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The role of household pests in the epidemiological transition of allergy

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Title:
The role of household pests in the epidemiological transition of allergy modernization of the domestic environment in Barbados
Creator:
Barnes, Kathleen Carole, 1960-
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Language:
English
Physical Description:
ixx, 422 leaves : ill. ; 29 cm.

Subjects

Subjects / Keywords:
Allergies ( jstor )
Asthma ( jstor )
Cockroaches ( jstor )
Diseases ( jstor )
Homes ( jstor )
House dust mites ( jstor )
Household pests ( jstor )
Housing ( jstor )
Parishes ( jstor )
Pests ( jstor )
Allergy -- Barbados ( lcsh )
Allergy -- Epidemiology -- Barbados ( lcsh )
Household pests -- Barbados ( lcsh )
Genre:
bibliography ( marcgt )
theses ( marcgt )
non-fiction ( marcgt )

Notes

Thesis:
Thesis (Ph. D.)--University of Florida, 1992.
Bibliography:
Includes bibliographical references (leaves 398-421).
General Note:
Typescript.
General Note:
Vita.
Statement of Responsibility:
by Kathleen Carole Barnes.

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University of Florida
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University of Florida
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Copyright [name of dissertation author]. Permission granted to the University of Florida to digitize, archive and distribute this item for non-profit research and educational purposes. Any reuse of this item in excess of fair use or other copyright exemptions requires permission of the copyright holder.
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AJU2440 ( NOTIS )
28997607 ( OCLC )

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THE ROLE OF HOUSEHOLD PESTS IN THE EPIDEMIOLOGICAL
TRANSITION OF ALLERGY: MODERNIZATION OF THE DOMESTIC
ENVIRONMENT IN BARBADOS


















By

KATHLEEN CAROLE BARNES


A DISSERTATION PRESENTED TO THE GRADUATE SCHOOL
OF THE UNIVERSITY OF FLORIDA IN PARTIAL FULFILLMENT
OF THE REQUIREMENTS FOR THE DEGREE OF
DOCTOR OF PHILOSOPHY

UNIVERSITY OF FLORIDA


1992





















Copyright 1992

by

Kathleen Carole Barnes
































This thesis is dedicated to the children of Barbados.














ACKNOWLEDGMENTS


The author would like to thank the following individuals

and organizations in Barbados for assistance in administering

this project: the Honorable Branford Taitt (Minister of

Health), Dr. Beverly Miller (Chief Medical Officer), Dr. E.

Ferdinand (Acting Chief Medical Officer during 1991), and all

of the medical staff at the polyclinics in which the study

took place. The author is grateful to Drs. Timothy Roach,

Malcolm Howitt, David Corbin, and Raana Naidu for their

assistance in selecting the children for the study. Thanks

also go to staff members at the Entomology Section of the

Ministry of Agriculture and the Leptospira Laboratory for

their many means of assistance throughout the year.

The author is indebted to Drs. C.O.R. Everard (Leptospira

Laboratory), J.C. Hudson (Carib-Agro Industries, Ltd.),

Michael Nathan (PAHO), and Jeffrey Jones (Ministry of

Agriculture) for advice, direction, and support.

The author is grateful for a Graduate Research

Assistantship and supplies from USDA/ARS and to Dow-Elanco for

additional financial support. Thanks are extended to Mrs.

Margaret Haile and Mr. Curtis Guinyard for technical support.

Identification of arthropods was graciously provided by Mr.

Lloyd Davis (USDA/ARS) in Gainesville, FL, and Dr. Enrique

iv








Fernandez-Caldas and Mr. Walter Trudeau (USF) in Tampa, FL.

Thanks go to Dr. Rick Helm (Arkansas Children's Hospital) for

methodological advice, Ms. Chris Anderson (FDA) and her staff

for conducting the serum assays, and to Mr. Kenneth Pope

(Baskerville & Sons, Richmond, VA) for the blueprints and

sketches. Additional gratitude is extended to Mr. Richard

Wadley (S.C. Johnson) and Mr. Walter Short (Geddes Grant

(Barbados) Ltd) for logistical assistance. Statistical

assistance was graciously provided by Ms. Cindy Hewitt & Dr.

David Nickerson (Orlando, FL), Mr. Victor Chew (Univ. of FL,

IFAS), and Ms. J. White (USDA, Gainesville, FL).

The author extends her appreciation to a warm and

supportive doctoral committee, including Drs. George

Armelagos, Richard Brenner, Leslie Lieberman, Linda Wolfe, and

Richard Patterson, and especially to her supervisory chair,

Dr. Gerald Murray, for his confidence, insight, and direction.

Very special thanks go to Dr. Richard Brenner, for his dynamic

and steadfast mentorship, friendship and multi-faceted

support.

Lastly, the author offers her deepest gratitude to her

friend, Mr. David E. Milne, without whose technical and

emotional support this work could never have been completed,

and to her parents, Robert and Carole Barnes, sister,

Christine, and brother-in-law, Kenneth Pope, whose endearing

support and belief in the author saw this project to its end.
















TABLE OF CONTENTS


ACKNOWLEDGMENTS ....

LIST OF TABLES .

LIST OF FIGURES .

ABSTRACT .. ..


. xii

. xvi

S xviii


CHAPTERS


1 ALLERGY AS A DISEASE OF MODERNIZATION .

Introduction: Rationale for the Study .
The Relationship Between Modernization
and Allergy .. ..........
The Role of Household Pests .
Objectives of the Study .
Defining the Epidemiological Transition .
Disease Ecology and the Evolution
of Human Allergy ..
Disease in Pre-State Society .
Disease in State Society .
Application of the Disease Ecology
Model: Allergy .
The Influence of Disease on Biological
Adaptation: Parasitic Infestations
and IgE .. .
The Influence of Disease on Cultural
Adaptation: The Gradual Decrease
in Exposure to Parasites .
Influencing Biological and Sociocultural
Factors . .
Genetic, MHC-related factor .
Genetic, non-MHC-related factor .
Familial factors .
Ethnic factors ...
Behavioral and nutritional factors
Miscellaneous behavioral factors .
Population behavior and the
macroenvironment ...


. 1

. 1

. 1
S. 3
S. 6
. 8


. .









Population behavior and the
microenvironment 40
Conclusions and the Allergy Disease Model 40
Notes. ... .. 42


2 THE STUDY DESIGN AND RESEARCH SETTING .. 44

The Construct of Allergy and Modernization:
A Review of the Objectives .. 44
The Research Site . 46
The Rising Incidence of Asthma
in Barbados .. 47
Infrastructure: The Developed Nature
of a Developing Country. ... 55
The Health Care Delivery System .. 57
Sampling and Methodology 64
The Survey Schedule 64
Topographical considerations 64
Selected entomological and
ethnographic research sites 70
Participant Selection and Resources .. 71
Clinical Testing and the Interview Schedule 74
Sub-Setting the Sample Population .. 78
Identifying and Classifying the
Independent Variables 79
Designing a Socioeconomic Indicator 80
Income 81
Occupation ......... 82
Amenities ...... 83
Monthly expenses .. 86
"House-related" variables 87
Creating the wealth index .. .. 88
Demographic Characteristics of
the Sample Population .. ... 92
Spatial Distribution 92
Personal and Socioeconomic Characteristics 96
Analysis and Presentation 98
Summary ................ .... 99
Notes . 99

3 SETTING THE STAGE FOR A CASE STUDY:
BARBADOS LAND TENURE PRACTICES AND EVOLUTION
OF THE BAJAN HOUSE FORM 101

A Historical Review of Land Distribution .. 101
The Birth of Barbadian Society:
The Pre-Emancipation Period .. 102
Land Allocation and Stratification of
the Planter Class .. 103


vii









Indentured Servitude and a White Lower Class 110
African Slaves: An Alternative
Labor Source 113
Acculturation of the Classes 115
Emancipation and the Landless Proletariat 117
Steps Towards Reform 121
The Contemporary Spatial Distribution of
Land and People 123
The Impact of Twentieth-Century Reforms 123
Barbadian Economy and Its Role in the
Urban/Rural Sector 125
The Over-Development of the Urban Sector 129
Inter-Migration and Changes in the
Spatial Distribution of Land and People 130
Demographic Decentralization and
the Development of Suburbia .. 131
The Continuation of Tenantry Residency 140
A Closer Look: Evolution of the
Barbadian Home 143
Traditional House Forms .. 144
Housing in the pre-emancipation era 144
Emancipation and the chattel house 146
Other house forms and modifications
of the chattel house 150
Trends in Contemporary Housing 156
The Role of Ownership 156
A decline in relocation 160
Upgrading the chattel and creating
new forms 161
The transition from wood to masonry 168
The problem of construction in the
informal sector 176
Elaboration of the indoor environment 181
Installation of indoor utilities 182
The Role of the Family System ...... 185
The impact of costs and tenure 185
Trends in household density 187
Housing Trends and Health Implications 188
Moisture .. 188
Ventilation ...... 197
Summary ................... 199
Notes. . 201

4 THE ASTHMA STUDY: AN ANALYSIS OF
CONTEMPORARY LAND TENURE PATTERNS, HOUSING,
AND ASPIRATIONS . .. 209

Spatial Distribution of Land
and Sociodemographics. .. 209
The "Ideal" Place of Residency. .. 216
Implications for Trends in Housing 220


viii









Housing Patterns Among the Asthma Study
Population .. .. 222
Ownership of Dwellings. 222
Construction of Dwellings 225
Structural Features and Demographics 230
Aspirations of the Study Population:
The "Ideal" House 231
Discussion and Summary .. 235
Notes . 238

5 NEW HOMES AND UNINVITED GUESTS:
HOUSEHOLD PEST INFESTATIONS 242

Introduction ...... ...... 242
Infamous Household Pests in Barbados .. ... 244
Pests Related to Disease .. .... 244
Mosquitoes .. ... 245
Other diptera ..... ... 247
Cockroaches ......... 247
Millipedes .. .. .... 248
Centipedes .. 249
House dust mites .. 249
Rodents ....... 251
Pests not Related to Disease .. 253
The Pest Collection: An Inventory
of Household Pests 255
Materials and Methods 255
Light/CO, trap .. 256
Flea trap ......... 257
Fly strips ........ .... 257
Cockroach traps .......... .257
Live trap 258
Mite sampling ........ 258
Results: Collective Taxonomy
of Barbadian Household Pests .. 260
Rodents and other mammals ... 261
Orthoptera .... ...... 263
Coleoptera ....... 264
Amphibians/reptiles .. 264
Diptera .... 265
Hymenoptera .. 266
Isoptera o 266
Lepidoptera ............ 266
Isopods .......... 267
House dust mites .. .. ..... 267
Discussion of the Pest Collection Results 271
Food and/or garbage pests .. 271
Pests dependent on human hosts 272
Moisture-related pests 273










Stored food pests .
House dust mites .
The Ethnographic Survey: Categorization,
Classification, and Responses
to Household Pests .
The Ethnographic Taxonomy .
Reported Temporal Distributions .
Interrelationships with Sociodemographic
and Structural Variables .
Rodents .
Cockroaches .
Mosquitoes .
Sand flies .
Others .
Classifying the Pests:
What's Good and Bad? .. .
Which of these are "disgusting"? .
Which of these are "harmful"? .
Which of these pests would
you kill? .
Which of these are "beneficial"? .
Are these pests indoor, outdoor,
or accidental? .
Behavior Directed at Controlling
Household Pests .
National Control .
Commercial Control .
Control in the Private Sector .
The Effect of National Campaigns Directed
at Community Control .
Summary .
Notes .


6 THE CLINICAL SETTING: THE EPIDEMIOLOGY
OF ALLERGY TO HOUSEHOLD PESTS
AMONG BARBADIAN CHILDREN .

Biomedical Testing .
Biomedical Materials .
Subjects .
Extracts .
Biomedical Methods .
Interviews .
Skin Test Results .
Individual Extracts .


House dust mites .
Crawling insects .
Flying insects .
Shellfish ..
Rodents ..


. 341


341
341
341
342
343
S 344
344
344
S 344
346
S 347
349
349


274
275


282
284
296

301
301
302
304
305
306

308
309
310

313
314

316

325
325
327
328

333
334
337


rr
rrr
rr~.
r
rrr


. .
. .
. .
. .
* .
* .
. .
. .









Cross-Reactivity .
Discussion ..
Symptomatology .
Individual Allergens .
Cross-Reactivity .
Summary . .
Notes . .

7 SUMMARY AND IMPLICATIONS FOR
FUTURE STUDIES . .

Asthma as a Disease of Modernization:
Concurrence with the Theoretical Construct .
Review of the Findings .
Modelling the Variables .
Implications for Community- and Household-Level
Management of Pests .
Implications for Patient Education .


Financial constraints .
Structural constraints .
Environmental constraints .
Ideological constraints ..
Implications for Further Research .


351
357
357
362
373
374
375


376


376
376
381


385
387


S. 389
S. 390
S. 392
S. 393
. 394


REFERENCE LIST . .

BIOGRAPHICAL SKETCH . .


398

422















LIST OF TABLES

Table 2-1 GNP per capital (1980), in U.S. dollars in
the Eastern Caribbean 56

Table 2-2 Health indicators for the Eastern
Caribbean . 60

Table 2-3 Profile of education in the Eastern
Caribbean .. 61

Table 2-4 Polyclinic/outstation attendances, 1990 63

Table 2-5 Frequency distribution of amenities by
household (N=177) .. 85

Table 2-6 Distribution of total monthly expenses in
the household sample (N=177). ... 87

Table 2-7 Distribution of residences by demographic
region (N=177) . 92

Table 2-8 Spatial Distribution of the Total Asthma
Study Population (N=335). 95

Table 2-9 Frequency and Percent of Types of Unions
per Informant (N=177) .. 97

Table 3-1 Percentage of gross domestic product (GDP)
by sector. ... 129

Table 3-2 Percentage distribution of the Barbadian
population by socio-geographic zone, from the
Government Statistical Department Census for
1970 and 1980 . 137

Table 3-3 Spatial distribution of tenantries by
parish, 1990. .. 140

Table 3-4 Tenants living in National Housing
Corporation units by parish, 1991 ... .159

Table 3-5 Dwelling tenure (owned, government rental,
or other) by parish, 1980 .. 163


xii









Table 3-6 Number of houses relocated by parish,
1981-1989. .. .. 164

Table 3-7 Number and percentage of dwellings by
type of material, for each parish, 1980 169

Table 3-8 Applications approved by the Town & Country
Development Planning Office for renovation of
dwelling units, by parish, 1980 .. 170

Table 3-9 Number of new and renovated dwellings by
house type, approved by the Environmental
Division, Engineering Ministry of Housing &
Lands, 1982 1989 173

Table 3-10 Number of persons per household by
parish, for the years 1946, 1970, 1980,
and 1990 . 189

Table 3-11 Percent of households calculated for the
number of persons by the number of rooms 191

Table 3-12 Sources of moisture in the home .. 192

Table 4-1 Land ownership patterns according to
demographic region (N=177) ... 211

Table 4-2 Frequency and percentage of households
owning their residential lot, by parish 213

Table 4-3 Distance from the nearest neighbor
(in yards) according to demographic region
(N=177) . 214

Table 4-4 Analysis of residential preference by
parish among households .. 219

Table 4-5 Overall rank of parishes as "the ideal
place to live" according to the total informant
population (N=166) .. 220

Table 4-6 Home ownership patterns according to
demographic region (N=177) .. 224

Table 4-7 Frequency and percentage of informants
owning their dwelling, by parish .. 226

Table 4-8 Comparison of housing quality (concrete
or mixed structure) by wealth score, home
ownership, and land ownership .. 227


xiii









Table 4-9 Structural features of the dwelling by
the type of material the dwelling is constructed
and for the total number of dwellings, for the
asthma study households .

Table 5-1 Density of house dust mite species D.
pteronyssinus and D. farinae in 17 Barbadian
homes . ..

