De Vera MJ, Drapkin S, Moy JN. Ann Allergy Asthma Immunol. 2003;91:455–459
Purpose of the Study.
To assess the prevalence of positive allergy skin test results for common inhaled allergens and the association with wheezing among inner-city children being examined in a general pediatric clinic.
Seventy-five children, 2 months to 10 years of age, were studied. The children were undergoing well-child or follow-up visits in the general pediatric clinic at a teaching hospital in Chicago, Illinois. Children who had not been previously diagnosed as having asthma or other atopic diseases, as documented in their medical records, were selected.
Demographic data were collected for suburban versus urban residents. A questionnaire was administered regarding episodes of wheezing in the previous year and the presence of other allergic symptoms, family history, exposure to smoking and pets, and the presence of cockroaches in the home. Each child underwent standard allergy skin testing performed with the puncture method, with the Quintest skin test device (Hollister Stier Laboratories, Spokane, WA). Testing was performed for dust mites, cockroach mixture, cat hair, dog dander, mold mixture, grass mixture, and ragweed, with positive and negative control samples.
A total of 37% of the children demonstrated positive skin test results for ≥1 allergen; 29% of the children were sensitive to dust mites, 15% to cockroach mixture, 9% to cat hair, 7% to mold, 4% to grass, 3% to ragweed, and 1% to dog dander. Cockroach allergen was the only allergen that was correlated significantly with previous episodes of wheezing. Sixty-four percent of children with positive skin tests results for cockroach allergen had a history of wheezing, compared with 33% of those with negative results for cockroach allergen (P = .05). None of the families acknowledged seeing cockroaches in their homes. No significant correlation between exposure to cigarette smoke at home and a history of wheezing was noted.
Among a population of inner-city children not previously identified as atopic, more than one-third of the children showed sensitivity to ≥1 environmental allergen. Although dust mite allergen was the most common allergen to which children were sensitized, cockroach allergen sensitivity was the only response that was correlated significantly with previous episodes of wheezing.
Although this study was conducted in a general pediatric population, there are 3 messages that are very consistent with others that have focused on inner-city children with diagnosed asthma. First, wheezing is very common; second, allergic sensitization is extremely common, especially considering the age group included in this study; and third, cockroach is the allergen that is most associated with asthma morbidity in inner-city children.