Cockroaches are a common insect infestation problem in many households and other buildings in the United States. They shed the outside of their skin (cuticles), feces, saliva and eggs, all of which contain proteins that can be allergens.
This debris is a common trigger of allergies and allergic asthma attacks. Cockroach debris is more likely to trigger an asthma attack than cat dander, according to research by the National Institute of Environmental Health Science. The presence of cockroach debris indoors is also a major cause of asthma.
Cockroaches are frequently found in crowded cities and in the southern regions of the United States. Once a building is infested with cockroaches, it is very difficult to get rid of the insects and their associated debris. Cockroaches require sources of food, water, warmth and hiding places. The average household is an excellent environment for cockroaches, as all of their needs are met inside.
Between 17 and 41 percent of children and adults in the United States are allergic to these insects, with a higher occurrence of the allergy in inner cities.
Cockroach debris allergies produce the same symptoms associated with other allergic conditions. These include itchy and runny nose, itchy and watery eyes, sneezing and breathing difficulties.
Allergies to cockroach debris can cause serious reactions involving more than one body system (called anaphylaxis). While rare, anaphylactic reactions to cockroach debris can lead to a potentially life-threatening reaction called anaphylactic shock, which involves difficulty breathing and a drop in blood pressure.
Allergies to cockroach debris can be diagnosed and treated by a physician. A detailed medical history will be obtained and one or more allergy tests may be performed. Treatment options may include removal of all cockroach debris (if possible) and medications such as antihistamines and bronchodilators. Total removal of cockroach debris will require thorough and repeated cleansing of the entire indoor environment.
About cockroach debris
Cockroaches infest many households and other buildings in the United States. Cockroach debris refers to the cuticles (skin), feces, saliva, eggs and even the dead bodies of these insects – all of which can be allergens.
Cockroaches are constantly shedding cuticles and producing feces, saliva and eggs, and this debris can accumulate very quickly. This debris comprises a large portion of household dust, and becomes easily airborne. Allergens inhaled into the body can trigger allergy or asthma symptoms in sensitive people, including itchy and watery eyes, sneezing, breathing difficulties and chest pain. In rare cases, anaphylactic reactions to cockroach debris can lead to a potentially life-threatening reaction called anaphylactic shock, which involves difficulty breathing and a drop in blood pressure.
Cockroach debris is more likely to trigger an asthma attack than cat dander, according to research by the National Institute of Environmental Health Science. Cockroach debris can be found in many indoor environments including homes, schools and commercial/office buildings.
Exposure to cockroach debris is a major cause of asthma worldwide and can be considered a risk factor for the disease. In the United States 17 to 41 percent of people are allergic to these insects with a higher prevalence in inner cities, according to the American Academy of Allergy, Asthma and Immunology (AAAAI). Cockroaches are the most common cause of allergic asthma in children in the inner city. Children allergic to cockroach debris have a three times higher rate of hospitalization when cockroach allergens are in their bedrooms. Although cockroach allergy may develop in anyone, the rates are much higher for children in lower socioeconomic groups. In addition, exposure to cockroach allergens in the home contributes to the development of severe asthma.
Another cockroach allergen that is also found in dust mites and some seafood is called tropomyocin. Research is ongoing to determine whether tropomyocin will cause the development of shellfish allergies in someone with cockroach debris allergy.
An active cockroach infestation is not required for cockroach debris to be present indoors, and cockroaches do not have to be alive to cause problems. Human activities easily bring cockroaches, eggs and/or debris into previously non-infested environments. Cockroaches can be introduced to a home in grocery bags and furniture. People returning from a trip can also carry the insects in their luggage.
Cockroaches tend to live in groups, so where there is one cockroach there is usually many more. In fact, when one cockroach is seen scurrying across the kitchen floor, it is likely that there are 800 or more cockroaches located in various areas of the house.
Related allergies and conditions
Cockroach debris is a common allergen that affects many people year-round. It is closely linked with dust allergies, because household dust contains tiny particles of cockroach debris as well as pollen, mold, fabric fibers, dander and dust mites. Dust can produce symptoms in individuals who are allergic to any of these allergens.
