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Article summary:
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| Abstract | Background: Diverse environmental exposures, studied separately, have been linked to health outcomes in adult asthma, but integrated multi-factorial effects have not been modeled. We sought to evaluate the contribution of combined social and physical environmental exposures to adult asthma lung function and disease severity. Methods: Data on 176 subjects with asthma and/or rhinitis were collected via telephone interviews for sociodemographic factors and asthma severity (scored on a 0-28 point range). Dust, indoor air quality, antigen-specific IgE antibodies, and lung function (percent predicted FEV1) were assessed through home visits. Neighborhood socioeconomic status, proximity to traffic, land use, and ambient air quality data were linked to the individual-level data via residential geocoding. Multiple linear regression separately tested the explanatory power of five groups of environmental factors for the outcomes, percent predicted FEV1 and asthma severity. Final models retained all variables statistically associated (p < 0.20) with each of the two outcomes. Results: Mean FEV1 was 85.0 ± 18.6%; mean asthma severity score was 6.9 ± 5.6. Of 29 variables screened, 13 were retained in the final model of FEV1 (R2 = 0.30; p < 0.001) and 15 for severity (R2 = 0.16; p < 0.001), including factors from each of the five groups. Adding FEV1 as an independent variable to the severity model further increased its explanatory power (R2 = 0.25). Conclusions: Multivariate models covering a range of individual and environmental factors explained nearly a third of FEV1 variability and, taking into account lung function, one quarter of variability in asthma severity. These data support an integrated approach to modeling adult asthma outcomes, including both the physical and the social environment. |
| Full text | Full Text in PDF (907 KB) |
| Source link | http://www.ehjournal.net/content/pdf/1476-069X-9-24.pdf |
| Included Refrences | 46 References (List...) |
| Cited by other Articles | 0 Citations (List...) |
| Name | Affiliation | Home page | Total pubs | |
| Balmes JR | Division of Environmental Health Sciences, School of Public Health, University of California Berkeley, Berkeley, CA USA | 1 | ||
| Blanc PD | Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of California, San Francisco, UCSF Box 0924, San Francisco, CA 94113-0924, USA | 2 | ||
| Chen H | College of Environmental Science and Engineering, Donghua University, Shanghai 200051, China | hszhuang@dhu.edu.cn | 3 | |
| Eisner MD | Department of Medicine, University of California, San Francisco, UCSF Box 0924, San Francisco, CA 94113-0924, USA | 2 | ||
| Hammond SK | Division of Environmental Health Sciences, School of Public Health, University of California Berkeley, Berkeley, CA USA | 1 | ||
| Katz PP | nstitute for Health Policy Studies, University of California, San Francisco, UCSF Box 0920, San Francisco, CA 94113-0920, USA | 2 | ||
| Lurmann F | Sonoma Technology Incorporated, Petaluma, CA USA | 1 | ||
| Quinlan PJ | Department of Medicine, University of California San Francisco, San Francisco, CA USA | 1 | ||
| Thorne PS | Department of Occupational and Environmental Health, College of Public Health, University of Iowa, Iowa City, IA USA | 1 | ||
| Trupin L | Department of Medicine, University of California, San Francisco, UCSF Box 0924, San Francisco, CA 94113-0924, USA | laura.trupin@ucsf.edu | 2 | |
| Yelin EH | Institute for Health Policy Studies, University of California, San Francisco, UCSF Box 0920, San Francisco, CA 94113-0920, USA | 2 |
References included in article:
| Order of appearence | Full citation | SRCosmos Link |
| 1 | Gent JF, Belanger K, Triche EW, Bracken MB, Beckett WS, Leaderer BP, 2009, Association of pediatric asthma severity with exposure to common household dust allergens. Environmental Research 109:768-774. | |
