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Am J Epidemiol 2003; 158:195-202.
Copyright © 2003 by Johns Hopkins Bloomberg School of Public Health


ORIGINAL CONTRIBUTIONS

Symptoms of Wheeze and Persistent Cough in the First Year of Life: Associations with Indoor Allergens, Air Contaminants, and Maternal History of Asthma

Kathleen Belanger1 , William Beckett2, Elizabeth Triche1, Michael B. Bracken1, Theodore Holford1, Ping Ren1, Jean-ellen McSharry1, Diane R. Gold3,4, Thomas A. E. Platts-Mills5 and Brian P. Leaderer1

1 Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, CT.
2 Occupational Medicine Division, Department of Environmental Medicine, School of Medicine and Dentistry, University of Rochester, Rochester, NY.
3 Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital, Boston, MA.
4 Pulmonary Division, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
5 Department of Medicine, Division of Allergy and Immunology, University of Virginia Medical Center, Charlottesville, VA.

In a cohort of 849 infants with an asthmatic sibling, the authors examined the relations of exposure to allergens (dust mite, cockroach, cat, and dog), nitrogen dioxide, and mold with symptoms of wheeze and persistent cough in the first year of life (1998–2000). Among infants whose mothers had physician-diagnosed asthma, neither dust mite allergen nor dog allergen was associated with either symptom. Exposure to cockroach allergen (Bla g 1 at >=2 U/g) modestly increased the risk for wheeze (odds ratio (OR) = 1.87, 95% confidence interval (CI): 0.94, 3.71), and exposure to cat allergen modestly decreased the risk (OR = 0.60, 95% CI: 0.35, 1.03). Among infants of mothers with no asthma history, exposure to gas stoves (OR = 1.50, 95% CI: 1.05, 2.15) and wood-burning stoves (OR = 2.09, 95% CI: 1.12, 3.91) increased the risk of persistent cough. Similarly, measured nitrogen dioxide concentration was associated with persistent cough (OR = 1.21, 95% CI: 1.05, 1.40). Persistent mold affected both infants of mothers with asthma (for wheeze, OR = 2.27, 95% CI: 1.27, 4.07; for cough, OR = 1.83, 95% CI: 1.04, 3.22) and infants of mothers without asthma (for cough, OR = 1.55, 95% CI: 1.04, 2.31). Reported exposure was confirmed by an association of measured fungi with wheeze (OR = 1.23, 95% CI: 1.01, 1.49). This appears to have been the first study to measure all of these home exposures (indoor allergens, nitrogen dioxide, fungi) and to prospectively measure the frequency of infant wheeze and persistent cough.

allergens; cockroaches; cough; dust; fungi; infant; nitrogen dioxide; respiratory sounds

Abbreviations: Abbreviations: CI, confidence interval; OR, odds ratio.


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