Endotoxin in inner-city homes: Associations with wheeze and eczema in early childhood

Matthew S. Perzanowski, Rachel L. Miller, Peter S. Thorne, R. Graham Barr, Adnan Divjan, Beverley J. Sheares, Robin S. Garfinkel, Frederica P. Perera, Inge F. Goldstein, Ginger L. Chew

Research output: Contribution to journalArticlepeer-review

136 Scopus citations


Background: An inverse association between domestic exposure to endotoxin and atopy in childhood has been observed. The relevance of this aspect of the hygiene hypothesis to US inner-city communities that have disproportionately high asthma prevalence has not been determined. Objectives: To measure endotoxin in the dust from inner-city homes, evaluate associations between endotoxin and housing/lifestyle characteristics, and determine whether endotoxin exposure predicted wheeze, allergic rhinitis, and eczema over the first 3 years of life. Methods: As part of an ongoing prospective birth cohort study, children of Dominican and African-American mothers living in New York City underwent repeated questionnaire measures. Dust samples collected from bedroom floors at age 12 or 36 months were assayed for endotoxin. Results: Among the samples collected from 301 participants' homes, the geometric mean endotoxin concentration (95% CI) was 75.9 EU/mg (66-87), and load was 3892 EU/m 2 (3351-4522). Lower endotoxin concentrations were associated with wet mop cleaning and certain neighborhoods. Endotoxin concentration correlated weakly with cockroach (Bla g 2: r = 0.22, P < .001) and mouse (mouse urinary protein: r = 0.28; P < .001) allergens in the dust. Children in homes with higher endotoxin concentration were less likely to have eczema at age 1 year (odds ratio, 0.70 [0.53-0.93]) and more likely to wheeze at age 2 years (odds ratio, 1.34 [1.01-1.78]). These associations were stronger among children with a maternal history of asthma. Conclusion: Endotoxin levels in this inner-city community are similar to those in nonfarm homes elsewhere. In this community, domestic endotoxin exposure was inversely associated with eczema at age 1 year, but positively associated with wheeze at age 2 years. Clinical implications: Endotoxin exposure in the inner-city community may be related to wheeze in the early life; however, given the inverse association seen with eczema, the long-term development of allergic disease is still in question.

Original languageEnglish
Pages (from-to)1082-1089
Number of pages8
JournalJournal of Allergy and Clinical Immunology
Issue number5
StatePublished - May 2006
Externally publishedYes


  • Endotoxin
  • allergy
  • asthma
  • eczema
  • hygiene hypothesis
  • inner-city
  • wheeze


Dive into the research topics of 'Endotoxin in inner-city homes: Associations with wheeze and eczema in early childhood'. Together they form a unique fingerprint.

Cite this