| 2 | Langley SJ, Goldthorpe S, Craven M, Morris J, Woodcock A, Custovic A, 2003, Exposure and sensitization to indoor allergens: association with lung function, bronchial reactivity, and exhaled nitric oxide measures in asthma. J Allergy Clin Immunol 112:362-368. | |
| 3 | Lewis SA, Weiss ST, Platts-Mills TA, Burge H, Gold DR, 2002, The role of indoor allergen sensitization and exposure in causing morbidity in women with asthma. Am J Respir Crit Care Med 165:961-966. | |
| 4 | Maestrelli P, Zanolla L, Puccinelli P, Pozzan M, Fabbri LM, 2001, Low domestic exposure to house dust mite allergens (Der p 1) is associated with a reduced non-specific bronchial hyper-responsiveness in mite-sensitized asthmatic subjects under optimal drug treatment. Clin Exp Allergy 31:715-721. | |
| 5 | Salo PM, Jaramillo R, Cohn RD, London SJ, Zeldin DC, 2009, Exposure to mouse allergen in U.S. homes associated with asthma symptoms. Environ Health Perspect 117:387-391. | |
| 6 | Thorne PS, Kulhankova K, Yin M, Cohn R, Arbes SJ, Zeldin DC, 2005, Endotoxin exposure is a risk factor for asthma - The National Survey of Endotoxin in United States Housing. American Journal of Respiratory and Critical Care Medicine 172:1371-1377. | |
| 7 | Eisner MD, 2008, Passive smoking and adult asthma. Immunol Allergy Clin North Am 28:521-537. | |
| 8 | Baena-Cagnani CE, Gomez RM, Baena-Cagnani R, Canonica GW, 2009, Impact of environmental tobacco smoke and active tobacco smoking on the development and outcomes of asthma and rhinitis. Curr Opin Allergy Clin Immunol 9:136-140. | |
| 9 | Sahakian NM, Park JH, Cox-Ganser JM, 2008, Dampness and mold in the indoor environment: Implications for asthma. Immunology and Allergy Clinics of North America 28:485-505. | |
| 10 | Belanger K, Triche EW, 2008, Indoor combustion and asthma. Immunol Allergy Clin North Am 28:507-519 | |
| 11 | Kim H, Bernstein JA, 2009, Air pollution and allergic disease. Curr Allergy Asthma Rep 9:128-133. | |
| 12 | Salam MT, Islam T, Gilliland FD, 2008, Recent evidence for adverse effects of residential proximity to traffic sources on asthma. Curr Opin Pulm Med 14:3-8. | |
| 13 | Sarnat JA, Holguin F, 2007, Asthma and air quality. Curr Opin Pulm Med 13:63-66. | |
| 14 | Riedl M, Diaz-Sanchez D, 2005, Biology of diesel exhaust effects on respiratory function. J Allergy Clin Immunol 115:221-228. | |
| 15 | Tatum AJ, Shapiro GG, 2005, The effects of outdoor air pollution and tobacco smoke on asthma. Immunol Allergy Clin North Am 25:15-30. | |
| 16 | Balmes JR, Earnest G, Katz PP, Yelin EH, Eisner MD, Chen H, Trupin L, Lurmann F, Blanc PD, 2009, Exposure to traffic: Lung function and health status in adults with asthma. J Allergy Clin Immunol 123:626-631. | |
| 17 | Holguin F, 2008, Traffic, outdoor air pollution, and asthma. Immunology and Allergy Clinics of North America 28:577-588. viii-ix | |
| 18 | Jacquemin B, Sunyer J, Forsberg B, Aguilera I, Bouso L, Briggs D, De-Marco R, Garcia-Esteban R, Heinrich J, Jarvis D, et al., 2009, Association between modelled traffic-related air pollution and asthma score in the ECRHS. Eur Respir J 34:834-842. | |
| 19 | Diette GB, Mc-Cormack MC, Hansel NN, Breysse PN, Matsui EC, 2008, Environmental issues in managing asthma. Respir Care 53:602-615. discussion 616-607 | |
| 20 | Strachan DP, 2000, The role of environmental factors in asthma. Br Med Bull 56:865-882. | |
| 21 | Delfino RJ, 2002, Epidemiologic evidence for asthma and exposure to air toxics: linkages between occupational, indoor, and community air pollution research. Environ Health Perspect 110(Suppl 4):573-589. | |
| 22 | Blanc PD, Cisternas M, Smith S, Yelin EH, 1996, Asthma, employment status, and disability among adults treated by pulmonary and allergy specialists. Chest 109:688-696. Erratum: Chest 2000;118:2564 | |
| 23 | Toren K, Brisman J, Olin AC, Blanc PD, 2000, Asthma on the job: work-related factors in new-onset asthma and in exacerbations of pre-existing asthma. Respiratory Medicine 94:529-535. | |
| 24 | Saarinen K, Karjalainen A, Martikainen R, Uitti J, Tammilehto L, Klaukka T, Kurppa K, 2003, Prevalence of work-aggravated symptoms in clinically established asthma. European Respiratory Journal 22:305-309. | |
