Indoor pollutant exposures modify the effect of airborne endotoxin on asthma in urban children

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, Andrew H. Liu

Research output: Contribution to journalArticlepeer-review

37 Scopus citations


Rationale: The effect of endotoxin on asthma morbidity in urban populations is unclear. Objectives: To determine if indoor pollutant exposure modifies the relationshipsbetweenindoor airborne endotoxinandasthmahealth and morbidity. Methods: One 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 assessmentof airborne nicotine, endotoxin,andnitrogen 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 Results: Both air nicotine and NO 2 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, endotoxinwasnegatively associated with acute visit (interaction P value = 0.05). NO2 also modified the effect of endotoxin on asthma symptom outcomes in a similar manner. Conclusions: The 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.

Original languageEnglish (US)
Pages (from-to)1210-1215
Number of pages6
JournalAmerican journal of respiratory and critical care medicine
Issue number10
StatePublished - Nov 15 2013


  • Childhood asthma
  • Endotoxin
  • Indoor pollution
  • Nitrogen dioxide
  • Second-hand smoke

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine


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