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Can reducing cockroaches in the home improve asthma outcomes?

Published Online: February 2017

Asthma is a complex, highly prevalent disease that causes substantial morbidity. Exposure to cockroaches in the home is related to severe asthma outcomes and reducing exposure to cockroaches is an important asthma management strategy. Integrated pest management (IPM) is the recommended strategy for cockroach control, however, it is costly and difficult to implement. Controlled studies have shown that using insecticidal bait (alone) may be an effective alternative to IPM. The impact of reducing cockroaches on asthma outcomes has not been studied.

In a study recently published in The Journal of Allergy and Clinical Immunology (JACI), Rabito and colleagues conducted a 12-month, single component, randomized controlled trial to determine if using insecticidal bait results in sustained cockroach elimination in the homes of low-income asthmatic children in New Orleans, Louisiana. Further, they assessed whether reducing the number of cockroaches in the home was associated with reduced asthma morbidity, improved biomarkers of inflammation, and reduced health care utilization. One-hundred and two moderate to severe asthmatic children were enrolled in the study.

Researchers found that homes where insecticidal bait was applied had significantly fewer cockroaches than in control homes and cockroach elimination was sustained over the 12-month follow-up. After 12 months, no intervention home had cockroach infestation compared to 22% of control homes. Reducing cockroaches in the home was associated with improved asthma outcomes. Children living in intervention homes had significantly fewer days with asthma symptoms, had better lung function, and less health care utilization.

Current recommendations for asthma management include multi-faceted allergen reduction strategies. Findings from this study suggest that targeted reduction of cockroaches in the home, using insecticidal baiting, is an effective alternative to more complex asthma cockroach management strategies and results in significant health benefits.  Baits are inexpensive, readily accessible, and are easily applied. If these findings are replicated, perhaps it is time to reconsider the need for multifaceted interventions for prevention of asthma exacerbation in homes with cockroaches.

The Journal of Allergy and Clinical Immunology (JACI) is the official scientific journal of the AAAAI, and is the most-cited journal in the field of allergy and clinical immunology.

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