• Elizabeth C Matsui, Nadia N Hansel, Charles Aloe, Allison M Schiltz, Roger D Peng, Nathan Rabinovitch, Mary Jane Ong, D'Ann L Williams, Patrick N Breysse, Gregory B Diette, and Andrew H Liu.
• 1 Division of Pediatric Allergy and Immunology and.
• Am. J. Respir. Crit. Care Med.. 2013 Nov 15;188(10):1210-5.

RationaleThe effect of endotoxin on asthma morbidity in urban populations is unclear.ObjectivesTo determine if indoor pollutant exposure modifies the relationships between indoor airborne endotoxin and asthma health and morbidity.MethodsOne hundred forty-six children and adolescents with persistent asthma underwent repeated clinical assessments at 0, 3, 6, 9, and 12 months. Home visits were conducted at the same time points for assessment of airborne nicotine, endotoxin, and nitrogen dioxide (NO2) concentrations. The effect of concomitant pollutant exposure on relationships between endotoxin and asthma outcomes were examined in stratified analyses and statistical models with interaction terms.Measurements And Main ResultsBoth air nicotine and NO2 concentrations modified the relationships between airborne endotoxin and asthma outcomes. Among children living in homes with no detectable air nicotine, higher endotoxin was inversely associated with acute visits and oral corticosteroid bursts, whereas among those in homes with detectable air nicotine, endotoxin was positively associated with these outcomes (interaction P value = 0.004 and 0.07, respectively). Among children living in homes with lower NO2 concentrations (<20 ppb), higher endotoxin was positively associated with acute visits, whereas among those living in homes with higher NO2 concentrations, endotoxin was negatively associated with acute visit (interaction P value = 0.05). NO2 also modified the effect of endotoxin on asthma symptom outcomes in a similar manner.ConclusionsThe effects of household airborne endotoxin exposure on asthma are modified by coexposure to air nicotine and NO2, and these pollutants have opposite effects on the relationships between endotoxin and asthma-related outcomes.

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