Table 5-2 Reported pests in Barbadian homes by
informants in the asthma study. .


Table 5-3 Ethnographic taxonomy of 33 pests
(frequency and percent of responses, N=65).


Table 5-4 Frequency and percentage of responses to
the question: "Which pest do you have the
biggest problem with?" .

Table 5-5 Frequency and percent of specimen
categorization regarding when informant sees the
animal around the house (N=65). .


Table 5-6 Responses (frequency distribution and
percentages) to the question: "Which of these
pests do you consider to be 'disgusting'?" .

Table 5-7 Responses (frequency distribution and
percentages) to the question: "Which of these
pests can cause physical harm to people, and
how?" (N=65) . .

Table 5-8 Responses (frequency distribution and
percentages) to the question: "Which of these
pests would you kill if you saw it?" (N=65)


S 317




S 318


322


Table 5-9 Correlations between pests that were
classified as "disgusting," and those that the
informant "would kill" (Chi-square) .

Table 5-10 Responses (frequency distribution and
percentages) to the question: "Which of these
pests are beneficial, or good to have around?",
and "Why?" . .

Table 5-11 Pests for which over-the-counter
insecticides are used, by frequency (percent) of
the informant population (N=65) .


323


324



330


xiv


232



277


286


287



296



297


* .









Table 6-1 Relationship between allergies to house
dust mites, D. pteronvssinus, and D. farinae,
and structural and demographic variables. 348

Table 6-2 Total number and proportions of responses
to specific extracts. ......... 352

Table 6-3 Frequency distribution for total numbers
of different pests reacted to in the battery of
skin testing. . 353

Table 6-4 Frequency distribution of stimulants
responsible for an asthmatic attack (N=168).. 360

Table 6-5 Time period when child is reportedly most
likely to experience an asthmatic attack 361















LIST OF FIGURES


Figure 1-1 The Allergy Disease Model in the
Ecological Perspective .. 43

Figure 2-1 Asthmatic attendances to the Accident &
Emergency Department, Queen Elizabeth Hospital,
in thousands, for 1980 1990. 49

Figure 2-2 Number of asthmatics attending the
Accident & Emergency Department, Queen Elizabeth
Hospital, for the month of October, 1974 1990 50

Figure 2-3 Monthly Asthmatic Attendances to the
Accident & Emergency Department Compared to Monthly
Rainfall, 1990 . 51

Figure 2-4 Monthly Asthmatic Attendances to the
Accident & Emergency Department Compared to Monthly
Rainfall, 1991 . 52

Figure 2-5 Distribution of outpatient health care
facilities . 62

Figure 2-6 Geophysical Subdivisions of Barbados 66

Figure 2-7 Annual total rainfall by region, in
inches, based on 1887-1986 data .. 69

Figure 2-8 Location of selected communities for the
entomological and ethnographic surveys 75

Figure 2-9 Resource centers for asthma study sample 76

Figure 2-10 Non-linear regression analysis
demonstrating the relationship between the
variables "monthly house rent/mortgage" and
"amenities" . 91

Figure 2-11 Spatial distribution of households by
parish, for the asthma study .. 93


xvi








Figure 3-1 Inter-migration patterns by parish,
1970-1990 . 133

Figure 3-2 Settlement and Land Use Policy of
Barbados .... 135

Figure 3-3 Chattel house floorplan ... 165

Figure 3-4 Sketches of the three stages of the
chattel house .. 166

Figure 4-1 Correlation matrix (p-values) for structural
and demographic variables in the Asthma Study
households . 239

Figure 4-2 Correlation matrix for structural and
demographic variables in the asthma study
households . 240

Figure 4-3. The Allergy Disease Model in the
Architectural Perspective .. 241

Figure 6-1 Graded Skin Test Response (Krouse &
Klaustermeyer 1980) .. 344

Figure 6-2 Correlation matrix for pest allergies by
structural and demographic variables 354

Figure 6-3 P-values for pest allergies by
structural and demographic variables .. 355

Figure 6-4 Correlation matrix for positive skin
tests, indicating the interrelationship between
each of the extracts .. 356

Figure 7-1 Modelling the variables: a summary 384


xvii














Abstract of Dissertation Presented to the Graduate School
of the University of Florida in Partial Fulfillment of the
Requirements for the Degree of Doctor of Philosophy

THE ROLE OF HOUSEHOLD PESTS IN THE EPIDEMIOLOGICAL
TRANSITION OF ALLERGY: MODERNIZATION OF THE DOMESTIC
ENVIRONMENT IN BARBADOS

By

Kathleen Carole Barnes

December, 1992

Chairperson: Dr. Gerald Murray
Major Department: Anthropology


Allergy is referred to as part of the epidemiological

transition of disease; it is uncommon in traditional

societies, is steadily increasing in developed societies, and

demonstrates dramatic incidences in transitional societies.

Some of the most antigenic allergens are from arthropods

(arboallergens). Pan allergy to insects and noninsect

arthropods has been exhibited in individuals who have

previously been sensitized to only a few arboallergens.

Previous research demonstrated that D_. teronvssinus (pp)

was the predominant house dust mite (HDM) in Barbados and that

wood homes on rock foundations provided an ideal mite habitat.

The contemporary trend is an integration of permanent features

into the traditional house form (e.g., concrete and indoor

plumbing into the traditional house form); this trend is a

xviii








metaphor for sociocultural change because of the historically

tenuous nature of land tenure and housing in Barbados.

Concrete, plumbing, and other "modern" features have been

incriminated in increasing indoor relative humidity and

reducing air flow, two factors which create favorable habitats

for a number of household pests.

Asthma is increasing in Barbados; asthmatic attacks

reported to the Casualty Clinic doubled in 10 years to 7,137

in 1990. The current study was undertaken to examine the

effects of contemporary housing on the distribution of

household pests and the harmful effects that exposure to

arboallergens might have on the asthmatic. Densities of pg

were found in 100% of homes sampled and were higher in

concrete homes (f=9.55, p<0.001); qualitative data suggest

that other pests prevail in both types of construction.

Asthmatic children (168) were skin tested against 11 household

pest allergens; HDM elicited the greatest number of responses

(77.4% to DD and 74.4% to D. farinae, or Df). Allergy to P2

was correlated to living in a concrete home (X2=4.37, p=0.04).

The high incidence of allergy to Df despite low or absent

densities and a positive reaction to an average of four

different pests suggest cross-reactivity. The implications of

the study are the following: housing trends have a direct

influence on the presence of Dp, a highly allergenic pest; and

sensitivity to DD possibly predisposes asthmatics to develop

other arboallergen hypersensitivities, thus increasing the

likelihood of morbidity related to arboallergens.

ixx














CHAPTER 1
ALLERGY AS A DISEASE OF MODERNIZATION


Introduction: Rationale for the Study


The Relationship Between Modernization and Allercg

As humans have evolved culturally, we have increasingly

exposed ourselves to numerous pathogens due to our

alterations in the environment, complex food-producing

practices, and intense contact with other infected humans

and their waste products (for many populations this picture

remains the same today, although the sociopolitical reasons

have changed with time). The bulk of these pathogens in

earlier agriculturalist populations were those responsible

for infectious disease, usually vector-borne and parasitic

and not dependent on large populations or even human hosts

for their survival. With the development of industrial

societies, cultural advances in technology enhanced the

provision of better sanitary practices (e.g., systems for

waste disposal, treated water), which eliminated a number of

the parasitic diseases, and biomedical advances provided

chemotherapy and immunization against many of the

debilitating and mortal communicable diseases. As a result,

large numbers of people living in what are considered

"developed" countries have never even been exposed to a

1










parasite or to many of the viruses and bacteria that

eliminated whole societies. This process has resulted in

what has been termed the "epidemiological transition" of

disease, defined as a trend from acute infectious diseases

to chronic noninfectious disease and generally industrial

and degenerative in nature (Omran 1971; Corruccini and Kaul

1983). The increasing prevalence of these diseases is

related to human modernization and urbanization.

Extreme changes in contemporary modes of production

have resulted in the introduction of new organic and

inorganic substances in the contemporary macroenvironment.

These substances are inhaled and ingested both at home and

at the work place, or the microenvironment. There is

extreme class consciousness, as well as continuous efforts

to "move up" socially and "improve" the home environment

with the addition of non-consumable goods and climate

control. The net result of these cultural changes is

exposure to large amounts of substances never before

encountered in human history and, more importantly,

subjection to these substances in a very short period of

time.

One of the new chronic diseases resulting from the

epidemiological transition is allergy. Although we do not

know the degree of prevalence of allergy in previous

populations, we do know that the incidence of allergy is on

the rise (Corruccini & Kaul 1983; Massicot & Cohen 1986;










National Asthma Education Program 1991). Contributing to

this is exposure to many antigens that, for reasons not

completely understood, are highly allergenic. The most

common of these are pollens, molds, and notably, arthropods

(Gergen et al. 1987). Schwartz (1990) argues that

arthropods are more important as allergens than are pollens

because they are so widespread.


The Role of Household Pests

Possibly the most significant impact in regard to

allergic disease as a result of modernizing our

microenvironment has been the increased exposure to peri-

domestic and domestic arthropods and rodents. In

elaborating the home environment for the purpose of removing

ourselves from climatic elements, we have provided ideal

habitats for a number of "pests." This is most evident in

the study of urban entomology; household infestations of

most pests increase with the degree of urbanization (Aedes

SPP. mosquitoes, Gratz 1973, Slosek 1986; cockroaches,

Ebeling 1975, Koehler et al. 1987; rodents, McNeill 1976).

What is most alarming about the relationship between

urbanization and household pest infestations is the extreme

allergenicity of arthropods and certain other animals.

The relationship between an increase in the incidence

of allergy in general and modernization has been largely

attributed to the development of housing conditions that are

favorable to house dust mites (Massicot & Cohen 1986). In










fact, the most predominant allergen among residents in

developed and developing countries alike is the house dust

mite (Buchanan & Jones 1972; Kang & Sulit 1978; Dowse et al.

1985; Massicot & Cohen 1986; National Asthma Education

Program 1991). Dowse et al. (1985) studied the incidence of

asthma in eight South Fore villages in the Eastern Highlands

of Papua New Guinea. There had been an alarming increase in

prevalence over a 10-year period; the overall rate was 39

and 46 times higher than rates noted in 1972 and 1975,

respectively, and was much higher than rates reported from

other highland regions. The reason was attributed to the

introduction of woolen blankets into the villages;

Dermatophagoides pteronyssinus and D. farinae were found in

97% of the blankets used by the Fore (Dowse et al. 1985).

Baldo and Panzani (1988) suggest that "pan allergy" to

insects may exist in individuals who have previously been

sensitized to one or several insects and that allergenic

similarities possibly extend to other noninsect arthropods,

such as spiders or crustaceans. The ramifications of this

finding are frightening from an epidemiological point of

view when one considers the widespread distribution of

arthropods, and the consumption of many of those arthropods

(e.g., shrimp, lobster). It implies that any household pest

is a potential source of allergen.

Numerous studies have been published that confirm the

relationship between cockroach allergens and bronchial










asthma (Kang 1976; Kang & Sulit 1978; Kang & Chang 1985;

Kang 1990). Individuals of lower socioeconomic status

within the United States reportedly have higher incidences

of cockroach hypersensitivity compared to individuals of

higher socioeconomic status (Bernton & Brown 1967; Kang &

Chang 1985). Authors conclude that this likely is

correlated to higher cockroach infestations in poor housing

and related to the duration of exposure (Bernton & Brown

1967; Twarog et al. 1977). However, the reverse is true in

developing countries (Marchand 1966; Brenner et al. 1990;

Brenner et al. 1991). In Puerto Rico, Marchand found that

his patients who demonstrated hypersensitivity to

cockroaches were from the middle to upper socioeconomic

strata (1966). In the Dominican Republic, the incidence of

allergy to cockroaches was proportionately related to the

quality of the house structure (X2=7.36, df=2, p<<0.01);

individuals from higher quality homes had a greater

incidence of allergy to cockroaches (Brenner et al. 1990;

Brenner et al. 1991). Data suggested that the higher

quality homes built of masonry had less air flow than the

homes of wood, thereby producing a more favorable

environment for the cockroach and also an accumulation of

arboallergens.' More favorable environments and larger

populations also may increase the likelihood of physical

contact with cockroaches, resulting in an injectant or

ingestant contact with the allergen; cockroach "biting" was










reported in heavily infested, urban environments in both

North Central Florida and the Dominican Republic (Barnes &

Brenner, in prep.).

In another study, a relationship was found between the

presence of house dust mites and the structure of houses.

Pearson and Cunnington (1973) identified 23 species of house

dust mites in Barbados (D. Dteronvssinus was the most

predominant) and concluded that they were so proliferative

because of the timber dwellings situated on top of porous

coral rock foundations, which, close to the soil, generated

a sufficient amount of moisture to provide excellent

habitats for the house dust mites.


Objectives of the Study

Based on the concept that allergy is a disease of

modernization and arboallergens as well as other pest

allergens (e.g., rodents) play a significant role in the

incidence of allergy, a study was designed to test the

hypothesis that modernization of the domestic environment is

related to allergy to household pests. The domestic

environment was chosen as the focal domain because two of

the best-known producers of arboallergens--the house dust

mite and the cockroach--are domestic pests. Certainly the

most concentrated human exposure to arthropods is indoors

rather than outdoors.

As with most other diseases that are part of the

epidemiological transition, there is a strong genetic









7
component in the development of allergy. Although people do

not have control over their genetic make-up, they do have

control over their behavior and to a limited degree, control

over their environment. Behaviors and the environment over

which the lay person probably has the most control are those

related to the home. Because "household pests," as the

definition connotes, thrive within the domestic domain,

certain sociodemographic variables related to the home

likely play a role in both household pest infestations and

allergy to pests. If such variables can be controlled by

the people living in the affected environment, then

residents might be able to play a central role in their -own

promotion of health and well-being.

Herein lies the guiding research question: What

existing human perceptions, behaviors, and household

environmental factors contribute to the notion that allergy

is a disease of modernization? Specifically, are household

pest infestations influenced by modernization of the home,

and to what degree do they contribute to allergy? From an

immunological perspective, it is suspected that the

relationship might be due to the likelihood and degree of

exposure to certain household pest species. Exposure to

household pest allergens primarily is dependent on two

factors: first, there must be a substantial population of

the pest for it to produce allergens (most typically

aeroallergens); and second, the domestic environment must be










conducive to the maintenance of the pest population and/or

the accumulation of the attendant allergens. It is apparent

that modernization of specific features of the home

increases the degree of pest infestations indirectly, by

providing a suitable habitat for the pest. Additionally,

cultural and socioeconomic characteristics unique to a given

population may accelerate the development of certain

architectural and sociodemographic features. The primary

objective of the following study was to identify these

features and to create a model for predicting the likelihood

of developing allergies to certain pests in the event that

these features are present.

The following paragraphs present an elaborated view of

the epidemiological transition of disease. Following this

presentation, the evolutionary perspective of allergy will

be discussed, so as to better understand the

interrelationship between the physiological and cultural

elements of allergy.


Defining the Epidemiological Transition

An interesting characteristic of many of the

contemporary, chronic diseases is that they are particularly

prevalent and "epidemic"-like in transitional societies, or

those populations undergoing the shift from developing to

developed modes of production. In developing countries,

many of the chronic diseases associated with the

epidemiological transition appear first in members of the










upper socioeconomic strata (Burkitt 1973), probably because

of their access to Western products and practices. The

diseases typically share common, etiological factors related

to human culture, including diet, activity level, mental

stress, behavioral practices, and environmental pollution.

