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Published ahead of print on July 25, 2002, doi:10.1164/rccm.200203-256OC

Am. J. Respir. Crit. Care Med., Volume 166, Number 7, October 2002, 939-944

A more recent version of this article appeared on October 1, 2002
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Submitted on April 12, 2002
Accepted on July 19, 2002

House dust endotoxin and allergic sensitization in children

Ulrike Gehring1*, Wolfgang Bischof2, Barbel Fahlbusch3, H.-Erich Wichmann1, and Joachim Heinrich4

1 Institute of Epidemiology, GSF National Research Center for Environment and Health, Neuherberg, Germany; Chair of Epidemiology, Ludwig-Maximilians-University of Munich, Institute of Medical Data Management, Biometrics and Epidemiology, Munich, Germany, 2 Department Indoor Climatology (ark), Friedrich-Schiller-University of Jena, Institute of Occupational, Social and Environmental Medicine, Erfurt, Germany, 3 Institute of Clinical Immunology, Friedrich-Schiller-University of Jena, Jena, Germany, 4 Institute of Epidemiology, GSF National Research Center for Environment and Health, Neuherberg, Germany

* To whom correspondence should be addressed. E-mail: gehring{at}gsf.de.

A higher exposure to endotoxin was hypothesized to contribute to lower prevalence of allergic sensitization and hay fever in children growing up on a farm. We studied the association between to house dust endotoxin and allergic sensitization. We randomly selected 740 children, aged 5-10 years, from participants of two cross-sectional surveys performed in Saxony-Anhalt, Germany, in 1992-93 and 1995-96 such that 50% of the children were atopic or had a diagnosis of asthma. In 1996-98, we collected living room floor dust in the homes of 454 of these children (61%). House dust content to endotoxin was quantified using a chromogenic kinetic limulus amoebocyte lysate test and related to health outcomes measured in the preceding cross-sectional surveys. Multiple logistic regression analyses adjusted for place of residence, gender, age, parental education, parental atopy, and pet ownership showed a negative association between exposure to endotoxin and sensitization to >=1 allergen [aOR (95% CI) 0.95 (0.83;1.10)] and >=2 allergens [aOR (95% CI) 0.80 (0.67;0.97)] using 0.35 kU/L as a cut-off value for sensitization. The protective effect was strengthened with an increasing degree of sensitization. In conclusion, exposure to higher levels of house dust endotoxin is associated with lower prevalence of allergic sensitization in children.




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