A number of allergic conditions can be caused by cockroach debris allergies and symptoms vary depending on how the allergen affects the individual. Related conditions include:
- Allergic rhinitis. Commonly called hay fever, allergic rhinitis is an inflammation of the inner lining of the nose that occurs when an allergic individual encounters an airborne allergen such as cockroach debris, pollen, mold, dust mites or animal dander. Usually inhaled, these triggers generate allergy symptoms such as sneezing, coughing, runny nose, sore throat and itchy and watery eyes.
- Asthma. A chronic inflammation of the body’s bronchial (airway) tissues that afflicts millions of people in the United States. Cockroach debris allergies can trigger asthma attacks in some individuals. People with asthma experience shortness of breath, chest tightness, coughing and wheezing.
- Allergic conjunctivitis. An allergic reaction of the eye to an airborne allergen such as cockroach debris. It involves an inflammation of the clear membrane that covers the white of the eye (conjunctiva) and can result in itching, burning, and redness in the eye. Swollen eyelids, watery eyes and eye discharge also are symptoms of allergic conjunctivitis.
- Allergic bronchitis. An allergy–related inflammation of the bronchial tubes in the respiratory system. It is a type of asthma, an inflammatory condition of the airways. Allergic bronchitis is also linked with allergic rhinitis. This occurs through the nature of the respiratory system, which is a continuum from the nose to the lungs.
- Allergic sinusitis. An inflammation of the sinus cavities in the face caused by infection, allergies or irritants. Symptoms include runny nose, headache, sensitivity in the teeth, nasal congestion and facial swelling.
In addition, patients with chronic stuffy nose, skin rash, constant sinus infection and recurring ear infections are more likely to develop an allergy to cockroach debris.
Signs and symptoms
Cockroach debris may generate a variety of allergy and asthma symptoms, including:
- Itchy and runny nose
- Itchy and watery eyes
- Breathing difficulties
- Scratchy throat
- Hives or itchy skin
- Chest pain or tightness
The severity of reactions to cockroach debris varies between patients. In rare cases, an allergic reaction may progress to a severe and potentially deadly reaction known as anaphylactic shock. This reaction requires a visit to the emergency room, especially in the case of severe breathing difficulty.
Diagnosis and treatment
A physician trying to diagnose cockroach allergies will compile a medical history and a list of symptoms. In addition, an allergy skin test may be performed. This test involves introducing a small amount of cockroach extract to the patient’s skin to determine if the person is allergic to that allergen. If a rash or small bump develops, the patient is most likely allergic to the substance.
The best way to reduce or eliminate allergic reactions is to avoid the allergen that triggers symptoms. However, controlling cockroach debris can be difficult. Even after extensive extermination methods, removing cockroach debris will require thorough and repeated cleansing of an entire house or building.
People living in apartment buildings may find it impossible to eliminate cockroach debris without the assistance of their neighbors. This is because the cockroaches in one apartment will often move to another apartment and return when the pesticides in the original apartment wear off.
Individuals are also likely to be exposed to cockroach allergens in environments outside the home (e.g., office building). Therefore, patients may require allergy and/or asthma medication to help control their symptoms.
Over-the-counter and prescription medications that can treat the symptoms associated with cockroach allergies include:
- Antihistamines (prevent the release of symptom-causing chemicals into the body)
- Decongestants (reduce nasal and chest congestion)
- Corticosteroids (reduce inflammation)
- Bronchodilators (open breathing passages)
- Mast cell stabilizers (prevent the release of symptom-causing chemicals into the body)
Individuals who are susceptible to anaphylaxis may also be advised to carry an epinephrine injection with them, which can quickly reverse the symptoms of the condition.
If treatment with medication is unsuccessful, a physician may recommend allergy shots (immunotherapy). Allergy shots are a form of allergy and asthma treatment in which low doses of an allergen are injected into a patient over a period of time. The goal is to increase the patient’s tolerance to the allergen while reducing symptoms brought on by an allergic reaction. Allergy shots have provided relief to some patients, but are generally not considered highly effective for cockroach allergy treatment.
Tips for eliminating cockroach debris
There are four conditions necessary for cockroaches to survive:
- Food. Food for cockroaches includes crumbs, paints, wallpaper paste, boxes and book bindings.
- Water. Sources of water include sweating pipes, standing water, moist objects or moist areas.
