HOME-ENVIRONMENT AND SEVERE ASTHMA IN ADOLESCENCE - A POPULATION-BASED CASE-CONTROL STUDY

Objective-To investigate the effects of the home environment on the ri sk of severe asthma during adolescence. Design-A questionnaire based c ase-control study drawn from a cross sectional survey of allergic dise ases among secondary school pupils in Sheffield in 1991.Subjects-763 c hildren whose parents had reported that over the previous 12 months th ey had suffered either 12 or more wheezing attacks or a speech limitin g attack of wheeze. A further 763 children were frequency matched for age and school class to act as controls. Analysis was restricted to 48 6 affected children and 475 others born between 1975 and 1980 who had lived at their present address for more than three years. Results-Inde pendent associations with severe wheeze were seen for non-feather bedd ing, especially foam pillows (odds ratio 2.78; 95% confidence interval 1.89 to 4.17), and the ownership of furry pets now (1.51; 1.04 to 2.2 0) and at birth (1.70; 1.20 to 2.40). These estimates were derived fro m subjects whose parents denied making changes in the bedroom or avoid ing having a pet because of allergy. Parental smoking, use of gas for cooking, age of mattress, and mould growth in the child's bedroom were not significantly associated with wheezing.Conclusions-Either our stu dy questionnaire failed to detect the avoidance or removal of feather bedding by allergic families or there is some undetermined hazard rela ted to foam pillows. Synthetic bedding and furry pets were both widesp read in this population and may represent remediable causes of childho od asthma.