Home environment allergen exposure scale in older adult cohort with asthma

Jessica Castner, Russell Barnett, Luz Huntington Moskos, Rodney J. Folz, Barbara Polivka

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Objectives: Home environmental exposures are a primary source of asthma exacerbation. There is a gap in decision support models that efficiently aggregate the home exposure assessment scores for focused and tailored interventions. Three development methods of a home environment allergen exposure scale for persons with asthma (weighted by dimension reduction, unweighted, precision biomarker-based) were compared, and racial disparity tested. Methods: Baseline measures from a longitudinal cohort of 187 older adults with asthma were analyzed using humidity and particulate matter sensors, allergy testing, and a home environment checklist. Weights for the dimension reduction scale were obtained from factor analysis, applied for loadings > 0.35. Scales were tested in linear regression models with asthma control and asthma quality of life outcomes. Racial disparities were tested using t tests. Scale performance was tested using unadjusted regression analyses with asthma control and asthma quality of life outcomes, separately. Results: The 7-item empirically weighted scale demonstrated best performance with asthma control associations (F = 4.65, p = 0.03, R2 =.02) and quality of life (F = 6.45, p = 0.01, R2 =.03) as follows: evidence of roach/mice, dust, mold, tobacco smoke exposure, properly venting bathroom fan, self-report of roach/mice/rats, and access to a HEPA filter vacuum. Pets indoors loaded on a separate scale. Racial differences were observed (t = − 3.09, p = 0.004). Conclusion: The Home Environment Allergen Exposure Scale scores were associated with racial disparities. Replicating these methods in populations residing in high-risk/low-income housing may generate a clinically meaningful, tailored assessment of asthma triggers. Further consideration for variables that address allergic reactivity and biomarker results is indicated to enhance the potential for a precision prevention score.

Original languageEnglish (US)
Pages (from-to)97-106
Number of pages10
JournalCanadian Journal of Public Health
Volume112
Issue number1
DOIs
StatePublished - Feb 2021

Keywords

  • Adult
  • Aged
  • Allergy and immunology
  • Asthma
  • Environment
  • Home care services

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

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