Home environment and childhood asthma

The prevalence of childhood asthma has increased dramatically in the past 20 years. The reasons for the increase are unclear but many authors suggest that changes in the home environment favourable to proliferation of the house dust mite are to blame. Our study aimed to compare home environment of children with asthma and controls. A questionnaire on home environment was administered to the parents of 134 children with asthma and 118 controls. Detailed studies of home temperature, humidity and dust mite allergen (DERp1) levels were performed in 20 homes (10 from each group). The questionnaire response rate was 86%. There were no significant differences between asthma and control homes with respect to social class, type of housing, smoking habits, pets, insulation, home heating, bedding, carpeting and domestic cleaning habits. A first degree family history of atopy was obtained in 42% of asthmatic families and in 16% of controls. Temperature, humidity and dust mite allergen levels were similar in both groups. The majority gave readings exceeding recommended norms. Values for DERp1 were above thresholds by a factor of 5 in 48%. Home environment does not significantly differ in children with or without asthma. The home environment is now generally mite friendly, and large segments of the childhood population are now exposed to high levels of DERp1. This may account for the increasing prevalence as more and more children with an atopic background develop overt symptoms in response to high levels of allergen load.