Original Articles: Asthma, Rhinitis, Other Respiratory Diseases
The prevalence of environmental exposure to perceived asthma triggers in children with mild-to-moderate asthma: Data from the Childhood Asthma Management Program (CAMP),☆☆,

https://doi.org/10.1067/mai.2001.113869Get rights and content

Abstract

Background: The Childhood Asthma Management Program, a 5-year randomized clinical trial of treatments for childhood asthma, has enrolled and characterized a cohort of 1041 children with mild-to-moderate asthma. Objective: We sought to describe self-reported sensitivities and environmental exposures and investigate the relationships between self-report of these exposures as asthma triggers and their prevalence in the home. Methods: Self-reports of sensitivities and home exposures were obtained by interview with the child or parent. Sensitivities were further assessed by using allergy skin testing (prick or puncture) against a core battery of allergens. Home exposures were further assessed by using analysis of a home dust sample. Results: Environmental exposures were surprisingly common despite self-reported sensitivities to environmental factors. Of patients reporting that cigarette smoking frequently causes asthma symptoms, 26% reported having at least one parent who smokes cigarettes. Thirty-nine percent of patients reporting that exposure to animals frequently causes asthma symptoms live with a furry pet in their home. We found a smaller proportion of homes with a high level of cat allergen (P < .001) among the children who reported that animals frequently or always trigger asthma symptoms compared with those who reported that animals never or occasionally trigger asthma symptoms, suggesting modification of the home environment. No such results were seen for dog exposure. However, clinical symptoms did not reduce exposure to parental cigarette smoking (P = .15), house dust (P = .31), or damp and musty areas (P = .51). Conclusion: These data suggest that children with mild-to-moderate asthma are frequently symptomatic and exposed to a wide variety of environmental exposures that are perceived to trigger symptoms by means of self-report. Although environmental modification of asthmatic homes may occur, many children remain exposed to agents that are known to trigger their asthma. (J Allergy Clin Immunol 2001;107:634-40.)

Section snippets

Methods

The details of the CAMP study design, rationale, and methods have been published.12 Children aged 5 to 12 years with chronic asthma were recruited over a 23-month period from clinic rosters; emergency department records; primary care practices; radio, television, and newspaper advertisements; and other sources. Entry criteria included asthma symptoms, medication use, or both for 6 months or more in the previous year. Patients were excluded if they had needed prednisone bursts more than 5 times

Demographics

Characteristics of the CAMP population are summarized in Table I, and more detailed descriptions can be found elsewhere.10, 11 The mean age of the children at study entry was 8.4 years, and 60% were boys. Thirty-two percent of the children represented various ethnic minority groups. The educational background of the parent or legal guardian escorting the child to the initial screening visit suggests that most of the children came from well-educated families; 82% had some college or

Discussion

The characteristics of the CAMP participants approximate the goals of the trial reasonably well, which were to enroll children with mild-to-moderate asthma that might potentially benefit from long-term anti-inflammatory therapy and hence influence growth of lung function. The descriptive characteristics of the CAMP participants demonstrate a consistency with known truisms about prepubertal childhood asthma.1, 2, 3, 4, 5, 6, 7, 8, 9, 16 In general, this disease has a male predominance, as is

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  • Cited by (0)

    Supported by contracts NO1-HR-16044, 16045, 16046, 16047, 16048, 16049, 16050, 16051, and 16052 with the National Heart, Lung, and Blood Institute and General Clinical Research Center grants M01RR00051, M01RR0099718-24, M01RR02719-14, and RR00036 from the National Center for Research Resources. The Harvard Pilgrim Health Care Foundation provides additional support for the CAMP center at Brigham & Women’s Hospital.

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    *See appendix for listing of members of the CAMP Research Group.

    Reprint requests: Alice Sternberg, ScM, CAMP Coordinating Center, Johns Hopkins Center for Clinical Trials, 615 North Wolfe Street, Room 5010, Baltimore, MD 21205.

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