHODS A clinical cross-sectional study of schoolchildren (aged 7-17 years) was conducted in the province of Saskatchewan, Canada. Children with asthma (n = 116) were identified from 335 participants using a combination of survey responses and objective clinical assessments. We then ascertained asthma severity based on recommended guidelines (continuous daytime asthma symptoms, frequent nighttime asthma symptoms, and ≤ 60% predicted FEV1). Levels of indoor endotoxin and beta-(1 → 3)-D-glucan were measured in dust samples obtained from play area floors and child's mattresses. RESULTS The study population of 116 children with asthma was comprised of 75.9% mild asthma and 24.1% moderate/severe asthma. Higher mattress endotoxin concentration was associated with increased odds of moderate/severe asthma [adjusted odds ratio (aOR) = 11.40, 95% confidence interval (CI): 1.45-89.43] while higher beta-(1 → 3)-D-glucan concentration (aOR = 0.16, 95% CI: 0.03-0.89) and load (aOR = 0.10, 95% CI: 0.02-0.72) in play areas were inversely associated with moderate/severe asthma. Furthermore, higher mattress endotoxin concentration was associated with lower FVC (p = 0.01) and FEV1 (p = 0.03). These associations were not seen for beta-(1 → 3)-D-glucan. CONCLUSION Our results showed differential effects of microbial exposures on childhood asthma severity and further highlight domestic endotoxin exposure effects on respiratory health outcomes in children with asthma.
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Affiliation(s)
- Oluwafemi Oluwole
- Department of Community Health and Epidemiology, University of Saskatchewan, 104 Clinic Place Saskatoon, SK, S7N 2Z4, Canada; Canadian Centre for Health and Safety in Agriculture, College of Medicine, University of Saskatchewan, 104 Clinic Place, PO Box 23, Saskatoon, SK, S7N 2Z4, Canada.
| | - Donna C Rennie
- Canadian Centre for Health and Safety in Agriculture, College of Medicine, University of Saskatchewan, 104 Clinic Place, PO Box 23, Saskatoon, SK, S7N 2Z4, Canada; College of Nursing, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK, S7N 2Z4, Canada
| | | | - Roland Dyck
- Canadian Centre for Health and Safety in Agriculture, College of Medicine, University of Saskatchewan, 104 Clinic Place, PO Box 23, Saskatoon, SK, S7N 2Z4, Canada; Department of Medicine, College of Medicine, University of Saskatchewan, 103 Hospital Drive, Saskatoon, SK, S7N 0W8, Canada
| | - Anna Afanasieva
- Canadian Centre for Health and Safety in Agriculture, College of Medicine, University of Saskatchewan, 104 Clinic Place, PO Box 23, Saskatoon, SK, S7N 2Z4, Canada
| | - Shelley Kirychuk
- Canadian Centre for Health and Safety in Agriculture, College of Medicine, University of Saskatchewan, 104 Clinic Place, PO Box 23, Saskatoon, SK, S7N 2Z4, Canada; Department of Medicine, College of Medicine, University of Saskatchewan, 103 Hospital Drive, Saskatoon, SK, S7N 0W8, Canada
| | - George Katselis
- Canadian Centre for Health and Safety in Agriculture, College of Medicine, University of Saskatchewan, 104 Clinic Place, PO Box 23, Saskatoon, SK, S7N 2Z4, Canada; Department of Medicine, College of Medicine, University of Saskatchewan, 103 Hospital Drive, Saskatoon, SK, S7N 0W8, Canada
| | - Joshua A Lawson
- Canadian Centre for Health and Safety in Agriculture, College of Medicine, University of Saskatchewan, 104 Clinic Place, PO Box 23, Saskatoon, SK, S7N 2Z4, Canada; Department of Medicine, College of Medicine, University of Saskatchewan, 103 Hospital Drive, Saskatoon, SK, S7N 0W8, Canada
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10
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Oluwole O, Rennie DC, Senthilselvan A, Dyck R, Afanasieva A, Adamko DJ, Lawson JA. Asthma diagnosis among children along an urban-rural gradient. J Asthma 2018; 55:1242-1252. [PMID: 29420108 DOI: 10.1080/02770903.2017.1407335] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Studies have reported lower asthma prevalence in rural compared to urban areas. While environmental factors have mostly been implicated for these differences, the lower asthma prevalence could also be linked to asthma under-diagnosis in rural children. We investigate if rural children experience under-diagnosis of asthma more compared to urban children. METHODS In 2013, we conducted a cross-sectional survey of schoolchildren across an urban-rural gradient in Saskatchewan, Canada. The participants formed sampling frame for future studies. In 2015, we approached those who gave consent in 2013 for further testing, repeated the survey, and conducted clinical testing. Based on survey responses, children were classified into "no asthma," "at-risk-for-asthma," and "diagnosed asthma." We then classified asthma status as either "no asthma" or "probable asthma" based on a validated asthma algorithm. RESULTS The study population of 335 schoolchildren (aged 7-17 years) comprised of 73.4% from large urban, 13.7% from small urban, and 12.8% from rural areas. Proportion with report of physician-diagnosed asthma was 28.5% (Large urban), 34.8% (Small urban), and 20.9% (Rural). Mean percent predicted FEV1 and FEF25%-75% were lower in rural compared to small urban and large urban children (p < 0.05). Among those not classified as with "diagnosed asthma" by the survey, the algorithm further identified presence of asthma in 5.5% large urban, 8.1% small urban, and 18.8% rural children (p = 0.03). CONCLUSION The study revealed evidence of asthma underdiagnosis in rural areas and further supports the use of objective measures in addition to symptoms history when investigating asthma across urban-rural gradients.