There are a number of contemporary chronic diseases

that may be used to exemplify the epidemiological transition

model. Biocultural anthropologists have investigated

dietary changes as an important etiological factor for the

development of many chronic diseases. Burkitt (1973) notes

that while the intake of fiber in British and American diets

between 1880 and 1960 fell by more than 90%, fat consumption

increased, and sugar consumption doubled. A low fiber, high

fat diet seems to have the greatest effect on the

development of noninfective bowel disease, including

diverticular disease, appendicitis, colon cancer, polyps,

and ulcerative colitis (Burkitt 1973). Similarly, high

serum cholesterol has been widely discussed as a major

factor in coronary heart disease (the number one cause of

death in developed countries) and gall-bladder disease

(Burkitt 1973). Obesity and high intakes of refined

carbohydrates are related to the increasing incidence of

heart disease and diabetes. Diabetes is particularly high

in groups undergoing the transition from traditional life-

style to "modern"; certain urban groups of the Bantu in

South Africa have rates 40 times greater than their










counterparts in the rural sector (Pelto & Pelto 1983).

Similarly, many Amerindian groups, including Mexicans,

experience unusually high incidences of obesity, adult onset

diabetes mellitus, and gallbladder disease; this has been

termed the "New World Syndrome" of disease (Weiss et al.

1984). Obesity is considered to be the most common form of

malnutrition in developed countries (Burkitt 1973; Pelto &

Pelto 1983) and is a direct result of an increasingly

sedentary life-style (which reduces caloric needs) in

conjunction with steady or increasing caloric intakes.

Medical technology has succeeded in eliminating many of

the communicable diseases that reduced whole populations

(e.g., the Black Death in Europe, smallpox in the Americas),

and chemotherapies and immunizations have the potential to

control a majority of other infectious diseases. It has

been calculated that public health measures alone (e.g.,

clean water and sewage provisions) increase life expectancy

in a population to almost 65 years (Baker 1989). The

control of infectious and communicable disease, resulting in

increasing life expectancies, has paved the way for

degenerative disease.

A feedback effect of medical technology is a shift in

demographic trends, whereby the rate of fertility continues

at a steady state while mortality drops sharply. The

eventual matching of fertility rates with mortality rates is

referred to as the "demographic transition," and this is the










current pattern in most of the developed countries (Baker

1989). However, societies in transition are slower to

achieve the equalizing of fertility with mortality, probably

largely due to the suddenness of changes in mortality rates.

The continuing increase in population size in conjunction

with an increase in commercialization of agriculture--

characterized by a reduced need for workers in the rural

sector and malnutrition--has had particularly detrimental

effects on the urban environment in transitional societies.

These urban environments are characterized by over-crowded

living arrangements, underemployment or unemployment, and a

chronic state of infectious disease (e.g., tuberculosis,

filariasis) for which biomedical treatments are not always

available (Miller 1973), plus the introduction of many of

the chronic, "modern" diseases.

While degenerative diseases are characteristically

higher in persons of older age, they are not limited to that

population. Baker (1989) argues that degenerative diseases

are not necessarily an inevitable process of ageing, because

many of them (e.g., myopia, high-frequency hearing loss in

middle-age) are completely absent in some groups.

Similarly, while malignancies can be found in all human

populations, and for that matter, other animals, the types

and locations of malignancies vary from traditional

populations to "modern" populations (Baker 1989).










A unique characteristic of the chronic diseases is

their relatively recent appearance in human history as a

major cause of morbidity. According to Corruccini and Kaul

(1983), this is indicative of a strong environmental factor

in disease etiology. Indeed, all of the above disease-

causing factors are those created by humans and their

culture. While biological factors such as genetics are no

doubt important in determining who is most likely to succumb

to which disease, genetics alone cannot explain the rapid

spread of chronic disease. Our genetic systems simply do

not operate in selecting for or against certain

physiological features in such a short period of time.

When evaluating the epidemiology of a specific disease,

what we see in developed countries is the end result of the

epidemiological transition; at this level it is difficult to

identify specific socio-environmental variables that are

responsible for the disease process. By including in the

epidemiological analysis less-developed societies and their

socio-environmental variables, we create the "whole

picture," or the evolutionary perspective of that disease.

By analyzing the natural history of a disease in different

societies and the different human behaviors associated with

the distribution of that disease, we will be able to

identify disease-causing variables and predict

epidemiological outcomes. This information can then be

applied to health education, and preventive medicine may, in










the ideal setting, be used to minimize the effects of that

disease.

Allergy is an excellent example of a disease which is

part of the epidemiological transition. As heretofore

described, allergy is uncommon in traditional societies,

reaches epidemic rates in transitional groups, and is

increasing in developed populations where it is most common

overall. Prevalence of allergy is characterized by the

degree of modernization within a population, for reasons

similar to--and in some ways quite different from--the

typical chronic diseases.


Disease Ecoloqg and the Evolution of Human Allergy

The theoretical framework most commonly used in

understanding the evolution of human disease is based on the

triad of host, pathogen, and environment. The current

ecological perspective places the most emphasis on the

environment and gives equal attention to both the physical

components (e.g., geologic, climatic, biotic) and the

cultural components (e.g., technological, social, and

ideological). The host represents both the individual and

the population and is responsive and constantly rallying to

maintain homeostasis. The pathogen is any insult against

the host.

The evolution of human disease has closely paralleled

the evolution of human modes of subsistence practice, and

this is probably why so many biocultural anthropologists








14

have referred to the different subsistence periods in human

history as a construct for analyzing disease evolution

(Cockburn 1971; Dunn 1977; Armelagos & Dewey 1978; Baker

1989; Armelagos et al. 1990). Subsistence modes dictate, to

a degree, biocultural factors such as demographics and

dietary practices.


Disease in Pre-State Society

Humans and their predecessors relied on hunting-

gathering as a means of subsistence from about four million

years ago until the beginning of the neolithic, some 11,000

years ago. Hunter-gatherers utilize as many edible products

as possible, including a variety of protein and carbohydrate

sources as food, and have well-balanced diets. (There are

exceptions; for example, Arctic aboriginals have evolved

physiological and cultural mechanisms whereby they survive

on a diet with little variation, mostly composed of animal

protein.) Hunter-gatherers are mobile for the purpose of

finding new sources of food after a particular region has

been exhausted and are small in population size to

facilitate that mobility. Their mobility negates the

possession of many nonconsumable goods; therefore, their

living quarters are simple and constructed of the ecological

materials readily available to them. Because of the large

area of land needed to support their subsistence, there is

limited contact with populations outside of the immediate

group.










Due to the small population size of early hunter-

gatherers, there were a limited number of infectious

diseases that could have established a symbiotic

relationship with human hosts. This factor highlights

several epidemiological principles essential for

understanding the evolution of human disease. Pathogens (a

collective term used here to represent bacteria, viruses,

fungi, spirochetes, and the parasites, including protozoa,

helminths and arthropods) must, in order to survive, affect

low mortality among their hosts. An underlying principle

when determining the evolutionary association between a

pathogen and a host is that the more stable the host-

pathogen relationship, the longer the two likely have

coexisted. In contrast, more pathogenic relationships are

assumed to have been recently developed, because they

apparently have not evolved a stable relationship. The

elaborate relationship that helminths have developed with

human hosts is indicative of their long history with

hominoids. For example, no single helminth parasite is

limited to humans as a necessary host, and all of them have

avoided the development of complete immunity in the human

host. This lack of immunity probably is indicative of the

very low mortality caused by helminths and complete immunity

is therefore not essential for the host's survival (Kliks

1983). An exception to this principle are pathogens that










cause high mortality--such as tetanus--but do not require

the host for their survival.

Another epidemiological principle is that the more

pathogenic the insult by the organism, especially against

hosts of a pre-reproductive age, the greater the selective

pressure will be on the population (Kliks 1983). Diseases

that produce low pathogenicity or are chronic and therefore

affect the post-reproductive population will exert less

selective pressure. Physiological adaptation (e.g., in the

form of acclimation, accommodation, or acclimatization) is a

response to selective pressures by which a host improves

his/her chance to rally against pathogenic insults, and may

take the form of genetic changes or physiological responses

completed within a single life span. Cultural "adaptation"

includes responses by which information is transferred to

subsequent generations to enhance survival in a given

environment. Genetic changes are the slowest adaptations to

evolve and signify long-term coexistence.

Many of the infectious diseases require large host

populations and rapid transmission time for their survival.

This is referred to as the population "threshold level"

(Cockburn 1971). If a host population is not a minimal size

for pathogen maintenance, then the pathogen will die.

Typically with infectious diseases large host populations

are required; the acute communicable infections of cholera,

rubella, smallpox, mumps, and measles are examples. The










population threshold is not necessarily due to mortality,

because even pathogens that can live as commensals within

the host often will die in a small community (Cockburn

1971). Furthermore, organisms that are highly pathogenic

often elicit an immune response, that subsequently limits

the number of susceptibles in a small population.

Two types of infectious diseases have been recognized

as affecting early hunter-gatherers: those which had

existed among the prehominids and persisted in the hominids

and those that were accidentally encountered from other

animals zoonosess) by means of vector, wounds, or

consumption of animals (Polgar 1964). Cockburn (1971)

listed a number of intestinal parasites, ectoparasites,

treponemal infections (including yaws), malaria, and several

viruses (herpes and hepatitis) that were present in primates

prior to the first humans. Many of the zoonoses were

acquired after eating infected or raw mammals, insects,

birds, and fish, the most common of which were probably

anthrax and botulism (Cockburn 1971). Zoonotic diseases

also were spread by arthropod vectors. Avian, or ichthyic,

tuberculosis was a disease of early humans (Cockburn 1971),

as was schistosomiasis (Baker 1989).

Hunter-gatherers rarely experienced malnutrition or

starvation, and chronic disease was infrequent (Dunn 1977).

Nevertheless, life expectancy was relatively short, rarely

longer than 30-35 years, with few living longer than 50










years (Baker 1989). It is believed that traumatic and

accidental death was the leading cause of mortality,

including falls, snakebites, and death by predators. Social

mortality involving infanticide, homicide, suicide, war, and

cannibalism was also a factor in mortality (Dunn 1977; Baker

1989).


Disease in State Society

The shift to agricultural forms of subsistence some

10,000 years ago marked some of the most significant changes

in culture since humankind's emergence. Large-scale

production of food changed the nomadic life-style of the

hunter-gatherer to a sedentary one. This resulted in the

accumulation of goods and the advancement of technology,

thus promoting the division of class and trading and

communication with other populations. To plant and harvest

farms and to replace animal sources of protein lost after

clearing land for the farms, many groups domesticated and

herded animals.

All of the above either directly or indirectly

contributed to human disease, most notably infectious

disease. The concentration of large numbers of human hosts

in a permanent location provided the "threshold" population

level necessary for the communicable diseases as well as the

vector-borne diseases. The sedentary life-style resulted in

a build-up of human waste proximal to living quarters and

water supplies, which promoted disease from parasites such










as the ascarids and hookworms. Contact with other

populations facilitated the spread of infectious disease to

epidemic proportions by providing organisms with "virgin"

hosts. New zoonotic diseases were encountered with the

constant contact of domestic animals, including anthrax,

brucellosis, tuberculosis, and Q fever (Polgar 1964).

Unwanted peri-domestic animals such as rodents and sparrows

developed permanent habitats in and around human dwellings.

By 3000 B.C. cities with populations of 50,000 or

greater were established in the Near East (Armelagos et al.

1990). All of the characteristics of the earlier

agricultural populations were present, but on a much larger

scale. There were increasing difficulties with supplying

water and food and with managing human waste, resulting in

outbreaks of cholera (Armelagos & Dewey 1978). Increasingly

complex societies also resulted in a breakdown of

traditional social practices; one example is the increase in

sexually transmitted diseases as a result of sexual

promiscuity (Armelagos & Dewey 1978). The same communicable

diseases that affected earlier agriculturalists continued,

but for the first time the populations were sufficient for

maintaining an endemic form (Armelagos et al. 1990). Yet

what was endemic to one population was often detrimental to

another. Cross-continental trade and exploration resulted

in intense epidemics (Zinsser 1936; McNeill 1976; Laird

1989). Large-scale wars resulted in some of the most








20
serious epidemics in history. Following the introduction of

Rattus into Western Europe by the Crusaders and the

introduction of the Xenopsvlla cheonis flea by seaborne

vessels, the Black Death began to take its toll in Europe in

1347 and, three years later, had eliminated at least a

quarter of the European population (approximately 25 million

people) (Laird 1989).

With increasing developments in technology evolved the

germ theory. A better understanding of disease causation

has admittedly resulted in increasing control over

infectious diseases. With the discovery of immunization

came the eradication of smallpox, and most of the other

communicable diseases have diminished in distribution. The

decrease in infectious disease has resulted in greater life

expectancies, so that chronic, degenerative diseases have

become the focus of morbidity and mortality. It has also

resulted in higher fertility rates producing worldwide

population explosions and leading to overcrowding,

underemployment and unemployment, and subsequently all of

the diseases associated with poverty.

Recently, much attention has been focused on the

detrimental effects of industrialization on the

international environment, including water, land, and

atmosphere. Massive industrial production of commodities

has caused pollution of much more than human waste.

Increasingly, there is concern over the health implications










of contaminated water supplies, overuse of pesticides in

commercialized agriculture, atmospheric chemicals, and the

future effects of a depleted ozone on human health and food

production. Increasing incidences of cancer among young

people and the increase in respiratory disease has been

implicated in these environmental changes. While most of

our current chronic diseases and conditions most certainly

existed in early populations (e.g., dental malocclusion,

myopia, and allergy) they must have been rare in order for

those populations to have survived without the technological

compensations which we know today, and their relatively

sudden appearance on such a large scale suggests an

environmental causation (Burkitt 1973; Corruccini & Kaul

1983).


Application of the Disease Ecology Model: Allergy

Clearly, human biological and cultural activities

interacting with the environment forged lasting yet dynamic

relationships between host and pathogen. However, the

effects are two-way. Until this point I have focused on how

human evolution has influenced disease, but at least as

important is the issue of how disease has influenced human

evolution. This has stimulated countless biological and

cultural adaptations so that the host--individual or

population--may be returned to a steady state of well-being.

In many instances these adaptations have feedback effects on

the disease ecology.










The effect of disease on human evolution can be

summarized as follows: as humans evolved from one stage of

subsistence to another, they increasingly altered their

environment, thereby promoting new diseases which did not

exert selective pressures on previous populations to the

same degree. These newly encountered diseases forced

biological and cultural adaptations on the population,

compelling society to alter or increase food production,

explore new territories for new resources, and advance

technologically to combat the insults. Because no two

environments or no two gene pools are identical, different

diseases evolved for different populations. With increasing

communication between groups, there was an increase in the

distribution of disease. This "evolution" is circular;

disease forced changes in the host and her/his environment,

changes were made, and new diseases arose, forcing more

change.

The evolution of human allergy is an excellent

illustration of this feedback effect. Allergy is an example

of how a disease response (hypersensitivity) possibly

evolved as an adaptation to another disease early in human

history and how this "adaptation" is currently causing

negative feedback effects on contemporary disease ecology.










The Influence of Disease on Biological Adaptation:
Parasitic Infestations and IqE

At the beginning of this essay it was noted that the

earliest diseases affecting humans were those which had

affected the prehominids and zoonoses. It was also noted

that one of the "epidemiological principles" is that the

more stable the host-pathogen relationship, the longer the

two have probably coexisted. Helminths were illustrated to

have evolved this type of relationship with human hosts, and

the very long history of that relationship and low mortality

are evident in that all of the helminths have avoided the

development of complete immunity in the human host,

indicating that complete immunity is not an essential

feature for the host's survival (Kliks 1983).

