Indoor allergen exposure, sensitization, and development of asthma in a high-risk birth cohort

Contradictory findings have been observed for the association of house dust mite (HDM), cat, and dog allergen exposure with sensitization and asthma. We sought to determine the relationship between exposures to these allergens, at various points during early childhood, and specific sensitization and asthma at age 7 in a high-risk birth cohort. As part of a multi-faceted Canadian intervention program for the primary prevention of asthma in high-risk infants, children were assessed by pediatric allergists at age 7 for asthma and underwent allergy skin prick testing. House dust samples were analyzed for HDM, cat, and dog allergen levels at several time points during years 1 and 7 of life. Multiple logistic regression analyses were carried out for the combined cohort and separately for the control and intervention groups. Exposure to a higher level of HDM allergen in year 1 or year 7 was associated with a higher risk of year 7 sensitization to HDM but not asthma. Exposure to higher levels of cat allergen in year 1 or year 7 did not affect the risk of year 7 sensitization to cat or asthma. Dog ownership, or exposure to higher levels of dog allergen in year 1 or year 7, did not affect the risk of year 7 sensitization to dog; however, year 7 dog allergen exposure (intervention group only) or ownership was associated with increased year 7 asthma risk. Our findings suggest that in high-risk children, there are allergen-specific associations of exposure with sensitization and with asthma; early life-elevated HDM exposure was associated with risk of sensitization but not asthma while the opposite was true for dog exposure.