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Affiliation(s)
- Oluwafemi Oluwole
- a Department of Community Health and Epidemiology , University of Saskatchewan , Saskatchewan , Canada.,b Canadian Centre for Health and Safety in Agriculture, College of Medicine , University of Saskatchewan , Saskatoon, Saskatchewan , Canada
| | - Donna C Rennie
- b Canadian Centre for Health and Safety in Agriculture, College of Medicine , University of Saskatchewan , Saskatoon, Saskatchewan , Canada.,c College of Nursing , University of Saskatchewan , Saskatchewan , Canada
| | | | - Roland Dyck
- b Canadian Centre for Health and Safety in Agriculture, College of Medicine , University of Saskatchewan , Saskatoon, Saskatchewan , Canada.,e Department of Medicine, College of Medicine , University of Saskatchewan , Saskatoon, Saskatchewan , Canada
| | - Anna Afanasieva
- b Canadian Centre for Health and Safety in Agriculture, College of Medicine , University of Saskatchewan , Saskatoon, Saskatchewan , Canada
| | - Darryl J Adamko
- f Department of Pediatrics , College of Medicine, University of Saskatchewan , Saskatoon, Saskatchewan , Canada
| | - Joshua A Lawson
- b Canadian Centre for Health and Safety in Agriculture, College of Medicine , University of Saskatchewan , Saskatoon, Saskatchewan , Canada.,e Department of Medicine, College of Medicine , University of Saskatchewan , Saskatoon, Saskatchewan , Canada
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House Dust Endotoxin Levels Are Associated with Adult Asthma in a U.S. Farming Population. Ann Am Thorac Soc 2018; 14:324-331. [PMID: 27977294 DOI: 10.1513/annalsats.201611-861oc] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
RATIONALE Endotoxin initiates a proinflammatory response from the innate immune system. Studies in children suggest that endotoxin exposure from house dust may be an important risk factor for asthma, but few studies have been conducted in adult populations. OBJECTIVES To investigate the association of house dust endotoxin levels with asthma and related phenotypes (wheeze, atopy, and pulmonary function) in a large U.S. farming population. METHODS Dust was collected from the bedrooms (n = 2,485) of participants enrolled in a case-control study of current asthma (927 cases) nested within the Agricultural Health Study. Dust endotoxin was measured by Limulus amebocyte lysate assay. Outcomes were measured by questionnaire, spirometry, and blood draw. We evaluated associations using linear and logistic regression. MEASUREMENTS AND MAIN RESULTS Endotoxin was significantly associated with current asthma (odds ratio [OR], 1.30; 95% confidence interval [CI], 1.14-1.47), and this relationship was modified by early-life farm exposure (born on a farm: OR, 1.18; 95% CI, 1.02-1.37; not born on a farm: OR, 1.67; 95% CI, 1.26-2.20; Interaction P = 0.05). Significant positive associations were seen with both atopic and nonatopic asthma. Endotoxin was not related to either atopy or wheeze. Higher endotoxin was related to lower FEV1/FVC in asthma cases only (Interaction P = 0.01). For asthma, there was suggestive evidence of a gene-by-environment interaction for the CD14 variant rs2569190 (Interaction P = 0.16) but not for the TLR4 variants rs4986790 and rs4986791. CONCLUSIONS House dust endotoxin was associated with current atopic and nonatopic asthma in a U.S. farming population. The degree of the association with asthma depended on early-life farm exposures. Furthermore, endotoxin was associated with lower pulmonary function in patients with asthma.