Given that parasites and humans coexisted for such a

long period, one would assume that the disease might have

influenced some sort of biologically adaptive means for

minimizing the pathogenic effects in the human host. We

already know, for example, some of these adaptive

mechanisms. Many of the parasites have evolved mechanisms

for assuring the survival of the host, as in concomitant

immunity, in which the adult worms prevent the survival of

subsequently acquired larvae of similar or different species

(Kliks 1983). The effects of more elaborate genetic

adaptations have also evolved (e.g., sickle cell trait),

which are specific to a parasitic species. Researchers

examining contemporary populations chronically infested with










parasites observe another common feature: stimuli that

cause some of the highest titers of serum IgE are the

protozoa and helminths (Johansson et al. 1968; Ito et al.

1972; Bazaral et al. 1973; Desowitz 1981; Sher & Ottesen

1988). Yet, while serum IgE is 10 times higher in people

with allergy than in normal people, IgE is 10 times higher

in people with parasitic infections than it is in allergic

(Sher & Ottesen 1988).

There are five immunoglobulins in the human immune

system: they are, in order of concentration, IgG, IgA, IgM,

IgD, and IgE. Immunoglobulins are more generally referred

to as antibodies and are produced from lymphocytes. Of all

the human immunoglobulins, the least is known about

immunoglobulin "E," referred to as IgE. Elevated IgE is

found only in two clinical conditions: helminthic

infestations and allergy. Allergy is the common name for

"hypersensitivity," or an inappropriate response to a

harmless antigen upon second contact with that antigen.

There are four types of allergic reactions, but "allergy"

generally refers to the Type I reaction, also called

immediate type hypersensitivity. The main mediator in Type

I hypersensitivity is IgE.

IgE is dispersed both free in the serum and bound on

the surface membrane of mast cells and basophils. Serum IgE

is very low in comparison to concentrations of other

immunoglobulins, typically ranging from 10 to 100










nanograms/ml, or, put another way, is less than 0.00001 of

all the body's total immunoglobulins (Johansson & Bennich

1985). IgE is unique among the classes of immunoglobulins;

although its normal concentration is extremely low, it may

increase several hundredfold following challenge to a

specific stimuli (Barbee et al. 1981).

Allergenic stimuli are referred to as allergens or

antigens. Antigens may be inhaled, injected, ingested, or

presented by dermal contact. When IgE comes into contact

with an antigen, it triggers the release of the contents in

the basophils and mast cells. These mediator substances

include: histamine, a vasodilator; slow-reacting substance

of anaphylaxis (SRS-A), a smooth muscle contractor; and the

eosinophil chemotactic factor of anaphylaxis (ECF-A), which

causes the accumulation of eosinophils where the interaction

occurs. The clinical feature of Type I hypersensitivity is

referred to as "atopy." Atopy can be manifested as asthma,

allergic rhinitis, or eczema, sometimes called dermatitis

(not to be confused with "contact dermatitis" which is a

manifestation of Type IV hypersensitivity). Atopic

individuals are, in the most extreme scenario, at risk of

anaphylaxis, a life-threatening reaction in which there is

vasodilation and constriction of smooth muscles,

particularly of the bronchus, thus interrupting the exchange

of metabolic gases.










The capacity for developing elevated levels of serum

IgE is largely determined by genetics. This predisposition

is controlled by the major histocompatibility complex, or

MHC (antigen-specific) and by a regulator gene (nonspecific)

(Menser et al. 1975; Marsh et al. 1981; Marsh et al. 1980b).

Prevalence of atopy is higher in non-European descendants

living in developed countries (Davis et al. 1961; Worth

1962; Orgel et al. 1974; Marsh et al. 1980a; Waite 1980),

While the functions of IgG, IgA, IgM and IgD are

relatively well understood, the physiological function of

IgE is less clear. IgE is important in facilitating fluid

transport across cell membranes, and it also functions in

fighting bacterial and viral disease, although to a much

lesser degree than the other immunoglobulins (Gerrard 1985;

Johansson & Bennich 1985). With increasing evidence of a

relationship between elevated IgE and parasitic

infestations, researchers began to determine what the

physiological relationship was between the parasite and the

immunoglobulin.

Animal studies demonstrated that serum IgE appeared to

function by minimizing the number of parasites in a host who

was chronically exposed to large numbers of parasites (Hsu

et al. 1974; Dessein et al. 1981). Dessein et al. (1981)

concluded that IgE-suppressed rats demonstrated

significantly less resistance to infection by Trichinella

spiralis than controls with normal IgE levels. Following








27
sequential challenges with Schistosomula iaponicum cercariae

to a rhesus monkey, hypersensitivity reactions were

determined using microscopic examination of skin biopsies

and macroscopic determinations wheall and flare) (Hsu et al.

1974). The schistosomulae were destroyed in the dermis of

the primate approximately 12 hours after the challenge.

After numerous other laboratory and clinical studies,

contemporary immunologists concluded the following

protective mechanism of IgE against heavy parasitic

infections: upon entering the host, soluble parasitic

antigens diffuse across the intestinal mucosa and are

transported to the lymph nodes, where an IgE-mediated

response occurs. Mast cells migrate to the same lymph

nodes, are sensitized by the development of parasite-

specific IgE on their surface, and return to the intestinal

mucosa. Upon contact with the parasitic antigen, the mast

cells degranulate and release their mediators, which

subsequently attract to the site eosinophils, complement,

and parasite-specific IgG, all of which function to damage

and expulse the parasite (see Brothwell 1972).

Having reviewed the relationship between parasitic

infections and IgE, and with the understanding that the only

other manifestation involving elevated IgE is allergy, the

question is posed: is there any relationship between

parasitic infections and allergy? Unfortunately, this

relationship is much less clear than the helminthic-IgE










relationship. Before discussing what is known about this

topic, a review of the evolutionary history of IgE as an

adaptive process will be presented.


The Influence of Disease on Cultural Adaptation: The
Gradual Decrease in Exposure to Parasites

With the confirmation of a relationship between IgE and

both allergy and parasitic infestations, there have been a

number of suggestions as to a "cause-and-effect"

relationship between the two. From an epidemiological point

of view, this information would be valuable in determining

the distribution of IgE-related disease in populations of

the past and predicting trends in contemporary societies.

The first evidence of a relationship between IgE and

parasites ironically came from a temperate environment

rather than the tropics, where parasitic infections are

typically endemic. D. Tullis (1970) declared that an unusual

epidemic of Ascaris lumbricoides, Trichuris trichiura,

Necator americanus, and Ancylostoma duodenale in the Niagara

Falls vicinity had coincided with an alarming increase in

the prevalence of asthma. One-hundred and ninety-eight of

the 201 asthmatics were diagnosed with intestinal

infestations involving one or several of the above

parasites. Tullis' conclusion was that there was a definite

correlation between the development of bronchial asthma and

intestinal parasitic infestations. Following Tullis'

report, other immunologists published similar findings,










concluding that parasites caused allergy (Huntley 1976;

Joubert et al. 1980; Desowitz et al. 1981).

The investigation was taken to the tropics where

populations traditionally have experienced high levels of

parasitic infections. As expected, and similarly to the

previous studies, populations that were heavily infested

with parasites demonstrated extremely high levels of IgE

(Godfrey 1975; Warrell et al. 1975). However, one

researcher, Godfrey (1975), noted in his study that, among

those patients with the extremely high serum IgE and

parasitosis, allergy was practically nonexistent.

Furthermore, he added a socio-demographic variable,

concluding that parasitosis was highest in the rural region

and asthma was highest in the urban region, where there was

a low incidence of parasitosis. Similar experiments in

laboratory settings revealed the same results; allergy was

minimized or absent in persons with heavy parasite

infections (Phills et al. 1972; Hsu et al. 1974; Godfrey &

Gradidge 1976; Dessein et al. 1981).

Curiously, other studies indicated that there was no

relationship between IgE, parasitic infections, and allergy;

atopy was just as prevalent in persons with helminthic

infestations as without them (Alcasid et al. 1973;

MacFarlane et al. 1979). These studies did not, however,

take into consideration various socioeconomic and

demographic variables, such as urban or rural residence.










The prevailing conclusion is that, under certain

conditions, all three of the above scenarios may occur. But

in the majority of cases involving heavy parasitosis in

endemic regions, the incidence of allergy to both parasites

and exogenous allergens is low. The mechanism for that

suppression is believed to be one of the following two

theories. Chronic exposure to large numbers of parasites

stimulates the production of both specific and nonspecific

IgE antibodies, resulting in "saturation" of the IgE

receptors on the mast cells and therefore preventing the

cell from responding to additional "specific" antigens, such

as molds or arthropods (Godfrey & Gradidge 1976; Ottesen

1985).

A second--and currently more widely accepted theory of

mechanism--is a "blocking antibody" mechanism, in which

persons chronically exposed to helminths produce antigen-

specific IgG-blocking antibodies which inhibit to a degree

the mast cell or basophil degranulation process (Ottesen

1985). Similar to other mechanisms involving human hosts

and parasites, the potential role of these antibodies

appears to be more to limit the degree of hypersensitivity

rather than to eliminate the reaction completely (Ottesen et

al. 1981; Ottesen 1985). This mechanism is specific for

maintaining a low incidence of allergy to parasites rather

than exogenous allergens and is not recognized in atopic

disease (Ottesen et al. 1981). It is, interestingly, also








31

the principle for which desensitization therapy for allergic

disease is administered (Ottesen et al. 1981; Ottesen 1985).

The blocking antibody theory explains why allergy to

helminths usually is seen only in the early phases of

parasitic infestation. At the sites of initial parasitic

contact, such as the mucous membrane or skin, the antigen

concentration is too great to succumb to the effects of the

blocking antibodies, yet as the parasitosis progresses and

sufficient IgG-blocking antibodies are generated, the

hypersensitive reaction gradually would be controlled

(Ottesen 1985). Consequently, in regions where

helminthiasis is in an acute, epidemic stage (e.g., Niagara

Falls) allergic responses to the helminths would be

expected.

A blocking mechanism specific for helminths--but not

for other allergens--would also explain why helminthiasis

and allergy occasionally occur simultaneously. Populations

that have been chronically exposed to parasites have a

genetic predisposition for elevated IgE. It is likely that

the occurrence of both phenomena is reflective of

populations undergoing a transition from developing to

developed living conditions, as in rural to urban migrations

in tropical countries, where they are exposed to both

parasites and new and numerous exogenous allergens.

Clearly, there is a cause-and-effect mechanism between

IgE and both helminthiasis and atopy. However, the sum










process is multi-causal. First, predisposition to develop

high levels of serum IgE is genetically-determined. The

fact that these elevated levels are higher in non-Europeans

than Europeans has already been mentioned. Presumably, the

selective advantage for a haplotype which is predisposed to

producing high levels of IgE--a key component the mechanism

for destroying invading helminths--would be highest in a

population chronically exposed to helminths. This

represents the protective role of IgE. Over millennia, and

following the cultural impact of widespread distribution of

once isolated gene pools, these haplotypes would also be

widely dispersed. Elevated IgE in populations chronically

exposed to parasites apparently did not produce adverse

health effects due to the check-and-balance mechanism of

IgG-blocking antibody and the control of the hypersensitive

state. This mechanism was advantageous to both the host and

pathogen. Without exposure to helminths, however, there is

apparently no IgG-blocking antibody and therefore no built-

in control over the immune response in the event of contact

with foreign allergens. This is the negative feedback

component of the immune mechanism. Traditional societies

exposed to many parasites--but few exogenous allergens in a

less complex environment--benefitted from the biological

adaptation of IgE; parasitosis was kept at a reasonable

state of low morbidity. Yet as humans evolved culturally

and biologically, they created an environment in which IgE









33
is not checked (e.g., no exposure to parasites) and in which

potential allergens abound.

In summary, it is apparent from this particular

illustration--IgE, helminths, and parasites--that disease

plays a major role in the adaptation of the human host, but

that many adaptations may in turn promote additional

diseases. A new trend in the ecological perspective of

disease is to shift our focus on adaptation as an "optimal"

mechanism to one of sufficiency. Gould and Vrba (1982)

argue that, in the case of evolution, the word "adaptation"

has been overused, because not all features that enhance

fitness were necessarily designed by natural selection for

their contemporary role. The authors suggest that

"exaptation" be used to explain certain characters that

either evolved for other purposes or for no purpose at all,

but were later "co-opted" for a contemporary purpose (Gould

& Vrba 1982).

Although "exaptation" may not be an appropriate

description for the development of IgE, we cannot eliminate

it as a possibility. Perhaps IgE did originate for a

similar purpose as the other immunoglobulins, but was also

efficient in functioning as an anti-helminthic mechanism.

By adopting this approach, we may include in our analysis of

human evolution other traits which have previously received

little attention, because "complete" adaptation was not the

end result.










Influencing Biological and Sociocultural Factors

People who live in developing regions of the world do

not exhibit a high prevalence of allergic disease (Godfrey

1975; Warrell et al. 1975) presumably because of functioning

IgG blocking-antibody. This is probably because exposure to

parasites is chronic due to their traditional modes of

production and because they have limited sources of clean

water and sanitary provisions. When they shift to a more

developed, urbanized environment the incidence of allergy

becomes comparable to incidences in developed countries.

This is, however, an over-simplification of the allergy

model. A number of biological and behavioral factors

contribute to allergic disease, as will be demonstrated

below.

Genetic. MHC-related factor

The development of allergic disease in an individual is

multi-causal. Perhaps one of the most predictive factors

for the development of allergy is genetic predisposition;

some individuals are genetically predisposed to produce more

IgE than others (Willcox & Marsh 1978; Marsh et al. 1980b;

Gerrard 1985). The phenotype of elevated serum IgE is at

least partly dictated by a genotype controlled by the MHC.

The MHC is a region on chromosome 6 in humans that contains

a number of gene loci. A particularly important complex is

composed of the four human lymphocyte antigen (HLA) loci,

designated as HLA-A, -B, -C and -D. Each locus contains a








35
number of different alleles, or HLA antigens, resulting in a

high degree of polymorphism. A set of HLA genes (that

includes four HLA determinants) constitutes a "haplotype".

Certain HLA antigens--or haplotypes--have been correlated

with immune responsiveness to aeroallergens (Menser et al.

1975; Blumenthal et al. 1980; Marsh et al. 1980b; Marsh et

al. 1981; Brostoff & Hall 1989). For example, HLA-Dw2 is

highly associated (92%) with allergy to the short ragweed

allergen Ra5, in contrast to a poor association (22%) for

those individuals with HLA-B7 (Marsh et al. 1981).

Genetic. non-MHC-related factor

High IgE levels are also dictated by a regulator gene

that is not linked to the MHC; total IgE is partially

regulated by an autosomal gene in which the genotype that

controls for high serum IgE is recessive (rr) and low total

IgE is dominant (Rr or RR) (Marsh et al. 1974; Gerrard et

al. 1978; Willcox & Marsh 1978; Marsh et al. 1980b; Rao et

al. 1980). It is postulated that the dominant allele (R)

functions by limiting the number of IgE antibodies that

clonally expand in response to an allergen, resulting in low

total serum IgE (Willcox & Marsh 1978). While the MHC class

of immune response (Ir) genes are antigen-specific, this

second genetic mechanism involving the regulator allele "R"

is nonantigen-specific (Willcox & Marsh 1978; Marsh et al.

1980b).










Familial factors

Predisposition to allergy is associated with a positive

family history of allergy (Gerrard et al. 1976; Gerrard et

al. 1978; Marsh et al. 1980b), although the familial

environment might be a more important factor; members of a

family living in the same household and sharing the same

behaviors might all be at a similar risk of developing

allergies. Nevertheless, results from studies involving

twins conclude that serum IgE is genetically determined and

monozygous twins express more similar levels of IgE than

dizygous twins (Bazaral et al. 1974).

Ethnic factors

Prevalence of clinical allergy reportedly has been

higher in non-European descendants living in developed

countries, including the following: Chinese Americans (Worth

1962); West Indian Blacks in England (Davis et al. 1961,

Pearson 1973); American-born Filipinos (Orgel et al. 1974);

and Polynesians in New Zealand (Waite 1980). Similarly,

Iraqi, Iranian, and Yemini immigrants in Israel had higher

rates of asthma than other ethnic groups (Asch et al. 1973).

