Asthma, allergy, and IgE levels in NYC head start children
Received 6 July 2009; accepted 20 October 2009. published online 16 November 2009. Corrected Proof
Summary
Background
Among preschool-age children in New York City neighborhoods with high asthma hospitalization rates, we analyzed the associations of total immunoglobulin E (IgE), specific IgE to common indoor allergens, and allergy symptoms with asthma.
Methods
Parents of children in New York City Head Start programs were asked to complete a questionnaire covering demographic factors, health history (including respiratory conditions), lifestyle, and home environment. Children's serum samples were analyzed for total IgE and specific IgE antibodies to cockroach, dust mite, mouse, and cat allergens by immunoassay. Logistic regression was used to model the association between asthma and IgE, controlling for age, gender, ethnicity/national origin, BMI, parental asthma, smokers in the household, and allergy symptoms (e.g., runny nose, rash).
Results
Among 453 participating children (mean age 4.0±0.5 years), 150 (33%) met our criteria for asthma. In our multivariable logistic regression models, children with asthma were more likely than other children to be sensitized to each allergen, to be sensitized to any of the four allergens (OR=1.6, 95% CI 1.0–2.6), or to be in the highest quartile of total IgE (OR=3.1, 95% CI 1.5–6.4). Allergy symptoms based on questionnaire responses were independently associated with asthma (OR=3.7, 95% CI 2.3–5.9).
Conclusions
Among preschool-aged urban children, asthma was associated with total IgE and sensitization to cat, mouse, cockroach, and dust mite allergens. However, allergy symptoms were more prevalent and more strongly associated with asthma than was any allergen-specific IgE; such symptoms may precede elevated specific IgE or represent a different pathway to asthma.
aDepartment of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th Street, 7th Floor, R736, NY 10032, New York, United States
bDepartment of Medicine, College of Physicians & Surgeons, Columbia University, 630 West 168th Street, P&S8-444, NY 10032, New York, United States
cDepartment of Environmental Health Sciences, Mailman School of Public Health, Columbia University, 60 Haven Avenue, B116, NY 10032, New York, United States
dDepartment of Pediatrics, College of Physicians & Surgeons, Columbia University, 630 West 168th Street, MSCHONY N746, NY 10032, New York, United States