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12
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Estrada RD, Ownby DR. Rural Asthma: Current Understanding of Prevalence, Patterns, and Interventions for Children and Adolescents. Curr Allergy Asthma Rep 2017; 17:37. [PMID: 28484946 PMCID: PMC6533905 DOI: 10.1007/s11882-017-0704-3] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
PURPOSE OF REVIEW Asthma is the most common chronic illness of children and adolescents in the USA. While asthma has been understood to disproportionately affect urban dwellers, recent investigations have revealed rural pediatric asthma prevalence to be very similar to urban and to be more closely correlated with socioeconomic and environmental factors than geographic location or population density. RECENT FINDINGS Rural children experience factors unique to location that impact asthma development and outcomes, including housing quality, cigarette smoke exposure, and small/large-scale farming. Additionally, there are challenging barriers to appropriate asthma care that frequently are more severe for those living in rural areas, including insurance status, lack of primary care providers and pulmonary specialists, knowledge deficits (both patient and provider), and a lack of culturally tailored asthma interventions. Interventions designed to address rural pediatric asthma disparities are more likely to be successful when targeted to specific challenges, such as the use of school-based services or telemedicine to mitigate asthma care access issues. Continued research on understanding the complex interaction of specific rural environmental factors with host factors can inform future interventions designed to mitigate asthma disparities.
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Affiliation(s)
| | - Dennis R Ownby
- Allergy & Immunology, Augusta University, Augusta, GA, USA
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Lawson JA, Chu LM, Rennie DC, Hagel L, Karunanayake CP, Pahwa P, Dosman JA. Prevalence, risk factors, and clinical outcomes of atopic and nonatopic asthma among rural children. Ann Allergy Asthma Immunol 2017; 118:304-310. [PMID: 28087381 DOI: 10.1016/j.anai.2016.11.024] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Revised: 11/19/2016] [Accepted: 11/29/2016] [Indexed: 11/26/2022]
Abstract
BACKGROUND Because of time and cost constraints, objective classification of atopic and nonatopic asthma has been limited in large epidemiologic studies. However, as we try to better understand exposure-outcome associations and ensure appropriate treatment of asthma, it is important to focus on phenotype-defined asthma classification. OBJECTIVE To compare atopic and nonatopic asthma in rural children with regard to risk factors and clinical outcomes. METHODS We conducted a cross-sectional study in rural Saskatchewan, Canada, in 2011. Parents of 6- to 14-year-old children completed a health and exposure survey. Skin prick tests were completed in a subsample of 529 children. Asthma was based physician diagnosis. Asthma status was defined as no asthma, nonatopic asthma, and atopic asthma. RESULTS Asthma prevalence was 14.7% of which 32.1% of cases were atopic. After adjustment, early respiratory illness and a family history of asthma were predictors of childhood asthma, regardless of atopic status (P < .05). Being overweight and having a dog in the home were associated with an increased risk of nonatopic asthma (P < .05). A mother with a history of smoking increased the risk of atopic asthma (P = .01). Compared with those with nonatopic asthma, in the past 12 months, children with atopic asthma were more likely to report a sneezy, runny, or blocked nose or have shortness of breath (odds ratio >2), whereas those with nonatopic asthma were more likely to have parents who missed work (odd ratio >3). Those with nonatopic asthma had significantly lower forced expiratory volume in 1 second compared w2ith those with atopic asthma. CONCLUSION Exposures may contribute differentially to atopic and nonatopic asthma and result in differential clinical presentation or burden. The study of these characteristics is important for etiologic understanding and management decisions.