In contrast, some races exhibit a lower prevalence of

allergy than European-descendants; Herxheimer & Schaefer

(1974) reported that the incidence of asthma among Canadian

Eskimos was extremely rare. Asthma was also rare for North

American Indians despite their unusually high levels of

serum IgE (Gerrard 1985). It has been suggested that the










low incidence of asthma among Canadian Eskimos and North

American Indians may be related to the low frequency of HLA-

A8 haplotype in that population; white children with HLA-A8

have a particularly high incidence of asthma (Menser et al.

1975). However, Gerrard (1985) noted that serum IgE levels

were high in the Indian population; he hypothesized that

inadequate medical services meant that the North American

Indian was forced to rely more heavily on his/her own immune

system, possibly resulting in higher IgE levels.

Behavioral and nutritional factors

Similarly to other chronic diseases of modernization,

genetics alone cannot explain the rapid increase in the

prevalence of allergy. Just as the environment probably was

important for the development of IgE--that is, exposure to

an environment plagued with intestinal helminths--so the

environment must be important for the development of another

IgE-related manifestation: Human allergy. After all,

elevated IgE cannot manifest itself as a hypersensitive

reaction unless there is some aggravating allergen present

to elicit the response.

One factor characteristic of modernization and

important in the development of allergy is both biological

and behavioral, and that is breastfeeding. Breastfeeding is

believed to decrease the likelihood of developing allergy

indirectly by minimizing infection. Breast milk contains

factors that promote the maturation of the intestinal tract










of the newborn and also provides secretary antibodies to

assist in immunity at the intestinal surface (Ogra & Ogra

1978). Also, breast milk contains fewer foreign proteins

than bottled milk and it is believed that both the

introduction of foreign antigens (Johansson & Bennich 1985)

and infection during early childhood (Marsh et al. 1981) may

initiate allergic disease.

It is often difficult to differentiate between true.

food allergies and genetically-based food intolerances (see

Lieberman & Barnes 1990). A number of the food intolerances

(e.g., celiac disease, G6PD-deficiency, and lactose

intolerance) have been managed by culture-specific

proscriptions and food preparation practices in regions

where they are most commonly distributed. However, when

individuals with food intolerant predispositions are exposed

to new foodways, either voluntarily or involuntarily,

adverse allergic-like reactions often occur. Newly

introduced sources of dietary proteins--particularly the oil

seeds and yeasts--as well as the chemical modification of

foods for large-scale commercialization have potentially

antigenic effects on persons predisposed to allergic disease

(Metcalfe et al. 1988). A well-publicized phenomenon is the

"Chinese Restaurant Syndrome," which is an adverse food

reaction to monosodium glutamate (MSG) (Man-Kwok 1968; Allen

& Baker 1988).










Miscellaneous behavioral factors

Other behaviors associated with modernization
contribute to the development of allergy. Cigarette smoking

is associated with elevated serum IgE (Gerrard 1985; Burrows

1989). Psychological stress has been implicated in at least

the exacerbation of allergy and possibly as a predisposing

factor (Graham 1967; Glazer 1969; Smith 1978). Stress is a

well-known insult in populations undergoing transitions from

rural to urban settings, immigration, and an increase in

complexity of modes of production (McElroy & Townsend 1985;

Goodman et al. 1988). The disproportionately high levels of

allergy among Iraqi and Yemeni immigrants into Israel was

partially attributed to psychological stress (Glazer 1969).

Population behavior and the macroenvironment

As the environment in which we live becomes more

complex and we become more mobile, we are increasingly

exposing ourselves to greater numbers of foreign proteins

that may function as allergens. Immunologists conducting

studies in tropical regions have found that prevalence of

allergy tends to be much lower in populations where

traditional means of living continue compared to prevalence

in more developed populations (Anderson 1974; Godfrey 1975;

VanNiekerk et al. 1979; Dowse et al. 1985). Specifically,

urban populations overwhelmingly present with higher rates

of allergy than rural populations, and this discrepancy is

most notable in developing countries; examples include the










Gambia (Godfrey 1975), Nigeria (Warrell et al. 1975), and

the Punjab (Corruccini & Kaul 1983). With the process of

urbanization and modernization, populations are subjected to

new foods, ingested chemicals, and synthetic materials, as

well as chemicals and pollutants emitted into the

environment from factories and transportation vehicles.

Urban pollutants such as sulfur dioxide, sulfuric acid,

carbon monoxide, and particulate matter serve as irritants

to asthmatics (Lopez & Salvaggio 1978; Smith 1978; Hackney &

Linn 1985; Weiss & Speizer 1985).

Population behavior and the microenvironment

The role of the domestic environment--or rather,

"microenvironment"--was discussed at the outset of this

chapter. Specifically, some of what is known regarding

allergens and the microenvironment is related to the

presence of arthropods. Also important is the production of

molds (Burr et al. 1985; Brunedreef et al. 1989; Platt et

al. 1989; Dales et al. 1991) and fungi (Arundel et al. 1986;

May et al. 1986) secondary to excessive moisture levels in

the home. Inadequate ventilatory practices in housing

construction contribute to elevated relative humidity levels

(Arundel et al. 1986).


Conclusions and the Allergy Disease Model

Figure 1-1 illustrates the cultural and biological

factors sufficient--but not necessary--for the development

of allergic disease. The biological and cultural factors









41
are a result of interactions between the host population and

the environment; both factors influence each other, from the

host, and to the host. These interactions create elements

in the environment that subsequently produce allergenic

stimuli, or "insults", which in turn affect the host.

Depending on inherent features of the host, they may or may

not produce disease.

In summary, by reviewing many of the known factors for

the development of the hypersensitivity response, it is

evident that allergy is a disease characterized by human

modernization and urbanization. By using the construct of

the epidemiological transition we can predict the

development of allergy as a significant form of morbidity

due to changes which typically occur during the transition

of traditional living toward modern living. It is apparent

that populations in the middle of this transitional period

will experience an epidemic-like form of the disease due to

the sudden exposure to numerous allergens. Many of those

individuals may be more likely to suffer from allergy

because of their genetic make-up, although this is not a

limiting factor. Evaluation of disease patterns outside of

the Western world and into regions where the disease-causing

relationship begins will provide medical researchers with

new insights into the evolution of many human diseases--in

this case, allergy.









42

Notes

1. "Arboallergen" is a term used to denote any arthropod-
borne allergen. It is based on the hypothesis that a number
of specific epitopes are found in different arthropods, and
possibly occur in proteins associated with the production of
chitin and molting and/or in common digestive enzyme systems
(Brenner et al. 1991). The resulting clinical picture is
cross-reactivity (hypersensitivity) to different arthropods.












43






















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CHAPTER 2
THE STUDY DESIGN AND RESEARCH SETTING


The Construct of Allergy and Modernization:
A Review of the Objectives

In Chapter One, allergy was defined as part of the

epidemiological transition of disease and both genetic and

behavioral factors were identified that are known to

contribute to the rising incidence of allergy on a worldwide

scale. It was suggested that a closer look at a population

in the midst of infrastructural transition may elucidate

factors that are playing a significant role in the incidence

of allergy in both societal settings--developed and

developing. Certainly, identifying etiological factors of

disease is more complicated in a developed society, after

the epidemiological transition has occurred, in that the

population as a whole has already achieved a certain degree

of adaptation in its effort to rally against the disease,

and it is therefore difficult to distinguish between causal

versus spurious co-variation of suspected independent

variables.

The overall objective of the study--identifying a

relationship between modernization of the domestic

environment and allergy to household pests--was presented in

Chapter One. The dependent variable in the study is allergy

to a given household pest at the individual level, a

44











biological measurement to be presented categorically; a

person is either reactive or nonreactive to a specific pest

allergen. To minimize variation in selection criteria and

symptomatology associated with atopy, only asthmatics were

chosen for the study. The independent variables in the

study are structural features of the domestic environment

and sociodemographic features of the household that may

contribute to the nutritional and reproductive needs of

various household pests, thus supporting a substantial

population of the pests. The presence or absence of these

various features will be correlated with the presence or

absence of a given pest allergy to support a causal

relationship. It is recognized that categorization of the

independent variables as a feature of modernization is

primarily a subjective process; however, an anthropological

presentation of the evolution of the Barbadian domestic

environment will elucidate the dynamic features of housing

in Barbados and illustrate the fact that Barbadians are

achieving a level of development similar to that of

industrialized countries such as the U.S..

This chapter presents the general materials and methods

relied upon to conduct the study. Following an ethno-

historical review of the development of land distribution

and housing in Barbadian society (Chapter Three)--which

ultimately affects the development of the domestic

environment and thus the presence of certain pests--specific










sociodemographic and housing variables will be identified

and analyzed in Chapter Four. Chapter Five presents

findings from the entomological survey as well as stated

behaviors, perceptions and attitudes about household pests.

Chapter Six is a presentation of the biomedical testing of

allergies to various household pests, including results and

discussion, and Chapter Seven concludes this dissertation

with a summary of findings and implications for future

studies.


The Research Site
Barbados was chosen as the research site for a number

of reasons. An important sociodemographic feature was the

fact that Barbados is the most heavily populated country in

the Western Hemisphere, at over 1500 persons per square

mile. Household infestations are a significant problem in

densely populated settings (Harwood & James 1979) and also

in the tropics (Marchand 1966; Pearson & Cunnington 1973;

Dowse et al. 1986; Lan et al. 1988). Because the Barbadian

population is almost equally divided between rural and urban

residence and because the island is so small--and therefore

easily accessible with clearly defined boundaries--Barbados

offered a unique opportunity to contrast the incidence of

allergy to household pests with crowded urban and rural

populations. Another sociodemographic feature was the

dynamic status of Barbadian housing. The level of

infrastructural development in Barbados and documented











health indicators assured that the epidemiological

transition from acute and infectious disease to chronic

disease had in fact taken place in Barbados, thus implying

the likelihood of a significant incidence of allergy in

general and asthma in particular.


The Rising Incidence of Asthma in Barbados

Despite the absence of any recent study on the status

of asthma in Barbados, it is unanimous among most

Barbadians--health care professionals as well as lay

persons--that asthma is on the increase. While exact

figures for the incidence of asthma is not known, PAHO

reports that the disease category

"bronchitis/emphysema/asthma" accounted for a crude death

rate (per 100,000 population) of 8.9 in 1988, or 23 persons

in Barbados; this figure correlates highly to the U.S. crude

death rate of 9.2 for the same category and year (1990).

The number of asthmatic attendances at the Accident and

Emergency (A&E) Department at Queen Elizabeth Hospital (QEH)

doubled within a 10-year period, from 3,503 visits in 1980

to 7,137 visits in 1990 (Figure 2-1). Annually, asthmatic

attacks account for more than 13% of all visits to the A&E

Department, averaging about 20 patients a day (Naidu 1988,

1990), and make up 12.5% of the Emergency Ambulance Service

(EAS) calls (Naidu 1992). A slight decrease in the numbers

of visits during 1989 and 1990, at 7,267 and 7,137,

respectively, suggested that the dispensing of free asthma











medications and the increase in public awareness and

educational programs were possibly stabilizing the incidence

of asthmatic attacks (McCarthy 1991a). But a record 7,808

visits in 1991 indicates a continuation in the trend of

rising incidence. Nearly half of all asthma-related visits

are children under the age of 15 (McCarthy 1991b).

The incidence of asthmatic attacks has a definite

seasonal pattern in Barbados. October is the month with the

greatest number of visits; Figure 2-2 illustrates the

dramatic increase from 1974 to 1991. There were an

unprecedented 936 visits in 1988, 899 in 1990, and a record

937 visits in 1991 (Naidu', personal communication). Also

in 1990, two of the three asthma-related deaths occurred in

October (McCarthy 1991c). This corresponds to the rainfall

patterns in Barbados, in which the average monthly rainfall

peaks in August and October (Depradine et al. 1984).

Figures 2-3 and 2-4 illustrate the relationship between

asthma visits to the A&E department and monthly rainfall for

1990 and 1991, respectively. Note the unusually large

amounts of rainfall for the month of October--and the

exceptional amount of rainfall for November, 1991--

correlated with the highest numbers of asthmatic visits on a

monthly basis.































































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The significance of the rising incidence of asthma in

Barbados is reflected in the facilities that have been

created in recent years to cope specifically with the

asthmatic patient. The current Minister of Health, Mr.

Branford Taitt, became particularly interested in asthma and

health care, due in part to the number of deaths from

asthmatic attacks and to the apparently overall increasing

incidence of asthma. A policy was instituted in which

polyclinics would have nebulizers, peak flow meters, and

oxygen available at all times, and asthma drugs would be

available in all polyclinic dispensaries. In 1990 the A&E

Department was remodeled and included a new "asthma bay"

designed especially for asthmatic clients. The bay is

situated directly in front of the nursing station, thus

allowing full-time observation. An important consideration

in understanding the increasing number of hospital visits

due to asthmatic attacks is a greater reliance on the A&E

Department than in previous years. Naidu suggests that this

trend may represent an increasing dependence by the public

on the A&E Department as a primary care center for the

treatment of asthmatic attacks (1990). It has also been

suggested that the decrease in reliance on home remedies and

increasing preference for A&E medical treatment is

responsible in part for the increase in attendances

(Ferdinand2, personal communication; Naidu, personal

communication).








54

Unfortunately, there are few physicians in Barbados who

specialize in asthma disease. One allergist conducts

allergy testing and desensitization therapy in his private

clinic, but the cost of his services are prohibitive to the

average Barbadian. A few physicians, both in the private

and public sector, who specialize in internal or respiratory

medicine, have earned a reputation as "asthma specialists"

and are preferred by asthmatics and parents of asthmatics

over polyclinic physicians. In 1990, medications for the

treatment of asthma were made free to all asthmatics through

the Barbados Drug Service. For the period between October

1989 and December 1990, 5,310 asthma therapy prescriptions

were filled at the QEH pharmacy and 7,892 were filled at

other government pharmacies, for a total of 13,202

prescriptions (Prescod3, personal communication). Money

spent on asthma medications actually decreased by 4.5% from

BDS4 $261,039 (note: all monetary figures in this thesis

will be presented in Barbados dollars, except when indicated

otherwise) between July 1988 to June 1989, to $249,435

between July 1989 to June 1990; this factor has been

attributed in part to the efficiency of the Drug Service

program (Prescod, personal communication).

In June, 1989, the Asthmatic Association of Barbados

was founded, following suggestions for the organization

during a "national asthma week" seminar provided by the

Barbados Drug Service. As of 1991 the organization boasted











some 150 members, most of whom were adult asthmatics or

parents of asthmatic children, although the meetings are

open to any interested person. The association meets once a

month and the primary objective is to disseminate

information on the control and management of asthma, usually

via a guest speaker5.

Infrastructure: The Developed Nature of a Developing
Country

In 1991 the United Nations revised the human

development index and declared Barbados the leading

"developing" country among all developing nations (United

Nations 1991), a step that Barbadians fear will eventually

reduce their eligibility for international aid. The

classification is supported in part by an estimated per

capital income of US $6,020, higher than the Republic of

Korea or oil-rich Venezuela (United Nations 1991). Thus,

according to the U.N., Barbados ranks ahead of its neighbors

in the Eastern Caribbean in human development; Table 2-1

illustrates the disparity of GNP (gross national product)

per capital within the Eastern Caribbean nations.

Barbados health indicators demonstrate a quality of

life more comparable to industrialized countries than

developing countries (Table 2-2). Great strides have been

made in Barbadian health care; between 1920 and 1922, life

expectancy was only 31.9 years for women and 28.5 years for











Table 2-1 GNP per capital (1980), in U.S. dollars in
the Eastern Caribbean.

