A narrative review on asthma and pest sensitization (cockroach, mouse and rat allergens): a social issue besides the medical problem

Abstract

Objective

Among animals defined as “pests”, cockroaches and rodents (mouse and rat) represent the most common cause of airway allergic sensitization and bronchial asthma worldwide. Their frequency of sensitization has been widely assessed in US and other countries but poorly in Western Europe. This narrative review aims to provide a synthesis of data resulting in MEDLINE concerning allergic sensitization/asthma to pests as well as their related environmental/social risk factors, specifically in the European area.

Data Sources

We performed a literature research in MEDLINE for clinical trials, randomized controlled trials, systematic reviews and meta-analyses.

Study Selections

We selected studies to the following key words: allergic sensitization, allergic rhinitis, bronchial asthma, cockroach, hypersensitivity, integrated pest management, material hardship, medication compliance, mouse, pest, poverty, rat, rodents.

Results

Current evidence indicates that residence in poor and urban areas, exposure to outdoor/indoor pollutants and tobacco smoke, poverty, material hardship, poor-quality housing, differences in health care quality, medication compliance, health care access contribute to increased pest-related allergic sensitization and asthma morbidity.

Conclusion

Further research should be done on many aspects of pest allergy such as a better characterization of allergens and epidemiological aspects. Relevant social actions should be carried out against poverty, healthcare disparities, psycho-social stress, poor compliance to therapy, with economic contributions to improve private and public living environments. Allergic sensitization to pests and pest-allergic respiratory diseases like asthma are "paradoxical" conditions, as they typically affect the poorest communities but can only be corrected by high-cost (diagnostic and preventive) interventions. We hope that progress can be made in this direction in the future.

Keywords:

• Allergic sensitization
• allergic rhinitis
• bronchial asthma
• cockroach
• hypersensitivity
• integrated pest management
• material hardship
• medication compliance
• mouse
• pest
• poverty
• rat
• rodents

Acknowledgements

We thank medical students Francesco Papa and Antonio Madonna for technical assistance in the preparation of this manuscript.

Authors’ contributions

All authors contributed equally in the writing and revision of the manuscript.

Conflict of interest and financial resources

All authors declare that they have no conflict of interest and that the study has been carried out without any financial support.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.