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Affiliation(s)
- Joshua A Lawson
- Department of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada; Canadian Center for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
| | - Luan M Chu
- Canadian Center for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Saskatchewan, Canada; Health Sciences Program, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Donna C Rennie
- Canadian Center for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Saskatchewan, Canada; College of Nursing, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Louise Hagel
- Canadian Center for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Chandima P Karunanayake
- Canadian Center for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Punam Pahwa
- Canadian Center for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Saskatchewan, Canada; Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - James A Dosman
- Canadian Center for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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14
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Lawson JA, Rennie DC, Cockcroft DW, Dyck R, Afanasieva A, Oluwole O, Afsana J. Childhood asthma, asthma severity indicators, and related conditions along an urban-rural gradient: a cross-sectional study. BMC Pulm Med 2017; 17:4. [PMID: 28056923 PMCID: PMC5216545 DOI: 10.1186/s12890-016-0355-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Accepted: 12/16/2016] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Asthma prevalence is generally lower in rural locations with some indication of an urban-rural gradient. However, among children with asthma, certain rural exposures thought to protect against the development of asthma could aggravate the condition. We examined childhood asthma prevalence and related conditions along an urban-rural gradient and also examined the characteristics of those with asthma along the urban-rural gradient. METHODS In 2013 we completed a cross-sectional survey of 3509 children aged 5-14 years living in various population densities of Saskatchewan, Canada. Location of dwelling was identified as belonging to one of the following population densities: large urban region (approximately 200,000), small urban (approximately 35,000), or rural (small town of <1,500 or farm dweller). Physician-diagnosed asthma and asthma-related symptoms were ascertained from responses in the parental-completed questionnaires. RESULTS Of the study population, 69% lived in a large urban region, 11% lived in a small urban centre and 20% were rural dwellers. Overall, asthma prevalence was 19.6% with differences in asthma prevalence with differences between locations (large urban = 20.7%; small urban = 21.5%; rural = 15.1%; p = 0.003). After adjustment for potential confounders, the association between location of dwelling and asthma remained significant. Despite a lower prevalence of asthma in the rural area, the prevalence and risk of ever wheeze and having more than 3 wheezing episodes in the past 12 months among those who reported asthma, was higher in rural locations after adjustment for potential confounders. CONCLUSIONS The results of this study support the evidence of a difference in childhood asthma prevalence between urban and rural locations and that once a child has asthma, certain rural exposures may aggravate the disease.
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Affiliation(s)
- Joshua A. Lawson
- Department of Medicine and Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, 104 Clinic Place, PO Box 23, Saskatoon, SK S7N 5E5 Canada
| | - Donna C. Rennie
- College of Nursing and Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, SK Canada
| | - Don W. Cockcroft
- Department of Medicine, University of Saskatchewan, Saskatoon, SK Canada
| | - Roland Dyck
- Department of Medicine and Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, 104 Clinic Place, PO Box 23, Saskatoon, SK S7N 5E5 Canada
| | - Anna Afanasieva
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, SK Canada
| | - Oluwafemi Oluwole
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, SK Canada
| | - Jinnat Afsana
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, SK Canada
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Padhi BK, Adhikari A, Satapathy P, Patra AK, Chandel D, Panigrahi P. Predictors and respiratory depositions of airborne endotoxin in homes using biomass fuels and LPG gas for cooking. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2017; 27:112-117. [PMID: 26956936 PMCID: PMC5017895 DOI: 10.1038/jes.2016.5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Accepted: 11/28/2015] [Indexed: 05/30/2023]
Abstract
Recent studies have highlighted the presence of endotoxin in indoor air and its role in respiratory morbidities. Burning of household fuels including unprocessed wood and dried animal dung could be a major source of endotoxin in homes. We measured endotoxin levels in different size fractions of airborne particles (PM10, PM2.5, and PM1), and estimated the deposition of particle-bound endotoxin in the respiratory tract. The study was carried out in homes burning solid biomass fuel (n=35) and LPG (n=35). Sample filters were analyzed for endotoxin and organic carbon (OC) content. Household characteristics including temperature, relative humidity, and carbon dioxide levels were also recorded. Multivariate regression models were used to estimate the contributing factors for airborne endotoxin. Respiratory deposition doses were calculated using a computer-based model. We found a higher endotoxin concentration in PM2.5 fractions of the particle in both LPG (median: 110, interquartile range (IQR) 100-120 EU/m3) and biomass (median: 350, IQR: 315-430 EU/m3) burning homes. In the multivariate-adjusted model, burning of solid biomass fuel (β: 67; 95% CI: 10.5-124) emerged as the most significant predictor followed by OC (β: 4.7; 95% CI: 2.7-6.8), RH (β: 1.6; 95% CI: 0.76-2.4), and PM2.5 (β: 0.45; 95% CI: 0.11-0.78) for airborne endotoxin (P<0.05). We also observed an interaction between PM organic carbon content and household fuel in predicting the endotoxin levels. The model calculations showed that in biomass burning homes, total endotoxin deposition was higher among infants (59%) than in adult males (47%), of which at least 10% of inhaled endotoxin is deposited in the alveolar region of the lung. These results indicate that fine particles are significant contributors to the deposition of endotoxin in the alveolar region of the lung. Considering the paramount role of endotoxin exposure, and the source and timing of exposure on respiratory health, additional studies are warranted to guide evidence-based public health interventions.