Country GNP per capital

Barbados 6,010
Antigua & Barbuda 3,690
Trinidad & Tobago 3,350
St. Kitts & Nevis 2,630
Grenada 1,720
Dominica 1,680
St. Lucia 1,540
St. Vincent 1,200
Jamaica 1,070

Source: United Nations 1991.


men (Dann 1984). This is in stark contrast to the average

of 75 years as of 1990 (United Nations 1991). In a "quality

of life" survey, sociologist Graham Dann found that "health"

received the highest score of the seven life satisfaction

domains (1984), indicating that Barbadians are content with

the status of their health and health care delivery. The

leading causes of death in Barbados are similar to those of

industrialized nations, and include: heart disease,

malignant neoplasms, cerebrovascular disease, diabetes

mellitus, and "other" circulatory system diseases (PAHO

1990).

Education in Barbados ranks as the leading priority in

government spending, at over one fifth of the national

budget, or, about $1 per person per day (Dann 1984). Table

2-3 compares educational indicators in Barbados with other

Eastern Caribbean countries. As illustrated, there is a 99%

literacy rate and education is compulsory for 11 years. It










has been argued that Barbadians are perhaps over-educated

for the jobs available, as unemployment for new graduates is

higher than in any other age group (Dann 1984). Recently

there have been efforts by the Ministry to design a

curriculum that would prepare students for the three

mainstays in Barbadian economy--tourism, manufacturing, and

agriculture, but this move has been sharply criticized by

certain nationalists as "encouraging a 'mental attitude of

subservience'" (Goddard 1991, p.6).

Barbados was controlled by Britain for some 350 years,

and at the time of Independence (1966) the British legal and

parliamentary system was adopted. Barbados is classified as

an independent, liberal-democratic state with competitive

parties, has the highest rating for political and civil

rights (according to the Freedom House Index) and a strong

emphasis on economic and social reforms (Stone 1985). There

is a network of approximately 860 miles of paved roads and

public transportation is available in all of the 11

parishes. PAHO (1988) reported 100% coverage of drinking

water supplies and sewerage or excreta disposal services in

Barbados, which no doubt contributes to the overall good

health of the nation. (See Chapter Three for a full

description of Barbadian economy).


The Health Care Delivery System

Barbadians enjoy an efficient socialized health care

system, reflected by the health indicators previously











illustrated. Government health expenditure per person in

1987 was US $230.58 and the percentage of total government

expenditure on health was 13.13 (PAHO 1990). The primary

resource centers for receiving health care in Barbados are

QEH6, including the hospital and polyclinics; the

distribution of these services is depicted in Figure 2-5.

The concept of polyclinics and public health care came

into existence in the mid-1970s. Initially the clinics were

serviced by General Practice (GP) doctors who maintained

both government and private offices and visited the clinics

several times a week. At that time, only patients who

passed a "means" test by the welfare department could visit

the free clinics or the hospital. In 1985 the government

began employing GP's full-time and regular GP sessions

commenced in the polyclinics. The "means" test was

eliminated and services became available to all residents.

While the exact number of persons attending private

physicians is not known, 135,810 attendances were recorded

in 1990 to the eight public polyclinics and five outstations

(see Table 2-4) (Sergeant7, personal communication).

According to R. Naidu, Director of the A&E Department at

QEH, the introduction of the polyclinic system has reduced

the number of visits to the A&E Department, except in the

parish of St. Michael, where there is still a

disproportionately high number of attendances when compared

to the percent of the population living in that parish









59
(Naidu 1988). The Barbados Drug Service provides free

prescription medications to all persons under the age of 16

years and those over 65 years and to any patient needing

medications for venereal disease, cancer, hypertension,

diabetes, glaucoma, and, as of 1990, epilepsy and asthma.

Dispensaries are available at each of the polyclinics.

















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Christ Church






Figure 2-5. Distribution of Outpatient Health Care
Facilities in Barbados.











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Sampling and Methodology


The Survey Schedule

The asthma study was conducted in Barbados from January

to December, 1991. The project was divided into 2 phases.

The principle objectives of Phase I were the following: (1)

to qualify the household pest species in the major

topographical regions of the island; and (2) to conduct an

ethnographic survey, primarily using the techniques of

participant observation and informal interviewing, for the

purpose of designing an appropriate questionnaire for the

study sample in Phase II. These separate operations were

conducted simultaneously; while the trapping was taking

place in one region, the ethnographic data were collected in

the selected households. Three to four weeks were spent at

each site during the dry season and two weeks were spent at

the sites during the rainy season.

Topographical considerations

Unlike its volcanic neighbors, Barbados is composed of

a coral limestone formation, resulting in a relatively flat

but terraced landscape, with a series of deep gullies as

well as vertical cliffs, the remnants of old coral reefs.

The coral limestone base contributes to a good drainage

system and a fluctuating but reasonable supply of water,

depending on the region, yet negates the presence of rivers

or streams. Although there were at one time a number of

coastal swamps on the leeward coast, the only remaining











swamp--and the only true body of water on the island at

present--is the Graeme Hall Swamp, situated in suburban

Christ Church.

The Town and Country Development Planning Office (1988)

has divided Barbados into nine topographical areas (Figure

2-6). In the northern cap is the flat St. Lucy Plain (1).

Below the First High Cliff area (2) lies almost the entire

western beach coast, 20-25 meters (66-82 feet) above sea

level. Below the Second Cliff area (3) the region is

divided into three sub-regions of terraces. About 35 meters

(116 feet) above sea level is St. George's Valley (4), a

synclinal structure and relatively small component of the

island, and to the east of that lies St. Philip Plain (5), a

very flat and poorly drained region. To the north and in

the center of the island is the Upland Plateau (6), with

dramatic variations of gullies and low terraces to

elevations from 130-330 meters (430-1090 feet). An

anticline of over 130 meters (430 feet) makes up the

southern Christ Church Ridge Unit (7). Finally, there is

the Scotland District (8 and 9) in the northeast, the most

distinctive of the regions, due to the heavy erosion and

subsequent exposure of underlying geological formations

consisting of shales, sands, silty clays, and marl (see Town

& Country Development Planning Office 1988).
















































Figure 2-6. Geophysical Subdivisions of Barbados. Numbers
correspond to the following regions: (1) St. Lucy Plain,
the flat, northern cap of the island; (2) First High Cliff
area, below which lies the western beach coast, 20-25 meters
(66-82 feet) above sea level; (3) Second Cliff area, divided
into three sub-regions of terraces; (4) St. George's
Valley, 35 meters (116 feet) above sea level; (5) St. Philip
Plain; (6) Upland Plateau, with elevations from 130-330
meters (430-1090 feet); (7) Southern Christ Church Ridge
Unit, an anticline of over 130 meters (430 feet); (8) & (9)
Scotland District. Figure adapted from map obtained with
permission by Town & Country Development Planning Office
1988.










There is significant variation in annual and seasonal

rainfall and, because of the terraced structure of the

island, rainfall varies considerably from region to region

(Figure 2-7). The Barbados Society of Technologists in

Agriculture compiled a list of monthly and total rainfall

figures in Barbados from 1847 to 1983 and found an annual

low of 39 inches in 1947 to a high of 91.5 inches in 1901

and an average annual rainfall of 59.68 inches (1984).

Seasonally, however, rainfall averages a low of 1.90 inches

in March and over seven inches per month from August to

November, during the "rainy season" (Barbados Society of

Technologists in Agriculture 1984). Figure 2-7 illustrates

the variation of rainfall within the different regions of

Barbados, showing the greatest amount of rain falling in the

central portions of the island (an average of 80 inches) and

the lowest amount in the southern Christ Ridge region and

St. Philip (an average of 45 inches) (Plantations Trading

Co. Ltd. 1989). Areas with the lowest rainfall correlate

with the three areas with the least fertile soil, the west,

south, and southeast coasts, and these are also the regions

that are the most densely populated (Town & Country

Development Planning Office 1988).

It is apparent from the above discussion that, although

Barbados is divided into 11 parishes, parish boundaries do

not necessarily represent the topographical boundaries. The

Leeward side of the island--or West and South coast--is the











most heavily populated and comprises the four major urban

centers of Barbados: Speightstown, Holetown, Bridgetown,

and Oistins. Within the metropolitan boundaries of Greater

Bridgetown live 45% of the national population and the

majority of governmental operations and industry. The area

between Bridgetown and Speightstown is predominantly devoted

to tourism, as resorts line the length of the coastline.

Speightstown is a semi-urban fishing town, populated by

Barbadians rather than transient tourists. The region south

of Bridgetown toward Oistins is also a tourist region,

though this area is mixed with residential areas and

businesses and is the seat of the main fish market.

Recently there has been considerable urban tourist-related

growth in a southeasterly direction, encompassing the parish

of St. Philip. The major center in this region is Six

Roads. Although the eastern portion of Christ Church and

the parish of St. Philip are increasingly the focus of

growth for industry, the region is still largely

agricultural. The northeastern Scotland District is the

most sparsely-populated region on the island.






















































Figure 2-7. Annual total rainfall by region, in inches,
based on data from 1887-1986. Compiled by Barbados Society
of Technologists in Agriculture. Figure adapted from map
obtained with permission by Plantations Trading Company
Ltd., 1989.











Selected entomological and ethnographic research sites

After conferring with members of the Ministries of

Health and Agriculture, it was decided that five general

areas would be systematically selected in order to represent

the major topographical regions of Barbados. Villages

included the following:


1) Chapman Street Village in the center of
Bridgetown, representing the most densely-
populated, urban region;

2) Oistins Christ Church, representing a semi-
urban, coastal population;

3) Cotton Vale a rural tenantry, north of Six
Roads, representing the St. Philip Plain and
agricultural sector;

4) Chalky Mount another rural tenantry, but
situated in the northeast Scotland District of St.
Andrew;

5) Rose Hill a semi-urban village, below the
Second Cliff area, just south of the St. Lucy
Plain and north of Speightstown, St. Peter.


Once a village was selected, the houses were mapped,

numbered, and listed. From that list four homes were

randomly selected. The adult present at the time of the

visit was asked to participate in the study. If a

consenting adult was not home, two subsequent visits were

made in an effort to include the household in the study. If

after the third visit no adult was home, or if that adult

declined to participate, another house was randomly

selected. This continued until four households in each of









71
the five villages agreed to participate. Figure 2-8 depicts

the location of the five sites for Phase I.

Entomological samples were collected during both the

"dry" season (January-May) and the "wet" season (September-

December). The methods and materials are presented in

Chapter Five, after which the results and discussion of

trapping are addressed.


Participant Selection and Resources

In order to select the sample population for the

biomedical testing, the following persons were consulted:

the acting Chief Medical Officer, a Ministry of Health

epidemiologist, Medical Directors of six polyclinics, the

Director of the A&E Department at QEH, a Respiratory

Medicine Specialist at QEH, and a private Internal Medicine

physician in St. Michael. With the assistance of these

persons, three major health care resource centers were

selected for choosing the sample population and included the

following:

1) five polyclinics and one outstation, the total
of which serviced patients from all regions of the
island;

2) a private practice clinic, situated in the
urban district of Greater Bridgetown and servicing
patients from all of the 11 parishes;

3) and the A&E Department at QEH, servicing the
entire Barbados population.


Figure 2-9 illustrates the resource centers used for

selecting the sample population. Notice that two of the










polyclinics selected were located in the parish of St.

Michael to account for the large proportion of the

population living in that parish, and two of the other

polyclinics--Sir Randall Phillip and Maurice Byer--were

located in the urban "belt", in the major towns of

Speightstown and Oistins, respectively. Maurice Byer

services patients from the northern region of the west

coast, north of Holetown, the northern cap of St. Lucy, and

the northeastern Scotland District. The remaining rural

residents in the southern Scotland District region are

serviced in part by the Gall Hill outstation in St. John.

The private physician's clientele were mixed; many were from

the lower socioeconomic strata, who preferred to use a

private physician rather than a polyclinic and others were

middle- and upper-income clients, many of whom lived in the

suburban terraces and heights8.

Three-hundred and fifty children between the ages of

five and 18 years were systematically selected from the

health care centers. Each asthmatic patient attending one

of the selected clinics was asked to participate until a

total of 175 asthmatics was obtained; in the event that the

parent/guardian agreed to participate, the next non-

asthmatic child attending the clinic that matched the

asthmatic by age and sex was selected, until 175 controls

were obtained. Because of the systematic selection process,

if the patient to be seen was accompanied by siblings or










relatives, asthmatic or non-asthmatic, the other children

were asked to participate as well. The only exclusion

criteria was that the child must either be an asthmatic or

non-asthmatic; other types of atopics were not included

(e.g., hay fever). Selection of asthmatics was based on a

positive history and physical examination and criteria

included previous attacks, diagnoses and treatment for

asthma. The history and physical are the primary means for

diagnosis of asthma in Barbados; diagnostic tests such as

serum titers, bronchial challenge tests, and skin tests are

not practiced routinely, largely due to prohibitive costs.

A "selection criteria" form was designed, approved by the

acting Chief Medical Officer, and completed for each child

(asthmatic and control) to confirm or eliminate a diagnosis

of asthma.

At the time of selection the parent/guardian of the

child read and signed a written informed consent and was

assigned an appointment for the allergy testing at one of

the six chosen polyclinics. The parent/guardian was asked

to choose the polyclinic that was closest to the child's

home and instructed to withhold antihistamines, ephedrine,

or asthma medications 24 hours prior to the testing. In the

event that medications had to be administered, the

appointment was rescheduled. Parents were reminded of the

appointment by telephone 24-48 hours before the test. If










that household did not have a telephone, the nearest

relative or neighbor with a telephone was contacted.


Clinical Testing and the Interview Schedule

The allergy test included skin testing (scratch and

intradermal) to various household pests (note: details of

the skin test procedure are described in Chapter Six).

Controls did not undergo the skin test due to the difficulty

in recruiting non-asthmatic participants for this aspect of

the testing; the skin test involved a battery of 11

extracts, requiring a minimum of 11 scratches and

potentially 11 injections. Receiving no personal benefit

from undergoing this procedure, parents and non-asthmatic

children were unlikely to volunteer as controls and it was

deemed unethical to subject them to the procedure. To

assure validity of the test within the asthmatic population,

a negative control was used in both the scratch and

intradermal test. Exclusion of non-asthmatics from the skin

testing procedure was further substantiated by the overall

objective of the study, which was to determine which

features of the domestic environment were contributing to

the likelihood of asthmatics developing allergies to certain

pest species.
















Rose HII
St.
St. Peter Andr w
0 halky Mount
St.
Jam/s
JQ s St. Joseph

St. Thomas
St. John


St. St. George 0 Cotton ale
Mic ael
o St. Ph'ilip
Chap an
Street Christ Church

Oistins





Figure 2-8. Location of selected communities for the
entomological and ethnographic surveys.
















Outstation
Private practice


Andrew \ l Accident & Emergency Dept.,
St. AQEH
James
St. Joseph
St. Thomas\ E
St. John

+ St. St. George
Michael St. Philip


Christ Church






Figure 2-9. Resource centers for the asthma study sample
population.











The questionnaire, designed from ethnographic data

collected during Phase I, was pre-tested on a randomly

selected population (N=10) prior to operationalizing Phase

II and included informants who were parents of asthmatic

(N=5) and non-asthmatic children (N=5) from the five

villages in which Phase I was conducted, but not from the

same households. The questionnaire was revised and pre-

tested again on another randomly selected population (N=10),

equally divided between parents of asthmatic and non-

asthmatic children and also from the five villages.

Following the pre-testing phase, the final

questionnaire was divided into two sections so as to

minimize the risk of informant fatigue and annoyance during

the interview. The first section was administered in the

clinic prior to the allergy testing and serum collection.

An appointment was made in the clinic for a home visit so

that the second section of the questionnaire could be

administered. In the event that a home visit was not

possible due to time constraints, a telephone interview was

conducted.

