Results of the National Cooperative Inner-City Asthma Study (NCICAS) environmental intervention to reduce cockroach allergen exposure in inner-city homes

J Allergy Clin Immunol. 1999 Mar;103(3 Pt 1):501-6. doi: 10.1016/s0091-6749(99)70477-x.


Background: Cockroach allergen is important in asthma. Practical methods to reduce exposure are needed.

Objective: We sought to evaluate the effectiveness of house cleaning and professional extermination on lowering cockroach antigen levels in inner-city dwellings.

Methods: As part of the National Cooperative Inner-City Asthma Study intervention, 265 of 331 families with asthmatic children who had positive skin test responses to cockroach allergen consented to a professional home extermination with 2 applications of a cockroach insecticide (Abamectin, Avert) combined with directed education on cockroach allergen removal. On a random subset of 48 homes undergoing cockroach extermination in the intervention group, Bla g 1 was measured in settled dust from the kitchen, bedroom, and TV/living room. The first sample was collected 1 week before extermination, with additional samples after the exterminations at approximately 2, 6, and 12 months after the first sample. Self-reported problems with cockroaches were collected at baseline and after 12 months of follow-up in both the intervention and control group.

Results: The geometric mean kitchen level of Bla g 1 decreased at 2 months (33.6 U/g) relative to preextermination levels (68.7 U/g, P <.05). The percent of kitchens with over 8 U/g of Bla g 1 followed a similar pattern, but only the decrease from preextermination to 6-month levels was significant (86.8% vs 64.3%, P <.05). By the 12-month visit, the allergen burden had returned to or exceeded baseline levels. Except for an increase in the bedroom at 2 months (8.9 U/g vs 11.1 U/g, P <.05), no other significant change was seen. Only about 50% of the families followed the cleaning instructions; no greater effect was found in these homes. Self-reported problems with cockroaches showed no difference between the intervention and control group after 1 year of follow-up.

Conclusions: Despite a significant, but short-lived, decrease the cockroach allergen burden remained well above levels previously found to be clinically significant.

Publication types

  • Clinical Trial
  • Clinical Trial, Phase II
  • Multicenter Study
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Allergens / adverse effects*
  • Allergens / analysis
  • Animals
  • Antigens, Plant
  • Asthma / epidemiology
  • Asthma / etiology
  • Asthma / prevention & control*
  • Cockroaches / immunology*
  • Cross-Sectional Studies
  • Dust / analysis*
  • Environmental Exposure
  • Housing*
  • Humans
  • Insect Control*
  • Insect Proteins / adverse effects*
  • Insect Proteins / analysis
  • Program Evaluation
  • United States / epidemiology
  • Urban Population


  • Allergens
  • Antigens, Plant
  • Dust
  • Insect Proteins
  • allergen Bla g 1