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Affiliation(s)
- Bijaya Kumar Padhi
- Center for Environmental and Occupational Health, Asian Institute of Public Health, Bhubaneswar, India
| | - Atin Adhikari
- Department of Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, PO Box 8015, Statesboro, Georgia 30460, USA
| | - Prakasini Satapathy
- Department of Biotechnology, Ravenshaw University, Cuttack, India
- Regional Medical Research Center, Bhubaneswar, Indian Council of Medical Research, Odisha, India
| | - Alok Kumar Patra
- Center for Global Health and Development, College of Public Health, University of Nebraska Medical Center, USA
| | - Dinesh Chandel
- Center for Global Health and Development, College of Public Health, University of Nebraska Medical Center, USA
| | - Pinaki Panigrahi
- Center for Global Health and Development, College of Public Health, University of Nebraska Medical Center, USA
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Weber J, Illi S, Nowak D, Schierl R, Holst O, von Mutius E, Ege MJ. Asthma and the hygiene hypothesis. Does cleanliness matter? Am J Respir Crit Care Med 2015; 191:522-9. [PMID: 25584716 DOI: 10.1164/rccm.201410-1899oc] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
RATIONALE The early hygiene hypothesis explained the development of allergies by a lack of infections; nowadays, the aspect of excessive cleanliness in affluent populations seems to have replaced this concept. Yet, no investigation has shown that home or personal cleanliness relate to allergic diseases. OBJECTIVES To relate personal and home cleanliness to risk of asthma and allergies. METHODS Comprehensive questionnaire information on home or personal cleanliness and allergic health conditions at school age was collected in 399 participants of the urban Perinatale Asthma Umwelt Langzeit Allergie Studie (PAULA) birth cohort. Bacterial markers were assessed in floor and mattress dust and were related to cleanliness and allergic diseases. MEASUREMENTS AND MAIN RESULTS Personal cleanliness was inversely related to bacterial compounds on floors and mattresses, whereas home cleanliness effectively reduced dust amount but not microbial markers. Exposure to muramic acid related to a lower prevalence of school-age asthma (adjusted odds ratio, 0.59 [95% confidence interval, 0.39; 0.90]). Mattress endotoxin in the first year of life was inversely associated with atopic sensitization (0.73 [0.56-0.96]) and asthma at school age (0.72 [0.55-0.95]). Despite the associations of dust parameters both with cleanliness and allergic health conditions, the development of allergies was not related to home and personal cleanliness. CONCLUSIONS Bacterial exposure in house dust determined childhood asthma and allergies. Personal cleanliness, such as washing hands, and home cleanliness were objectively reflected by dust parameters in homes. However, neither personal nor home cleanliness was associated with a risk for asthma and allergies. Other microbial components in house dust not affected by personal hygiene are likely to play a role.