The questionnaire included three general topics:

sociodemographic information on the child's residence and

structural information on the dwelling; the informant's

perceptions, knowledge, and behavior associated with health

and illness in general and asthma in particular; and the









78
informant's perceptions, knowledge, and behavior associated

with household pests and pest-related disease.


Sub-Setting the Sample Population

As described, the overall objective of the study was to

determine the relationship between sociodemographic and

architectural independent variables with the dependent

variable, hypersensitivity to individual household pests.

Seven asthmatic children and eight controls were eliminated

from the study after the trials and interviews because

either their classification of "asthmatic" or "control" was

questionable, or a follow-up interview could not be

administered. The group of asthmatic children who underwent

skin tests to determine the pests to which they were

allergic comprised the "asthma population" (N=168).

Controls (N=167) were used to compare informant responses

regarding perceptions, knowledge, and behavior related to

health care and asthma. The combination of asthmatics and

controls made up the total "study population" (N=335).

To conduct bivariate analyses on the sociodemographic

and structural variables and to construct a socioeconomic

index to be included in these bivariate analyses, it was

necessary to reduce the total study population to the

household level. The rationale for this breakdown is the

fact that 72 informants had more than one child in the

study; therefore, the weight of that informant's response

would be greater than that of an informant with only one











child in the study, resulting in a "pseudoreplication" of

responses and misleading correlations.

Consequently, one child from each household was

selected randomly from the total population, regardless of

his/her classification as asthmatic or control, using the

Q&A database program (Symantec Corp. 1991), and data on that

child and his/her household was entered into a subset

referred to as the "household sample". The total household

sample size was 177 (after disqualification of cases with

insufficient or ambiguous data). Bivariate analyses on all

of the independent variables were first administered on this

sample population to identify correlations and selection of

the appropriate independent variables that would later be

analyzed for the asthma population.


Identifying and Classifying the Independent Variables

The word "modernization" connotes the up-grading of

standard of living at both the population and the household

level. Standard of living at the population level is

typically measured by socioeconomic indices such as per

capital income, quality of housing, and quality of life

factors, including health. In this respect, Barbados fares

well according to U.N. standards.

Standard of living at the household level may vary

tremendously within a population and can be used to

represent the degree of class disparity in a given society.

While Barbados enjoys a high standard of living compared to










other developing countries, in no way is Barbados a

"classless society", as there clearly exists a significant

degree of class consciousness and stratification (Dann 1984;

Potter 1983a,1986). For example, nearly a quarter of the

population lived below the poverty line between 1980 and

1988 (United Nations 1991). In order to classify

respondents according to socioeconomic status, an attempt

was made to create a socioeconomic index variable.

Designing a Socioeconomic Indicator

Graham Dann, a Barbadian sociologist, conducted a study

entitled "The Quality of Life in Barbados" (1984), in which

he addressed a number of socioeconomic and sociodemographic

issues in contemporary Barbados. He discussed the weakness

of most studies in the Caribbean prior to his own study, in

that the classification of socioeconomic status was usually

based on a single indicator, such as income or occupation,

thus failing to recognize "...that social class is multi-

faceted" (1984, p.30). In response, Dann constructed a six-

item index for measuring socioeconomic status among his

sample population, which included the following: (1) social

mobility (based on the improvement of residential location

and real income); (2) income group (reported monthly income,

grouped into quintiles); (3) occupation (5 categories, in

ascending levels of skill); (4) home ownership; (5)

amenities, (household possessions); and (6) education

(primary, secondary, and tertiary). Dann's index was









81
integrated into the asthma study questionnaire, but during

the analytical phase of the project, certain weaknesses were

realized regarding the application of this scale to the

asthma study.

Income

Reported income as a measure of socioeconomic status in

the Caribbean is unreliable for several reasons. One

problem is the predominance of a working class, which is

quite different than that seen in industrialized countries

(Dann 1984). Particularly in Barbados, credence must be

given to the importance of remittance as income secondary to

large-scale emigration (Roberts 1955; Cumper 1959; Ebanks et

al. 1979). Other influencing factors in household income--

and often undermined--are contributions from the informal

sector, underemployment, and the seasonality of'jobs. For

example, Dann (1984) reported that, of the 6,900 7,000

laborers in the sugar industry, 2,500 3,500 were seasonal

crop workers.

Not surprisingly, and probably due to a combination of

these factors and others, failure to report combined family

income was relatively frequent in the asthma study

population; 17 informants (9.6%) gave no information

whatsoever when asked what the monthly income was for the

household. Twenty-eight informants (16%) stated that she/he

had "no idea" what the entire household earned on a monthly

basis and could only report her/his own or one or more




Full Text
THE ROLE OF HOUSEHOLD PESTS IN THE EPIDEMIOLOGICAL
TRANSITION OF ALLERGY: MODERNIZATION OF THE DOMESTIC
ENVIRONMENT IN BARBADOS
By
KATHLEEN CAROLE BARNES
A DISSERTATION PRESENTED TO THE GRADUATE SCHOOL
OF THE UNIVERSITY OF FLORIDA IN PARTIAL FULFILLMENT
OF THE REQUIREMENTS FOR THE DEGREE OF
DOCTOR OF PHILOSOPHY
UNIVERSITY OF FLORIDA
1992

Copyright 1992
by
Kathleen Carole Barnes

This thesis is dedicated to the children of Barbados

ACKNOWLEDGMENTS
The author would like to thank the following individuals
and organizations in Barbados for assistance in administering
this project: the Honorable Branford Taitt (Minister of
Health), Dr. Beverly Miller (Chief Medical Officer), Dr. E.
Ferdinand (Acting Chief Medical Officer during 1991), and all
of the medical staff at the polyclinics in which the study
took place. The author is grateful to Drs. Timothy Roach,
Malcolm Howitt, David Corbin, and Raana Naidu for their
assistance in selecting the children for the study. Thanks
also go to staff members at the Entomology Section of the
Ministry of Agriculture and the Leptospira Laboratory for
their many means of assistance throughout the year.
The author is indebted to Drs. C.O.R. Everard (Leptospira
Laboratory), J.C. Hudson (Carib-Agro Industries, Ltd.),
Michael Nathan (PAHO), and Jeffrey Jones (Ministry of
Agriculture) for advice, direction, and support.
The author is grateful for a Graduate Research
Assistantship and supplies from USDA/ARS and to Dow-Elanco for
additional financial support. Thanks are extended to Mrs.
Margaret Haile and Mr. Curtis Guinyard for technical support.
Identification of arthropods was graciously provided by Mr.
Lloyd Davis (USDA/ARS) in Gainesville, FL, and Dr. Enrique
iv

Fernandez-Caldas and Mr. Walter Trudeau (USF) in Tampa, FL.
Thanks go to Dr. Rick Helm (Arkansas Children's Hospital) for
methodological advice, Ms. Chris Anderson (FDA) and her staff
for conducting the serum assays, and to Mr. Kenneth Pope
(Baskerville & Sons, Richmond, VA) for the blueprints and
sketches. Additional gratitude is extended to Mr. Richard
Wadley (S.C. Johnson) and Mr. Walter Short (Geddes Grant
(Barbados) Ltd) for logistical assistance. Statistical
assistance was graciously provided by Ms. Cindy Hewitt & Dr.
David Nickerson (Orlando, FL), Mr. Victor Chew (Univ. of FL,
IFAS), and Ms. J. White (USDA, Gainesville, FL).
The author extends her appreciation to a warm and
supportive doctoral committee, including Drs. George
Armelagos, Richard Brenner, Leslie Lieberman, Linda Wolfe, and
Richard Patterson, and especially to her supervisory chair,
Dr. Gerald Murray, for his confidence, insight, and direction.
Very special thanks go to Dr. Richard Brenner, for his dynamic
and steadfast mentorship, friendship and multi-faceted
support.
Lastly, the author offers her deepest gratitude to her
friend, Mr. David E. Milne, without whose technical and
emotional support this work could never have been completed,
and to her parents, Robert and Carole Barnes, sister,
Christine, and brother-in-law, Kenneth Pope, whose endearing
support and belief in the author saw this project to its end.
v

TABLE OF CONTENTS
ACKNOWLEDGMENTS iv
LIST OF TABLES XÜ
LIST OF FIGURES xvi
ABSTRACT xviii
CHAPTERS
1 ALLERGY AS A DISEASE OF MODERNIZATION 1
Introduction: Rationale for the Study 1
The Relationship Between Modernization
and Allergy 1
The Role of Household Pests 3
Objectives of the Study 6
Defining the Epidemiological Transition 8
Disease Ecology and the Evolution
of Human Allergy 13
Disease in Pre-State Society 14
Disease in State Society 18
Application of the Disease Ecology
Model: Allergy 21
The Influence of Disease on Biological
Adaptation: Parasitic Infestations
and IgE 2 3
The Influence of Disease on Cultural
Adaptation: The Gradual Decrease
in Exposure to Parasites 28
Influencing Biological and Sociocultural
Factors 34
Genetic, MHC-related factor 34
Genetic, non-MHC-related factor .... 35
Familial factors 36
Ethnic factors 36
Behavioral and nutritional factors ... 37
Miscellaneous behavioral factors .... 39
Population behavior and the
macroenvironment 39
vi

Population behavior and the
microenvironment 40
Conclusions and the Allergy Disease Model .... 40
Notes 42
2 THE STUDY DESIGN AND RESEARCH SETTING 44
The Construct of Allergy and Modernization:
A Review of the Objectives 4 4
The Research Site 4 6
The Rising Incidence of Asthma
in Barbados 47
Infrastructure: The Developed Nature
of a Developing Country 55
The Health Care Delivery System 57
Sampling and Methodology 64
The Survey Schedule 64
Topographical considerations 64
Selected entomological and
ethnographic research sites 70
Participant Selection and Resources 71
Clinical Testing and the Interview Schedule . 74
Sub-Setting the Sample Population 78
Identifying and Classifying the
Independent Variables 79
Designing a Socioeconomic Indicator 80
Income 81
Occupation 82
Amenities 83
Monthly expenses 86
"House-related" variables 87
Creating the wealth index 88
Demographic Characteristics of
the Sample Population 92
Spatial Distribution 92
Personal and Socioeconomic Characteristics . 96
Analysis and Presentation 98
Summary 99
Notes 99
3 SETTING THE STAGE FOR A CASE STUDY:
BARBADOS LAND TENURE PRACTICES AND EVOLUTION
OF THE BAJAN HOUSE FORM 101
A Historical Review of Land Distribution .... 101
The Birth of Barbadian Society:
The Pre-Emancipation Period 102
Land Allocation and Stratification of
the Planter Class 103
vii

Indentured Servitude and a White Lower Class 110
African Slaves: An Alternative
Labor Source 113
Acculturation of the Classes 115
Emancipation and the Landless Proletariat . 117
Steps Towards Reform 121
The Contemporary Spatial Distribution of
Land and People 123
The Impact of Twentieth-Century Reforms . . 123
Barbadian Economy and Its Role in the
Urban/Rural Sector 125
The Over-Development of the Urban Sector . 129
Inter-Migration and Changes in the
Spatial Distribution of Land and People . . 130
Demographic Decentralization and
the Development of Suburbia 131
The Continuation of Tenantry Residency . . 140
A Closer Look: Evolution of the
Barbadian Home 143
Traditional House Forms 144
Housing in the pre-emancipation era . 144
Emancipation and the chattel house . . 146
Other house forms and modifications
of the chattel house 150
Trends in Contemporary Housing 156
The Role of Ownership 156
A decline in relocation 160
Upgrading the chattel and creating
new forms 161
The transition from wood to masonry . 168
The problem of construction in the
informal sector 176
Elaboration of the indoor environment 181
Installation of indoor utilities . . 182
The Role of the Family System 185
The impact of costs and tenure ... 185
Trends in household density 187
Housing Trends and Health Implications . . 188
Moisture 188
Ventilation 197
Summary 199
Notes 201
4 THE ASTHMA STUDY: AN ANALYSIS OF
CONTEMPORARY LAND TENURE PATTERNS, HOUSING,
AND ASPIRATIONS 2 09
Spatial Distribution of Land
and Sociodemographics 209
The "Ideal" Place of Residency 216
Implications for Trends in Housing 220
viii

Housing Patterns Among the Asthma Study
Population 222
Ownership of Dwellings 222
Construction of Dwellings 225
Structural Features and Demographics ... 230
Aspirations of the Study Population:
The "Ideal" House 231
Discussion and Summary 235
Notes 238
5 NEW HOMES AND UNINVITED GUESTS:
HOUSEHOLD PEST INFESTATIONS 242
Introduction 242
Infamous Household Pests in Barbados 244
Pests Related to Disease 244
Mosquitoes . . . 245
Other diptera 247
Cockroaches 247
Millipedes 248
Centipedes 249
House dust mites 249
Rodents 251
Pests not Related to Disease 253
The Pest Collection: An Inventory
of Household Pests 255
Materials and Methods 255
Light/C02 trap 256
Flea trap 257
Fly strips 257
Cockroach traps 257
Live trap 258
Mite sampling 258
Results: Collective Taxonomy
of Barbadian Household Pests 260
Rodents and other mammals 261
Orthoptera 263
Coleóptera 2 64
Amphibians/reptiles 264
Diptera 265
Hymenoptera 266
Isoptera 2 66
Lepidoptera 2 66
Isopods 267
House dust mites 2 67
Discussion of the Pest Collection Results . 271
Food and/or garbage pests 271
Pests dependent on human hosts .... 272
Moisture-related pests 273
ix

Stored food pests 274
House dust mites 275
The Ethnographic Survey: Categorization,
Classification, and Responses
to Household Pests 282
The Ethnographic Taxonomy 284
Reported Temporal Distributions 296
Interrelationships with Sociodemographic
and Structural Variables 301
Rodents 301
Cockroaches 3 02
Mosquitoes 3 04
Sand flies 305
Others 306
Classifying the Pests:
What's Good and Bad? 308
Which of these are "disgusting"? . . . 309
Which of these are "harmful"? .... 310
Which of these pests would
you kill? 313
Which of these are "beneficial"? . . . 314
Are these pests indoor, outdoor,
or accidental? 316
Behavior Directed at Controlling
Household Pests 325
National Control 325
Commercial Control 327
Control in the Private Sector 328
The Effect of National Campaigns Directed
at Community Control 333
Summary 334
Notes 337
6 THE CLINICAL SETTING: THE EPIDEMIOLOGY
OF ALLERGY TO HOUSEHOLD PESTS
AMONG BARBADIAN CHILDREN 341
Biomedical Testing 341
Biomedical Materials 341
Subjects 341
Extracts 342
Biomedical Methods 343
Interviews 344
Skin Test Results 344
Individual Extracts 344
House dust mites 344
Crawling insects 346
Flying insects 347
Shellfish 349
Rodents 349
x

Cross-Reactivity 351
Discussion 357
Symptomatology 357
Individual Allergens 362
Cross-Reactivity 373
Summary 374
Notes 375
7 SUMMARY AND IMPLICATIONS FOR
FUTURE STUDIES 376
Asthma as a Disease of Modernization:
Concurrence with the Theoretical Construct ... 376
Review of the Findings 376
Modelling the Variables 381
Implications for Community- and Household-Level
Management of Pests 385
Implications for Patient Education 387
Financial constraints 389
Structural constraints 390
Environmental constraints 392
Ideological constraints 393
Implications for Further Research 394
REFERENCE LIST 398
BIOGRAPHICAL SKETCH 422
xi

