The association between endotoxin and lung function among children and adolescents living in a rural area.

UNLABELLED BACKGROUND⁄ OBJECTIVES Knowledge of the effects of domestic endotoxin on children's lung function is limited. The association between domestic endotoxin and asthma or wheeze and lung function among school-age children (six to 18 years of age) was examined. The interaction between endotoxin and other personal and environmental characteristics and lung function was also assessed. METHODS A case-control study was conducted in and around the rural community of Humboldt, Saskatchewan, between 2005 and 2007. Parents of cases reported either doctor-diagnosed asthma or wheeze in the previous year. Controls were randomly selected from those not reporting these conditions. Data were collected by questionnaire to ascertain symptoms and conditions, while spirometry was used to measure lung function including forced vital capacity and forced expiratory volume in 1 s. Dust collected from the child's play area floor and the child's mattress was used to quantify endotoxin, and saliva was collected to quantify cotinine levels and assess tobacco smoke exposure. RESULTS There were 102 cases and 207 controls included in the present study. Lower forced expiratory volume in 1 s was associated with higher mattress endotoxin load among female cases (beta=-0.25, SE=0.07 [P<0.01]). There was a trend toward lower forced vital capacity, which was associated with higher play area endotoxin load among cases with high tobacco smoke exposure (beta=-0.17, SE=0.09 [P<0.10]). CONCLUSIONS Findings indicated that high endotoxin levels present in common household areas of rural children with asthma or wheeze may also affect their lung function. These associations may be potentiated by tobacco smoke exposure and female sex.

[1]  J. Lawson,et al.  Relationship of endotoxin and tobacco smoke exposure to wheeze and diurnal peak expiratory flow variability in children and adolescents , 2011, Respirology.

[2]  D. Cockcroft,et al.  Assessment of endotoxin levels in the home and current asthma and wheeze in school-age children. , 2008, Indoor air.

[3]  Lennart Larsson,et al.  Asthmatic symptoms among pupils in relation to microbial dust exposure in schools in Taiyuan, China , 2008, Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology.

[4]  D. Cockcroft,et al.  Occurrence of new-onset wheeze in a 3-year follow-up study of schoolchildren. , 2007, Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology.

[5]  L. Williams,et al.  Endotoxin Exposure Is a Risk Factor for Asthma: The National Survey of Endotoxin in United States Housing , 2007, Pediatrics.

[6]  J. Cantor,et al.  SHORT-TERM CIGARETTE SMOKE EXPOSURE POTENTIATES ENDOTOXIN-INDUCED PULMONARY INFLAMMATION , 2007, Experimental lung research.

[7]  T. Holmen,et al.  Adolescent respiratory symptoms--girls are at risk: the Young-HUNT study, Norway. , 2006, Respiratory medicine.

[8]  James R Murphy,et al.  Importance of the personal endotoxin cloud in school-age children with asthma. , 2005, The Journal of allergy and clinical immunology.

[9]  D. Cockcroft,et al.  Regional variations in risk factors for asthma in school children. , 2005, Canadian respiratory journal.

[10]  C. Pickering,et al.  Endotoxin exposure in asthmatic children and matched healthy controls: results of IPEADAM study. , 2005, Indoor air.

[11]  B. Szponar,et al.  Tobacco smoking increases dramatically air concentrations of endotoxin. , 2004, Indoor air.

[12]  D. Strachan,et al.  Phase II of the International Study of Asthma and Allergies in Childhood (ISAAC II): rationale and methods , 2004, European Respiratory Journal.

[13]  D. Nowak,et al.  Determinants of endotoxin levels in living environments of farmers' children and their peers from rural areas , 2004, Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology.

[14]  B. Szponar,et al.  Characterization of Lipopolysaccharides Present in Settled House Dust , 2004, Applied and Environmental Microbiology.

[15]  D. Cockcroft,et al.  Differences in respiratory symptoms and pulmonary function in children in 2 Saskatchewan communities. , 2004, Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology.

[16]  E. Barrett-Connor,et al.  Gender differences in the impact of adolescent smoking on lung function and respiratory symptoms. the Nord-Trøndelag Health Study, Norway, 1995-1997. , 2002, Respiratory medicine.

[17]  D. Nowak,et al.  Environmental exposure to endotoxin and its relation to asthma in school-age children. , 2002, The New England journal of medicine.

[18]  D. Milton,et al.  Endotoxin-stimulated innate immunity: A contributing factor for asthma. , 2001, The Journal of allergy and clinical immunology.

[19]  B. Vargaftig,et al.  Endotoxins, asthma, and allergic immune responses. , 2000, Toxicology.

[20]  Braun‐Fahrländer,et al.  Exposure to endotoxin or other bacterial components might protect against the development of atopy , 2000, Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology.

[21]  M. Klinnert,et al.  Relation between house-dust endotoxin exposure, type 1 T-cell development, and allergen sensitisation in infants at high risk of asthma , 2000, The Lancet.

[22]  P. Sly,et al.  Modification of the inflammatory response to allergen challenge after exposure to bacterial lipopolysaccharide. , 2000, American journal of respiratory cell and molecular biology.

[23]  D. Leung,et al.  Levels of environmental endotoxin and prevalence of atopic disease. , 2000, JAMA.

[24]  J. Hasday,et al.  Bacterial endotoxin is an active component of cigarette smoke. , 1999, Chest.

[25]  D. Strachan,et al.  Parental smoking and spirometric indices in children , 1998 .

[26]  Shah Aa.  Worldwide variations in the prevalence of asthma symptoms: the International Study of Asthma and Allergies in Childhood (ISAAC) , 1998, The European respiratory journal.

[27]  R. Pauwels,et al.  Severity of asthma is related to endotoxin in house dust. , 1996, American journal of respiratory and critical care medicine.

[28]  Yue Chen,et al.  Influence of Environmental Tobacco Smoke on Asthma in Nonallergic and Allergic Children , 1996, Epidemiology.

[29]  C. Infante-Rivard,et al.  Induced abortion as a risk factor for subsequent fetal loss. , 1996 .

[30]  M. Chan-yeung,et al.  Mite and cat allergen levels in homes and severity of asthma. , 1995, American journal of respiratory and critical care medicine.

[31]  D. Schwartz,et al.  The role of endotoxin in grain dust-induced lung disease. , 1995, American journal of respiratory and critical care medicine.

[32]  D. Dockery,et al.  Pulmonary function growth velocity in children 6 to 18 years of age. , 1993, The American review of respiratory disease.

[33]  R. Sergysels,et al.  Domestic endotoxin exposure and clinical severity of asthma , 1991, Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology.

[34]  R. Sergysels,et al.  Effect of inhaled endotoxin on bronchial reactivity in asthmatic and normal subjects. , 1989, Journal of applied physiology.

[35]  M. Jarvis,et al.  Passive exposure to tobacco smoke: saliva cotinine concentrations in a representative population sample of non-smoking schoolchildren. , 1985, British medical journal.

[36]  D. Cotton,et al.  Effects of smoking and occupational exposure on peripheral airway function in young cereal grain workers. , 1982, The American review of respiratory disease.

[37]  B. Ferris,et al.  Epidemiology Standardization Project (American Thoracic Society). , 1978, The American review of respiratory disease.