Maternal Education and Cockroach Sensitization in Asthmatic Children

Abstract

Environmental allergies are a trigger for allergic asthma. Sensitization to pests, such as cockroach, is associated with more acute asthma visits. Our goal was to evaluate how various social determinants of health, particularly maternal education, were associated with sensitization to pests in asthmatic children. Children’s Mercy Kansas City’s environmental health department collected data during home assessments for families with asthmatic children. Demographics collected included household income, maternal education, and type of insurance. Maternal education level was categorized as less than high school, high school, college, and graduate. A Tobit regression model was developed that left-censored patients with IgE values <0.35 ku/L, which was the lowest limit of detection. For this model, the dependent variable, German cockroach IgE, was used to measure sensitization to pests. Independent variables included income, mother’s education, insurance, and home allergen levels for Alternaria, cockroach, and mouse. In our dataset, 167 participating families had maternal education level and German cockroach IgE values. Detectable cockroach and mouse allergen levels were in 69 homes. German cockroach IgE values ranged from 0.42 to 26.4 ku/L. For each increase in maternal education level, the expected German cockroach IgE was 3.38 ku/L lower than values from homes with less maternal education, holding all other variables constant (p=0.024). Cockroach sensitization was seen to a greater degree for homes with lower reported maternal education level. This data suggests an association between the home environment and maternal education level, which may impact the health of asthmatic children. Larger prospective studies minimizing study dropouts are warranted.