Journal article
Endotoxin Exposure: Predictors and Prevalence of Associated Asthma Outcomes in the United States
American journal of respiratory and critical care medicine, Vol.192(11), pp.1287-1297
12/01/2015
DOI: 10.1164/rccm.201502-0251oc
PMCID: PMC4731700
PMID: 26258643
Abstract
Inhaled endotoxin induces airway inflammation and is an established risk factor for asthma. The 2005-2006 National Health and Nutrition Examination Survey included measures of endotoxin and allergens in homes as well as specific IgE to inhalant allergens.
To understand the relationships between endotoxin exposure, asthma outcomes, and sensitization status for 15 aeroallergens in a nationally representative sample.
Participants were administered questionnaires in their homes. Reservoir dust was vacuum sampled to generate composite bedding and bedroom floor samples. We analyzed 7,450 National Health and Nutrition Examination Survey dust and quality assurance samples for their endotoxin content using extreme quality assurance measures. Data for 6,963 subjects were available, making this the largest study of endotoxin exposure to date. Log-transformed endotoxin concentrations were analyzed using logistic models and forward stepwise linear regression. Analyses were weighted to provide national prevalence estimates and unbiased variances.
Endotoxin exposure was significantly associated with wheeze in the past 12 months, wheeze during exercise, doctor and/or emergency room visits for wheeze, and use of prescription medications for wheeze. Models adjusted for age, sex, race and/or ethnicity, and poverty-to-income ratio and stratified by allergy status showed that these relationships were not dependent upon sensitization status but were worsened among those living in poverty. Significant predictors of higher endotoxin exposures were lower family income; Hispanic ethnicity; participant age; dog(s), cat(s), cockroaches, and/or smoker(s) in the home; and carpeted floors.
In this U.S. nationwide representative sample, higher endotoxin exposure was significantly associated with measures of wheeze, with no observed protective effect regardless of sensitization status.
Details
- Title: Subtitle
- Endotoxin Exposure: Predictors and Prevalence of Associated Asthma Outcomes in the United States
- Creators
- Peter S Thorne - 1 Department of Occupational and Environmental Health, College of Public Health, University of Iowa, Iowa City, IowaAngelico Mendy - 1 Department of Occupational and Environmental Health, College of Public Health, University of Iowa, Iowa City, IowaNervana Metwali - 1 Department of Occupational and Environmental Health, College of Public Health, University of Iowa, Iowa City, IowaPäivi Salo - 2 Division of Intramural Research, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina; andCaroll Co - 3 Social & Scientific Systems, Inc., Durham, North CarolinaRenee Jaramillo - 3 Social & Scientific Systems, Inc., Durham, North CarolinaKathryn M Rose - 3 Social & Scientific Systems, Inc., Durham, North CarolinaDarryl C Zeldin - 2 Division of Intramural Research, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina; and
- Resource Type
- Journal article
- Publication Details
- American journal of respiratory and critical care medicine, Vol.192(11), pp.1287-1297
- DOI
- 10.1164/rccm.201502-0251oc
- PMID
- 26258643
- PMCID
- PMC4731700
- NLM abbreviation
- Am J Respir Crit Care Med
- ISSN
- 1535-4970
- eISSN
- 1535-4970
- Publisher
- United States
- Grant note
- P30 ES005605 / NIEHS NIH HHS Z01 ES025041 / Intramural NIH HHS P30 DK054759 / NIDDK NIH HHS
- Language
- English
- Date published
- 12/01/2015
- Academic Unit
- Civil and Environmental Engineering; Occupational and Environmental Health
- Record Identifier
- 9983997492302771
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