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Relationship Between Housing Components and Development of Eosinophilic Esophagitis

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Abstract

Background

While the environment contributes to EoE pathogenesis, few environmental risk factors for EoE have been identified.

Aim

To determine whether housing components such as exterior materials, heating systems, and house age are associated with EoE.

Methods

This case–control study used the UNC EoE clinicopathologic database to identify newly diagnosed EoE patients. Controls were patients without EoE who underwent endoscopy during the study time frame. Housing data were collected from publicly available online sources, and cases and controls were compared. The primary analysis was restricted to those living at their provided address at the time of diagnostic endoscopy. Multivariable logistical regression estimated associations after adjusting for potential confounders.

Results

Of 451 EoE cases and 2421 controls identified, the primary analysis included 158 cases and 769 controls. Compared to controls, EoE cases were more likely to have a house with a brick exterior (35% vs 26%; p = 0.04), gas heating (14% vs 8%; p = 0.06), or forced air (57% vs 45%; p = 0.009). In adjusted analysis, brick exterior was positively associated with EoE diagnosis [aOR 1.83 (95% CI 1.11–3.02)]. The average duration a patient lived in their house before EoE diagnosis was 7.2 ± 5.9 years, while symptom duration prior to diagnosis was 6.8 ± 8.4 years.

Conclusion

EoE patients were more likely to have houses with a brick exterior, forced air, or gas heating, and brick exteriors were independently associated with EoE. Since symptoms generally started after moving into a house, housing-related environmental exposures may contribute to EoE disease development.

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Funding

This study was supported, in part, by NIH T35 DK007386 (SRC; MT), T32 DK007634 (CCC), R01 DK101856 (ESD), and R01 AI39126 (ETJ).

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Authors and Affiliations

  1. Center for Esophageal Diseases and Swallowing, UNC-CH, Chapel Hill, NC, USA

    S. Ryanne Corder, Manaswita Tappata, Olivia Shaheen, Cary C. Cotton, Elizabeth T. Jensen & Evan S. Dellon

  2. Department of Epidemiology and Prevention, Wake Forest School of Medicine, UNC-CH, Chapel Hill, NC, USA

    Elizabeth T. Jensen

  3. Center for Gastrointestinal Biology and Disease, Division of Gastroenterology and Hepatology, Department of Medicine, UNC-CH, Chapel Hill, NC, USA

    Evan S. Dellon

  4. UNC-CH, CB#7080, Bioinformatics Building, 130 Mason Farm Rd., Chapel Hill, NC, 27599-7080, USA

    Evan S. Dellon

Authors
  1. S. Ryanne Corder
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  2. Manaswita Tappata
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  3. Olivia Shaheen
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  4. Cary C. Cotton
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  5. Elizabeth T. Jensen
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  6. Evan S. Dellon
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Contributions

SRC contributed to project conception, study design, data collection, data analysis/interpretation, manuscript drafting, and critical revision.CCC and MT collected data and critically revised the manuscript. ETJ contributed to data interpretation and critical revision. ESD contributed to project conception, study design, data collection, data analysis/interpretation, manuscript drafting, and critical revision. All authors approved the final manuscript.

Corresponding author

Correspondence to Evan S. Dellon.

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None of the authors have relevant disclosures or potential conflicts of interest related to this study.

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Corder, S., Tappata, M., Shaheen, O. et al. Relationship Between Housing Components and Development of Eosinophilic Esophagitis. Dig Dis Sci 65, 3624–3630 (2020). https://doi.org/10.1007/s10620-020-06063-2

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  • DOI: https://doi.org/10.1007/s10620-020-06063-2

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