- Warmth. Optimal temperature ranges for cockroaches are between 45 degrees and 115 degrees Fahrenheit (7.2 degrees and 46.1 degrees Celsius). Temperatures above and below this range may kill cockroaches.
- Hiding places. Places to hide include cracks, crevices, cardboard boxes, newspapers and grocery bags.
Eliminating cockroach debris means eliminating the three sources of cockroach allergens:
- Cockroaches and their food sources
- Favorable environments (warmth, moisture, hiding places)
- Dust (which contains cockroach debris)
Cockroaches can live in almost any nook that is near to food and water. Tips for keeping cockroaches out of the home include:
- Store food and garbage in closed, tight-lidded containers.
- Avoid leaving food and dirty dishes out on kitchen counters or in the sink. Dirty dishes and utensils should be cleaned immediately after eating.
- Clean crumbs and spills immediately.
- Avoid leaving pet food and dirty food bowls out over night. Food bowls should be washed immediately after the pet has finished eating and the remaining food should be stored away.
- Wash kitchen floors and countertops at least once a week. Grease should also be removed from stove tops, ovens, counters and walls when necessary.
- Avoid spreading food around the house. Eating should be limited to the kitchen and dining room as much as possible.
- Plug crevices around the house. Cracks and holes in walls, floors and screens can provide cockroaches with an entryway to the home.
- Repair leaky faucets and drain pipes.
- Store recyclables (e.g., grocery bags, cardboard boxes, newspapers, bottles) outside of the home.
Individuals with mild cockroach infestation problems can use pest–control products to eliminate the insects. These include:
- Desiccants. Diatomaceous earth is a naturally occurring type of clay made from fossilized microscopic sea animals that works as a desiccant to dry out the body of the cockroach, thus killing them. Another desiccant is silica aerogel.
- Biochemicals. A variety of synthetic chemicals that either kill pests outright or interfere with the insects’ growth and reproduction. They include insect growth regulators.
Products in cans should be sprayed in kitchen cabinets and drawers (after they are emptied) every few months, or according to the product’s instructions. These products should also be sprayed behind appliances (e.g., stoves, washing machines) and in moist areas such as bathrooms and basements. Traps can be placed in these areas as well.
For severe cockroach infestations professional pest removal is the best option. Professional pest removal can usually kill all cockroaches within two days. However, pest removal does not get rid of the cockroach debris, which is the allergen. Cockroach debris is remarkably difficult to remove from indoor environments. The only way to eliminate cockroach debris indoors is with extensive and repeated cleaning using common cleansers and tools.
Cleaning tips that will help to eliminate cockroach debris include:
- Steam clean carpets, rugs and furniture
- Vacuum with a HEPA filter (empty vacuum immediately after vacuuming to prevent any live cockroaches from escaping)
- Clean under sinks
- Clean appliances
- Remove newspapers, bottles and other household clutter cockroaches inhabit
- Pull books off the bookshelves and thoroughly clean shelving
- Clean corners and walls
- Repeat this thorough cleaning every few months
During the 1990s the U.S. Agricultural Research Service studied the presence and amount of cockroach debris in a building after professional pest removal had killed the cockroach population. These researchers sealed the building after pest removal for six years and then returned and tested for cockroach debris. The cockroach debris remained even after six years.
The researchers found that the first extensive cleaning removed about 90 percent of the cockroach debris. A repeat cleaning removed the rest of the debris. However, these researchers developed a spatial analysis tool to locate the specific areas of cockroach debris and it was with this mechanism that they were able to identify the areas that the first cleaning missed. For the average household, extermination followed by repeated and thorough cleaning may be the only route for complete removal of cockroach debris.
Questions for you doctor on cockroach debris
Preparing questions in advance can help patients to have more meaningful discussions with their physicians regarding their conditions. Patients may wish to ask their doctor the following questions about cockroach debris:
- What methods will you use to determine if I am allergic to cockroach debris?
- Is my allergy to cockroach debris dangerous?
- What effect does having a cockroach debris allergy have on my asthma?
- I have never seen a cockroach in my home. Why am I experiencing symptoms?
- What are my treatment options?
- Would I benefit from allergy shots?
- What steps can I take to remove cockroach debris from my home? Is professional extermination enough?
- How soon after professional extermination and a thorough cleaning should I see an improvement in my symptoms?