| 25 | Tarlo SM, 2008, Occupational exposures and adult asthma. Immunology and Allergy Clinics of North America 28:563-576. | |
| 26 | Banks DE, Jalloul A, 2007, Occupational asthma, work-related asthma and reactive airways dysfunction syndrome. Curr Opin Pulm Med 13:131-136. | |
| 27 | Forno E, Celedon JC, 2009, Asthma and ethnic minorities: socioeconomic status and beyond. Curr Opin Allergy Clin Immunol 9:154-160. | |
| 28 | Bryant-Stephens T, 2009, Asthma disparities in urban environments. J Allergy Clin Immunol 123:1199-1206. | |
| 29 | Blanc PD, Yen IH, Chen H, Katz PP, Earnest G, Balmes JR, Trupin L, Friedling N, Yelin EH, Eisner MD, 2006, Area-level socio-economic status and health status among adults with asthma and rhinitis. European Respiratory Journal 27:85-94. | |
| 30 | Sandel M, Wright RJ, 2006, When home is where the stress is: expanding the dimensions of housing that influence asthma morbidity. Arch Dis Child 91:942-948. | |
| 31 | Eisner MD, Katz PP, Yelin EH, Henke J, Smith S, Blanc PD, 2000, Assessment of asthma severity in adults with asthma treated by family practitioners, allergists, and pulmonologists. Medical Care 1998, 36:1567-1577. Erratum: Med Care 38:1880-1885 | |
| 32 | Blanc PD, Trupin L, Eisner M, Earnest G, Katz PP, Israel L, Yelin EH, 2001, The work impact of asthma and rhinitis: Findings from a population-based survey. Journal of Clinical Epidemiology 54:610-618. | |
| 33 | Blanc PD, Eisner MD, Katz PP, Yen IH, Archea C, Earnest G, Janson S, Masharani UB, Quinlan PJ, Hammond SK, et al., 2005, Impact of the home indoor environment on adult asthma and rhinitis. Journal of Occupational and Environmental Medicine 47:362-372. | |
| 34 | Mortimer KM, Fallot A, Balmes JR, Tager IB, 2003, Evaluating the use of a portable spirometer in a study of pediatric asthma. Chest 123:1899-1907. | |
| 35 | American Thoracic Society. 1995, Standardization of Spirometry, 1994 Update. Am J Respir Crit Care Med 152:1107-1136. | |
| 36 | Hankinson JL, Odencrantz JR, Fedan KB, 1999, Spirometric reference values from a sample of the general U.S. population. Am J Respir Crit Care Med 159:179-187. | |
| 37 | Eisner MD, Boland M, Tolstykh I, Mendoza G, Iribarren C, 2005, Intensive care unit admission for asthma: A marker for severe disease. Journal of Asthma 42:315-323. | |
| 38 | Eisner MD, Yelin EH, Katz PP, Lactao G, Iribarren C, Blanc PD, 2006, Risk factors for work disability in severe adult asthma. American Journal of Medicine 119:884-891 | |
| 39 | Omachi TA, Iribarren C, Sarkar U, Tolstykh I, Yelin EH, Katz PP, Blanc PD, Eisner MD, 2008, Risk factors for death in adults with severe asthma. Annals of Allergy Asthma & Immunology 101:130-136. | |
| 40 | Marks G, Dunn S, Woolcock A, 1992, A scale for the measurement of quality of life in adults with asthma. J Clin Epidemiol 45:461-472. | |
| 41 | Katz PP, Eisner MD, Henke J, Shiboski S, Yelin EH, Blanc PD, 2001, The Marks Asthma Quality of Life Questionnaire: Further validation and examination of responsiveness to change. J Clin Epidemiol 1999, 52:667-675. Erratum: J Clin Epidemiol. 54:2105-2107 | |
| 42 | Lanc PD, Eisner MD, Balmes JR, Trupin L, Yelin EH, Katz PP, 2005, Exposure to vapors, gas, dust, or fumes: Assessment by a single survey item compared to a detailed exposure battery and a job exposure matrix. American Journal of Industrial Medicine 48:110-117. | |
| 43 | Eisner MD, Katz PP, Yelin EH, Hammond SK, Blanc PD, 2001, Measurement of environmental tobacco smoke exposure among adults with asthma. Environmental Health Perspectives 109:809-814. | |
| 44 | Gauderman WJ, Vora H, Mc-Connell R, Berhane K, Gilliland F, Thomas D, Lurmann F, Avoli E, Künzli N, Jerrett M, Peters J, 2007, Effect of exposure to traffic on lung development from 10 to 18 years of age: a cohort study. Lancet 369:571-577. | |
| 45 | Belsey D, Kuh E, Welsch R, 1980, Regression Diagnostics. New York: John Wiley & Sons. | |
| 46 | Ebrahim S, Montaner D, Lawlor DA, 2004, Clustering of risk factors and social class in childhood and adulthood in British women's heart and health study: cross sectional analysis. British Medical Journal 328:861-864. |