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Affiliation(s)
- Juliane Weber
- 1 Dr von Hauner Children's Hospital, Ludwig Maximilians University of Munich, Munich, Germany
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Kanchongkittiphon W, Mendell MJ, Gaffin JM, Wang G, Phipatanakul W. Indoor environmental exposures and exacerbation of asthma: an update to the 2000 review by the Institute of Medicine. ENVIRONMENTAL HEALTH PERSPECTIVES 2015; 123:6-20. [PMID: 25303775 PMCID: PMC4286274 DOI: 10.1289/ehp.1307922] [Citation(s) in RCA: 241] [Impact Index Per Article: 26.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2013] [Accepted: 10/09/2014] [Indexed: 05/18/2023]
Abstract
BACKGROUND Previous research has found relationships between specific indoor environmental exposures and exacerbation of asthma. OBJECTIVES In this review we provide an updated summary of knowledge from the scientific literature on indoor exposures and exacerbation of asthma. METHODS Peer-reviewed articles published from 2000 to 2013 on indoor exposures and exacerbation of asthma were identified through PubMed, from reference lists, and from authors' files. Articles that focused on modifiable indoor exposures in relation to frequency or severity of exacerbation of asthma were selected for review. Research findings were reviewed and summarized with consideration of the strength of the evidence. RESULTS Sixty-nine eligible articles were included. Major changed conclusions include a causal relationship with exacerbation for indoor dampness or dampness-related agents (in children); associations with exacerbation for dampness or dampness-related agents (in adults), endotoxin, and environmental tobacco smoke (in preschool children); and limited or suggestive evidence for association with exacerbation for indoor culturable Penicillium or total fungi, nitrogen dioxide, rodents (nonoccupational), feather/down pillows (protective relative to synthetic bedding), and (regardless of specific sensitization) dust mite, cockroach, dog, and dampness-related agents. DISCUSSION This review, incorporating evidence reported since 2000, increases the strength of evidence linking many indoor factors to the exacerbation of asthma. Conclusions should be considered provisional until all available evidence is examined more thoroughly. CONCLUSION Multiple indoor exposures, especially dampness-related agents, merit increased attention to prevent exacerbation of asthma, possibly even in nonsensitized individuals. Additional research to establish causality and evaluate interventions is needed for these and other indoor exposures.
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Maheswaran D, Zeng Y, Chan-Yeung M, Scott J, Osornio-Vargas A, Becker AB, Kozyrskyj AL. Exposure to Beta-(1,3)-D-glucan in house dust at age 7-10 is associated with airway hyperresponsiveness and atopic asthma by age 11-14. PLoS One 2014; 9:e98878. [PMID: 24905346 PMCID: PMC4048218 DOI: 10.1371/journal.pone.0098878] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2013] [Accepted: 05/08/2014] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Mould exposure has been linked to childhood asthma and bronchial hyper-responsiveness. Few studies have assessed beta-(1,3)-d-glucan (beta-glucan), a significant fungal cell wall constituent, in relation to asthma in adolescence. OBJECTIVE To determine whether house dust-derived beta-glucan exposure at age 7-10 is associated with the development and persistence of atopic and non-atopic asthma, and bronchial hyper-responsiveness (BHR) by age 11-14. METHODS Dust samples were collected from the 1995 Study of Asthma, Genes, and Environment (SAGE) birth cohort. This cohort was derived from Manitoba provincial healthcare administrative records of children high and low risk for asthma. Samples were collected from the homes of 422 children at age 7-10 and analyzed using beta-glucan and endotoxin-specific Limulus Amoebocyte Lysate assays. Asthma, atopy, and BHR status of each child were also assessed at ages 7-10 and 11-14. RESULTS At age 7-10, beta-glucan dust levels in the home were associated with persistent atopic asthma at age 11-14 (OR 1.79 for each unit increase in levels, 95% CI 1.14-2.81), independent of endotoxin exposure, and Alternaria or Cladosporium sensitization. The likelihood of BHR almost doubled with unit increases in dust beta-glucan in asthmatic children. In children without asthma, exposure to high beta-glucan levels at age 7-10 also elevated risk for BHR in adolescence (OR 1.74, 95% CI 1.05-2.89). New-onset atopic asthma was twice more likely following high beta-glucan exposure in children without asthma but the association did not reach statistical significance. No associations were evident with concurrent asthma phenotype at age 7-10 or non-atopic asthma at age 11-14. CONCLUSION These findings implicate home beta-glucan exposure at school-age as a risk factor for persistent atopic asthma and new-onset BHR. The higher prevalence of BHR in urban adolescents may be propagated by this home exposure.
