142nd APHA Annual Meeting and Exposition

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299568
Geographic Differences in Allergic Sensitization and Environmental Exposures among Children with Asthma: Comparing Patient Differences in a Study of Three Geographically-Distinct Federally Qualified Healthcare Centers

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Monday, November 17, 2014

Michelle Sever, PhD , Rho, Inc., Chapel Hill, NC
Ryan Bailey, MA , Rho, Inc., Chapel Hill, NC
Amanda Smith, MS , Rho, Inc., Chapel Hill, NC
Katy Jaffee, MS , Rho, Inc., Chapel Hill, NC
Suzanne Kennedy, PhD , Rho, Inc., Chapel Hill, NC
David Stevens, MD , Department of Health Policy, School of Public Health and Health Services, George Washington University, Washington, DC
Maya Gerstein, MPH , Department of Health Policy, Milken Institute School of Public Health, George Washington University, Washington, DC
Anne Markus, PhD, JD, MHS , Department of Health Policy, Milken Institute School of Public Health, George Washington University, Washington, DC
Herman Mitchell, PhD , Federal Operations, Rho, Chapel Hill, NC
  
Allergic sensitization and asthma morbidity are influenced by geographic factors including environmental exposures, climate, socioeconomic conditions, urbanicity, and population ethnicity.  What is less clear is how the unique characteristics of a given location impact allergic sensitization and household exposures of the local patient population with asthma.

CHAMPS (Community Healthcare for Asthma Management and Prevention of Symptoms) is a translational research study evaluating the effectiveness of an evidence-based childhood asthma intervention in 3 FQHCs in Arizona, Michigan, and Puerto Rico. 

CHAMPS enrolled 319 children with asthma between 5 and 12 years of age. Allergic sensitization was assessed by either skin prick test (Arizona) or IgE testing. Puerto Rican children had a higher prevalence of sensitization to all allergens tested, except for mold, where the highest prevalence was found in Arizona (37%), followed by Michigan (32%), and Puerto Rico (19%). In Puerto Rico, 77% of children were sensitized to Dust Mite, compared to 38% in Michigan and 34% in Arizona. Cockroach sensitization was 34% in Puerto Rico, 22% in Arizona, and 17% in Michigan. Housing type also varied by site. Nearly 60% of children in Arizona and Michigan lived in detached houses compared to only 24% in Puerto Rico. Over 30% of the children in Puerto Rico were living in a “handmade” house. Household exposures varied by site with Puerto Rico having more rodent exposure, 61% compared to 24% in Michigan and 18% in Arizona. Cockroach exposure varied the most by site (78 % in Puerto Rico, 32% in Arizona, and 13% in Michigan); however, exposure to mildew, moisture, and water damage varied less across sites (84% in Puerto Rico, 73% in Michigan, and 63% in Arizona).

Sensitivities and exposures vary by site; clinicians should consider local geographic and environmental influences when treating their patients with asthma.

Learning Areas:

Assessment of individual and community needs for health education
Chronic disease management and prevention
Environmental health sciences
Epidemiology
Implementation of health education strategies, interventions and programs
Public health or related research

Learning Objectives:
Compare allergic sensitization and household exposure patterns among three geographically distinct populations of children with asthma

Keyword(s): Child Health, Environmental Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the principal or co-investigator of multiple federally funded contracts and grants related to allergy, asthma, environmental exposures and interventions. My scientific interests include the influence of the home environment on children with asthma and understanding the biologic mechanisms of allergic disease.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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