Asthma, the most significant chronic lung disease in children, is strongly associated with sensitization to common indoor allergens. Our asthma program includes two studies: (a) a survey of allergen types and levels in the nation's housing to provide estimates of allergen exposure in the U.S. population (National Allergen Survey); and (b) a primary prevention trial to determine if environmental intervention aimed at reducing indoor allergen levels can prevent sensitization and decrease the prevalence of asthma in children at high risk for development of the disease (EIPPAC Study). The National Allergen Survey is a descriptive study of allergen types and levels in floor and bedding dust in the nation's housing. The survey design is a population-based, multi-stage area probability sample designed to represent all 50 states and the District of Columbia. It has approximately 850 homes in 75 primary sampling units. The major endpoints of the survey are measurements of allergen (Der f I, Der p I, Bla g I, Fel d I, Can f I, Mus m I, Rat n I, Alternaria) and endotoxin levels in dust collected from an array of sites in survey homes. The study will provide estimates of allergen exposure in the U.S. population and collect relevant data on housing conditions, demographic factors, and climate to facilitate evaluation of regional, ethnic, socioeconomic, and/or housing characteristic differences in the allergen burden. The EIPPAC Study is a clinical trial that will determine if environmental intervention aimed at reducing indoor allergen levels in homes can prevent sensitization and decrease the prevalence of asthma in high risk children. Pilot studies are being conducted to test the feasibility and effectiveness of various interventions to reduce indoor allergen levels in inner-city homes. Once an effective allergen reduction regimen is developed, approximately 500 children with a positive family history of asthma and/or allergy residing in low-income homes will be randomized, before birth, to one of two treatment groups: (a) comprehensive allergen reduction; or (b) placebo. Baseline data will include collection of dust from multiple household sites for measurement of allergens. All children and their dwellings will then be prospectively followed for six years with periodic clinical, immunological, and environmental assessments. This interventional study will provide important information concerning the role of environmental intervention in the primary prevention of asthma in children. This study will also provide insight into basic immunologic mechanisms operative during allergen sensitization and the expression of allergic diseases.

Agency
National Institute of Health (NIH)
Institute
National Institute of Environmental Health Sciences (NIEHS)
Type
Intramural Research (Z01)
Project #
1Z01ES025041-03
Application #
6432282
Study Section
(LPP)
Project Start
Project End
Budget Start
Budget End
Support Year
3
Fiscal Year
2000
Total Cost
Indirect Cost
Name
U.S. National Inst of Environ Hlth Scis
Department
Type
DUNS #
City
State
Country
United States
Zip Code
Salo, Päivi M; Wilkerson, Jesse; Rose, Kathryn M et al. (2018) Bedroom allergen exposures in US households. J Allergy Clin Immunol 141:1870-1879.e14
Cloutier, Michelle M; Salo, Paivi M; Akinbami, Lara J et al. (2018) Clinician Agreement, Self-Efficacy, and Adherence with the Guidelines for the Diagnosis and Management of Asthma. J Allergy Clin Immunol Pract 6:886-894.e4
Mendy, Angelico; Salo, Päivi M; Cohn, Richard D et al. (2018) House Dust Endotoxin Association with Chronic Bronchitis and Emphysema. Environ Health Perspect 126:037007
Mendy, Angelico; Wilkerson, Jesse; Salo, P?ivi M et al. (2018) Endotoxin predictors and associated respiratory outcomes differ with climate regions in the U.S. Environ Int 112:218-226
Gergen, Peter J; Mitchell, Herman E; Calatroni, Agustin et al. (2018) Sensitization and Exposure to Pets: The Effect on Asthma Morbidity in the US Population. J Allergy Clin Immunol Pract 6:101-107.e2
Salo, Paivi M; Cohn, Richard D; Zeldin, Darryl C (2018) Bedroom Allergen Exposure Beyond House Dust Mites. Curr Allergy Asthma Rep 18:52
Hoppin, Jane A; Umbach, David M; Long, Stuart et al. (2017) Pesticides are Associated with Allergic and Non-Allergic Wheeze among Male Farmers. Environ Health Perspect 125:535-543
Fessler, Michael B; Carnes, Megan U; Salo, Päivi M et al. (2017) House Dust Endotoxin and Peripheral Leukocyte Counts: Results from Two Large Epidemiologic Studies. Environ Health Perspect 125:057010
Winn, Amber K; Salo, Päivi M; Klein, Cynthia et al. (2016) Efficacy of an in-home test kit in reducing dust mite allergen levels: results of a randomized controlled pilot study. J Asthma 53:133-8
McGowan, Emily C; Peng, Roger D; Salo, Päivi M et al. (2016) Changes in Food-Specific IgE Over Time in the National Health and Nutrition Examination Survey (NHANES). J Allergy Clin Immunol Pract 4:713-20

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