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Affiliation(s)
- Dharini Maheswaran
- Faculty of Medicine, Nursing, and Health Sciences, Monash University, Melbourne, Victoria, Australia
| | - Yiye Zeng
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Moira Chan-Yeung
- Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - James Scott
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada,
| | - Alvaro Osornio-Vargas
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Allan B. Becker
- Department of Pediatrics and Child Health, Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Anita L. Kozyrskyj
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
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Relationships between Plasma Micronutrients, Serum IgE, and Skin Test Reactivity and Asthma among School Children in Rural Southwest Nigeria. J Biomark 2014; 2014:106150. [PMID: 26317027 PMCID: PMC4437362 DOI: 10.1155/2014/106150] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2013] [Revised: 04/18/2014] [Accepted: 05/05/2014] [Indexed: 01/05/2023] Open
Abstract
Objective. Increasing prevalence of asthma has been attributed to changes in lifestyle and environmental exposures. We conducted a case-control study to investigate the relationship between serum micronutrients and asthma in rural school children in Nigeria. Methods. We administered questionnaires to 1,562 children to identify children with asthma. Serum concentration levels of 12 micronutrients were determined in asthma cases (N = 37) and controls (N = 30). Allergy skin prick test and spirometry were also performed. Results. Plasma levels of the following micronutrients were significantly different between cases and controls: calcium (7.48 ± 2.16 versus 8.29 ± 1.62 mg/dL; P = 0.04), manganese (44.1 ± 11.5 versus 49.3 ± 7.9 mg/L; P = 0.01), selenium (76.1 ± 14.9 versus 63.3 ± 26.8 μg/L; P = 0.02), and albumin (3.45 ± 0.90 versus 3.91 ± 0.99 g/dL; P = 0.04). Plasma concentrations of iron and selenium were positively correlated with lung function, r = 0.43 (P < 0.05 in each case) while manganese serum concentration was negatively correlated with asthma (r = −0.44; P < 0.05). Conclusions. Children with asthma had reduced levels of plasma manganese, calcium, and albumin but raised level of selenium. The protective or risk effects of these micronutrients on asthma warrant further investigation.
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Kim JY, Kim EK, Lee HJ, Shin YH, Lee HK, Kim J. Effects of plasma endotoxin concentrations on the severity of atopic dermatitis in children. ALLERGY ASTHMA & RESPIRATORY DISEASE 2014. [DOI: 10.4168/aard.2014.2.1.59] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Joo Young Kim
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Eun Kyung Kim
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hye Jin Lee
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Youn Ho Shin
- Department of Pediatrics, CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, Korea
| | - Hye Kyung Lee
- Department of Laboratory Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jintack Kim
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Chang C, Gershwin ME, Thompson GR. Fungal disease of the nose and sinuses: an updated overview. Curr Allergy Asthma Rep 2013; 13:152-61. [PMID: 23135919 DOI: 10.1007/s11882-012-0320-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Fungal diseases of the nose and sinuses encompasses a diverse spectrum of disease. Clinical manifestations are largely dependent upon the immune status of the host, as, given the ubiquitous nature of these organisms, exposure is unavoidable. Asymptomatic colonization of the nasal passages by fungi warrants no treatment and is common, while allergic fungal rhinosinusitis is challenging and often requires a combined approach of surgical intervention, immunotherapy, and corticosteroid administration. A diagnosis requires a combination of IgE immune reactivity, eosinophilic infiltration, and fungi recovery. Similarly, invasive disease may present only after several months of slowly progressive disease, or in rapid and fulminant fashion in the appropriate host. A differentiation of these overlapping syndromes and the pathophysiologic processes at play, and recommended treatment algorithms, are the focus of this review.
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Affiliation(s)
- Christopher Chang
- Department of Pediatrics, Division of Allergy, Asthma, and Immunology, Nemours/A.I. Dupont Hospital for Children, Thomas Jefferson University, 1600 Rockland Road, Wilmington, DE, 19803, USA.
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Wang J, Cozen W, Thorne PS, Berhane K, Cerhan JR, Hartge P, Ward MH, De Roos AJ, Severson RK, Morton LM, Bernstein L, Linet MS, Colt JS. Household endotoxin levels and the risk of non-Hodgkin lymphoma. Cancer Causes Control 2013; 24:357-64. [PMID: 23277417 PMCID: PMC3800025 DOI: 10.1007/s10552-012-0121-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2012] [Accepted: 11/30/2012] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Endotoxin, a component of the outer membrane of gram-negative bacteria, elicits a strong innate and inflammatory immune response associated with the secretion of proinflammatory cytokines, including tumor necrosis factor-alpha (TNF-α). Because TNF-α polymorphisms that increase TNF-α production are associated with an increased risk of non-Hodgkin lymphoma (NHL), we hypothesized that increased levels of household endotoxin would be associated with an increased NHL risk. METHODS We evaluated this association in the National Cancer Institute/Surveillance, Epidemiology and End Results (NCI/SEER) NHL multicenter population-based case-control study. Used vacuum cleaner bags were collected from participants during a home interview. Dust samples from the bags of 594 cases and 442 controls were analyzed for endotoxin [endotoxin unit (EU)/mg of dust] using the kinetic chromogenic Limulus amebocyte lysate assay. Multivariable logistic regression was used to estimate the effect of endotoxin on NHL risk adjusted for age, sex, race, education, study center, and farm exposure. RESULTS Endotoxin was not associated with NHL overall [odds ratio (OR) for highest quartile of endotoxin levels = 0.81, 95 % confidence interval (CI) = 0.55, 1.20; p for trend = 0.35] or with diffuse large B-cell lymphoma (OR = 0.63, 95 % CI = 0.34, 1.16; p = 0.31) or follicular lymphoma (OR = 1.07, 95 % CI = 0.61, 1.89; p = 0.73) subtypes. Both working and living on a farm were associated with higher household endotoxin levels compared to never working (p = 0.009) or living (p = 0.01) on a farm. Excluding farmers from the analysis did not change the results. CONCLUSIONS We found no evidence of a role for household endotoxin in NHL etiology.
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Affiliation(s)
- Jun Wang
- Department of Preventive Medicine, USC Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Wendy Cozen
- Department of Preventive Medicine, USC Keck School of Medicine, University of Southern California, Los Angeles, CA
- Department of Pathology, USC Keck School of Medicine, University of Southern California, Los Angeles, CA
- Norris Comprehensive Cancer Center, USC Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Peter S. Thorne
- Department of Occupational and Environmental Health, University of Iowa, Iowa City, Iowa
| | - Kiros Berhane
- Department of Preventive Medicine, USC Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - James R. Cerhan
- Division of Epidemiology, College of Medicine, Mayo Clinic, Rochester, MN
| | - Patricia Hartge
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD
| | - Mary H. Ward
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD
| | - Anneclaire J. De Roos
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center and Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA
| | - Richard K. Severson
- Department of Family Medicine and Public Health Sciences, School of Medicine, Wayne State University, Detroit, MI
| | - Lindsay M. Morton
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD
| | - Leslie Bernstein
- Department of Preventive Medicine, USC Keck School of Medicine, University of Southern California, Los Angeles, CA
- Division of Cancer Etiology, Department of Population Sciences, Beckman Research Institute, City of Hope, Duarte, CA
| | - Martha S. Linet
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD
| | - Joanne S. Colt
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD
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Lawson JA, Rennie DC, Dosman JA, Cammer AL, Senthilselvan A. Obesity, diet, and activity in relation to asthma and wheeze among rural dwelling children and adolescents. J Obes 2013; 2013:315096. [PMID: 24191194 PMCID: PMC3804370 DOI: 10.1155/2013/315096] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2013] [Revised: 08/26/2013] [Accepted: 08/28/2013] [Indexed: 12/20/2022] Open
Abstract
AIMS AND OBJECTIVES We investigated associations between weight status, activity level, and diet with asthma or wheeze as well as the interrelationship between these factors. METHODS We conducted a case-control study of 6-18-year olds from 2005 to 2007. Cases (n = 87) were subjects reporting episodes or breathing medication use along with doctor-diagnosed asthma or wheeze in the past 12 months. Controls were randomly selected (n = 208) and without asthma or wheeze. Data regarding health outcomes, diet, and activity were obtained from questionnaire. Objectively measured height and weight were collected. RESULTS In the adjusted analysis, there was a trend (P = 0.07) towards an increased risk of asthma or wheeze associated with high fast food and/or pop consumption. Among cases, a significantly lower proportion (66%) classified as overweight participated in hard exercise in ≥9 of the past 14 days compared to those who were not overweight (86%). This pattern was not seen among controls (76% participating in hard exercise versus 78%, resp.). However, based on perceived weight status by the parent, the patterns were similar regardless of case-control status. CONCLUSIONS Overweight status may negatively impact activity level among those with asthma or wheeze. Efforts should be made to encourage healthy food choices, and activity programming must consider the needs of overweight children with asthma.
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Affiliation(s)
- Joshua A. Lawson
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, 3641-103 Hospital Drive, Royal University Hospital, Saskatoon, SK, Canada S7N 0W8
- Department of Medicine, University of Saskatchewan, Saskatoon, SK, Canada S7J 5B6
- *Joshua A. Lawson:
| | - Donna C. Rennie
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, SK, Canada S7N 0W8
- College of Nursing, University of Saskatchewan, Saskatoon, SK, Canada S7N 5E5
| | - James A. Dosman
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, SK, Canada S7N 0W8
| | - Allison L. Cammer
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, SK, Canada S7N 0W8
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