LIST OF TABLES
Table 2-1 GNP per capita (1980), in U.S. dollars in
the Eastern Caribbean 56
Table 2-2 Health indicators for the Eastern
Caribbean 60
Table 2-3 Profile of education in the Eastern
Caribbean 61
Table 2-4 Polyclinic/outstation attendances, 1990 . . 63
Table 2-5 Frequency distribution of amenities by
household (N=177) 85
Table 2-6 Distribution of total monthly expenses in
the household sample (N=177) 87
Table 2-7 Distribution of residences by demographic
region (N=177) 92
Table 2-8 Spatial Distribution of the Total Asthma
Study Population (N=335) 95
Table 2-9 Frequency and Percent of Types of Unions
per Informant (N=177) 97
Table 3-1 Percentage of gross domestic product (GDP)
by sector 129
Table 3-2 Percentage distribution of the Barbadian
population by socio-geographic zone, from the
Government Statistical Department Census for
1970 and 1980 137
Table 3-3 Spatial distribution of tenantries by
parish, 1990 140
Table 3-4 Tenants living in National Housing
Corporation units by parish, 1991 159
Table 3-5 Dwelling tenure (owned, government rental,
or other) by parish, 1980 163
xii

Table 3-6 Number of houses relocated by parish,
1981-1989 164
Table 3-7 Number and percentage of dwellings by
type of material, for each parish, 1980 .... 169
Table 3-8 Applications approved by the Town & Country
Development Planning Office for renovation of
dwelling units, by parish, 1980 170
Table 3-9 Number of new and renovated dwellings by
house type, approved by the Environmental
Division, Engineering Ministry of Housing &
Lands, 1982 - 1989 173
Table 3-10 Number of persons per household by
parish, for the years 1946, 1970, 1980,
and 1990 189
Table 3-11 Percent of households calculated for the
number of persons by the number of rooms .... 191
Table 3-12 Sources of moisture in the home 192
Table 4-1 Land ownership patterns according to
demographic region (N=177) 211
Table 4-2 Frequency and percentage of households
owning their residential lot, by parish .... 213
Table 4-3 Distance from the nearest neighbor
(in yards) according to demographic region
(N=177) 214
Table 4-4 Analysis of residential preference by
parish among households 219
Table 4-5 Overall rank of parishes as "the ideal
place to live" according to the total informant
population (N=166) 220
Table 4-6 Home ownership patterns according to
demographic region (N=177) 224
Table 4-7 Frequency and percentage of informants
owning their dwelling, by parish 226
Table 4-8 Comparison of housing quality (concrete
or mixed structure) by wealth score, home
ownership, and land ownership 227
xiii

Table 4-9 Structural features of the dwelling by
the type of material the dwelling is constructed
and for the total number of dwellings, for the
asthma study households 232
Table 5-1 Density of house dust mite species D.
pteronvssinus and D_j_ farinae in 17 Barbadian
homes 277
Table 5-2 Reported pests in Barbadian homes by
informants in the asthma study 286
Table 5-3 Ethnographic taxonomy of 33 pests
(frequency and percent of responses, N=65)... 287
Table 5-4 Frequency and percentage of responses to
the question: "Which pest do you have the
biggest problem with?" 296
Table 5-5 Frequency and percent of specimen
categorization regarding when informant sees the
animal around the house (N=65) 297
Table 5-6 Responses (frequency distribution and
percentages) to the question: "Which of these
pests do you consider to be 'disgusting'?" . . . 317
Table 5-7 Responses (frequency distribution and
percentages) to the question: "Which of these
pests can cause physical harm to people, and
how?" (N=65) 318
Table 5-8 Responses (frequency distribution and
percentages) to the question: "Which of these
pests would you kill if you saw it?" (N=65) . . 322
Table 5-9 Correlations between pests that were
classified as "disgusting," and those that the
informant "would kill" (Chi-square) 323
Table 5-10 Responses (frequency distribution and
percentages) to the question: "Which of these
pests are beneficial, or good to have around?",
and "Why?" 324
Table 5-11 Pests for which over-the-counter
insecticides are used, by frequency (percent) of
the informant population (N=65) 330
xiv

348
Table 6-1 Relationship between allergies to house
dust mites, D^_ pteronvssinus. and EL. farinae.
and structural and demographic variables. .
Table 6-2 Total number and proportions of responses
to specific extracts 352
Table 6-3 Frequency distribution for total numbers
of different pests reacted to in the battery of
skin testing 353
Table 6-4 Frequency distribution of stimulants
responsible for an asthmatic attack (N=168).. . 360
Table 6-5 Time period when child is reportedly most
likely to experience an asthmatic attack .... 361
xv

LIST OF FIGURES
Figure 1-1 The Allergy Disease Model in the
Ecological Perspective 43
Figure 2-1 Asthmatic attendances to the Accident &
Emergency Department, Queen Elizabeth Hospital,
in thousands, for 1980 - 1990 49
Figure 2-2 Number of asthmatics attending the
Accident & Emergency Department, Queen Elizabeth
Hospital, for the month of October, 1974 - 1990 . 50
Figure 2-3 Monthly Asthmatic Attendances to the
Accident & Emergency Department Compared to Monthly
Rainfall, 1990 51
Figure 2-4 Monthly Asthmatic Attendances to the
Accident & Emergency Department Compared to Monthly
Rainfall, 1991 52
Figure 2-5 Distribution of outpatient health care
facilities 62
Figure 2-6 Geophysical Subdivisions of Barbados ... 66
Figure 2-7 Annual total rainfall by region, in
inches, based on 1887-1986 data 69
Figure 2-8 Location of selected communities for the
entomological and ethnographic surveys 75
Figure 2-9 Resource centers for asthma study sample . 76
Figure 2-10 Non-linear regression analysis
demonstrating the relationship between the
variables "monthly house rent/mortgage" and
"amenities" 91
Figure 2-11 Spatial distribution of households by
parish, for the asthma study 93
xv i

Figure 3-1 Inter-migration patterns by parish,
1970-1990 133
Figure 3-2 Settlement and Land Use Policy of
Barbados 13 5
Figure 3-3 Chattel house floorplan 165
Figure 3-4 Sketches of the three stages of the
chattel house 166
Figure 4-1 Correlation matrix (p-values) for structural
and demographic variables in the Asthma Study
households 239
Figure 4-2 Correlation matrix for structural and
demographic variables in the asthma study
households 240
Figure 4-3. The Allergy Disease Model in the
Architectural Perspective 241
Figure 6-1 Graded Skin Test Response (Krouse &
Klaustermeyer 1980) 344
Figure 6-2 Correlation matrix for pest allergies by
structural and demographic variables 354
Figure 6-3 P-values for pest allergies by
structural and demographic variables 355
Figure 6-4 Correlation matrix for positive skin
tests, indicating the interrelationship between
each of the extracts 356
Figure 7-1 Modelling the variables: a summary . . . 384
xvii

Abstract of Dissertation Presented to the Graduate School
of the University of Florida in Partial Fulfillment of the
Requirements for the Degree of Doctor of Philosophy
THE ROLE OF HOUSEHOLD PESTS IN THE EPIDEMIOLOGICAL
TRANSITION OF ALLERGY: MODERNIZATION OF THE DOMESTIC
ENVIRONMENT IN BARBADOS
By
Kathleen Carole Barnes
December, 1992
Chairperson: Dr. Gerald Murray
Major Department: Anthropology
Allergy is referred to as part of the epidemiological
transition of disease; it is uncommon in traditional
societies, is steadily increasing in developed societies, and
demonstrates dramatic incidences in transitional societies.
Some of the most antigenic allergens are from arthropods
(arboallergens). Pan allergy to insects and noninsect
arthropods has been exhibited in individuals who have
previously been sensitized to only a few arboallergens.
Previous research demonstrated that H¡_ pteronvssinus (Dp)
was the predominant house dust mite (HDM) in Barbados and that
wood homes on rock foundations provided an ideal mite habitat.
The contemporary trend is an integration of permanent features
into the traditional house form (e.g., concrete and indoor
plumbing into the traditional house form); this trend is a
xviii

metaphor for sociocultural change because of the historically
tenuous nature of land tenure and housing in Barbados.
Concrete, plumbing, and other "modern" features have been
incriminated in increasing indoor relative humidity and
reducing air flow, two factors which create favorable habitats
for a number of household pests.
Asthma is increasing in Barbados; asthmatic attacks
reported to the Casualty Clinic doubled in 10 years to 7,137
in 1990. The current study was undertaken to examine the
effects of contemporary housing on the distribution of
household pests and the harmful effects that exposure to
arboallergens might have on the asthmatic. Densities of Dp
were found in 100% of homes sampled and were higher in
concrete homes (f=9.55, p<0.001); qualitative data suggest
that other pests prevail in both types of construction.
Asthmatic children (168) were skin tested against 11 household
pest allergens; HDM elicited the greatest number of responses
(77.4% to Dp and 74.4% to D¿. farinae. or Df) . Allergy to Dp
was correlated to living in a concrete home (X2=4.37, p=0.04).
The high incidence of allergy to Df despite low or absent
densities and a positive reaction to an average of four
different pests suggest cross-reactivity. The implications of
the study are the following; housing trends have a direct
influence on the presence of Dp, a highly allergenic pest; and
sensitivity to Dp possibly predisposes asthmatics to develop
other arboallergen hypersensitivities, thus increasing the
likelihood of morbidity related to arboallergens.
1XX

CHAPTER 1
ALLERGY AS A DISEASE OF MODERNIZATION
Introduction: Rationale for the Study
The Relationship Between Modernization and Allergy
As humans have evolved culturally, we have increasingly
exposed ourselves to numerous pathogens due to our
alterations in the environment, complex food-producing
practices, and intense contact with other infected humans
and their waste products (for many populations this picture
remains the same today, although the sociopolitical reasons
have changed with time). The bulk of these pathogens in
earlier agriculturalist populations were those responsible
for infectious disease, usually vector-borne and parasitic
and not dependent on large populations or even human hosts
for their survival. With the development of industrial
societies, cultural advances in technology enhanced the
provision of better sanitary practices (e.g., systems for
waste disposal, treated water), which eliminated a number of
the parasitic diseases, and biomedical advances provided
chemotherapy and immunization against many of the
debilitating and mortal communicable diseases. As a result,
large numbers of people living in what are considered
"developed" countries have never even been exposed to a
1

2
parasite or to many of the viruses and bacteria that
eliminated whole societies. This process has resulted in
what has been termed the "epidemiological transition" of
disease, defined as a trend from acute infectious diseases
to chronic noninfectious disease and generally industrial
and degenerative in nature (Omran 1971; Corruccini and Kaul
1983). The increasing prevalence of these diseases is
related to human modernization and urbanization.
Extreme changes in contemporary modes of production
have resulted in the introduction of new organic and
inorganic substances in the contemporary macroenvironment.
These substances are inhaled and ingested both at home and
at the work place, or the microenvironment. There is
extreme class consciousness, as well as continuous efforts
to "move up" socially and "improve" the home environment
with the addition of non-consumable goods and climate
control. The net result of these cultural changes is
exposure to large amounts of substances never before
encountered in human history and, more importantly,
subjection to these substances in a very short period of
time.
One of the new chronic diseases resulting from the
epidemiological transition is allergy. Although we do not
know the degree of prevalence of allergy in previous
populations, we do know that the incidence of allergy is on
the rise (Corruccini & Kaul 1983; Massicot & Cohen 1986;

3
National Asthma Education Program 1991). Contributing to
this is exposure to many antigens that, for reasons not
completely understood, are highly allergenic. The most
common of these are pollens, molds, and notably, arthropods
(Gergen et al. 1987). Schwartz (1990) argues that
arthropods are more important as allergens than are pollens
because they are so widespread.
The Role of Household Pests
Possibly the most significant impact in regard to
allergic disease as a result of modernizing our
microenvironment has been the increased exposure to peri-
domestic and domestic arthropods and rodents. In
elaborating the home environment for the purpose of removing
ourselves from climatic elements, we have provided ideal
habitats for a number of "pests." This is most evident in
the study of urban entomology; household infestations of
most pests increase with the degree of urbanization (Aedes
spp. mosquitoes. Gratz 1973, Slosek 1986; cockroaches.
Ebeling 1975, Koehler et al. 1987; rodents, McNeill 1976).
What is most alarming about the relationship between
urbanization and household pest infestations is the extreme
allergenicity of arthropods and certain other animals.
The relationship between an increase in the incidence
of allergy in general and modernization has been largely
attributed to the development of housing conditions that are
favorable to house dust mites (Massicot & Cohen 1986). In

4
fact, the most predominant allergen among residents in
developed and developing countries alike is the house dust
mite (Buchanan & Jones 1972; Kang & Sulit 1978; Dowse et al.
1985; Massicot & Cohen 1986; National Asthma Education
Program 1991). Dowse et al. (1985) studied the incidence of
asthma in eight South Fore villages in the Eastern Highlands
of Papua New Guinea. There had been an alarming increase in
prevalence over a 10-year period; the overall rate was 39
and 46 times higher than rates noted in 1972 and 1975,
respectively, and was much higher than rates reported from
other highland regions. The reason was attributed to the
introduction of woolen blankets into the villages;
Dermatophagoides pteronvssinus and D¿. farinae were found in
97% of the blankets used by the Fore (Dowse et al. 1985).
Baldo and Panzani (1988) suggest that "pan allergy" to
insects may exist in individuals who have previously been
sensitized to one or several insects and that allergenic
similarities possibly extend to other noninsect arthropods,
such as spiders or crustaceans. The ramifications of this
finding are frightening from an epidemiological point of
view when one considers the widespread distribution of
arthropods, and the consumption of many of those arthropods
(e.g., shrimp, lobster). It implies that any household pest
is a potential source of allergen.
Numerous studies have been published that confirm the
relationship between cockroach allergens and bronchial

5
asthma (Kang 1976; Kang & Sulit 1978; Kang & Chang 1985;
Kang 1990). Individuals of lower socioeconomic status
within the United States reportedly have higher incidences
of cockroach hypersensitivity compared to individuals of
higher socioeconomic status (Bernton & Brown 1967; Kang &
Chang 1985). Authors conclude that this likely is
correlated to higher cockroach infestations in poor housing
and related to the duration of exposure (Bernton & Brown
1967; Twarog et al. 1977). However, the reverse is true in
developing countries (Marchand 1966; Brenner et al. 1990;
Brenner et al. 1991). In Puerto Rico, Marchand found that
his patients who demonstrated hypersensitivity to
cockroaches were from the middle to upper socioeconomic
strata (1966). In the Dominican Republic, the incidence of
allergy to cockroaches was proportionately related to the
quality of the house structure (X2=7.36, df=2, p«0.01);
individuals from higher quality homes had a greater
incidence of allergy to cockroaches (Brenner et al. 1990;
Brenner et al. 1991). Data suggested that the higher
quality homes built of masonry had less air flow than the
homes of wood, thereby producing a more favorable
environment for the cockroach and also an accumulation of
arboallergens.1 More favorable environments and larger
populations also may increase the likelihood of physical
contact with cockroaches, resulting in an injectant or
ingestant contact with the allergen; cockroach "biting" was

6
reported in heavily infested, urban environments in both
North Central Florida and the Dominican Republic (Barnes &
Brenner, in prep.).
In another study, a relationship was found between the
presence of house dust mites and the structure of houses.
Pearson and Cunnington (1973) identified 23 species of house
dust mites in Barbados (D_j_ pteronvssinus was the most
predominant) and concluded that they were so proliferative
because of the timber dwellings situated on top of porous
coral rock foundations, which, close to the soil, generated
a sufficient amount of moisture to provide excellent
habitats for the house dust mites.
Objectives of the Study
Based on the concept that allergy is a disease of
modernization and arboallergens as well as other pest
allergens (e.g., rodents) play a significant role in the
incidence of allergy, a study was designed to test the
hypothesis that modernization of the domestic environment is
related to allergy to household pests. The domestic
environment was chosen as the focal domain because two of
the best-known producers of arboallergens—the house dust
mite and the cockroach—are domestic pests. Certainly the
most concentrated human exposure to arthropods is indoors
rather than outdoors.
As with most other diseases that are part of the
epidemiological transition, there is a strong genetic

7
component in the development of allergy. Although people do
not have control over their genetic make-up, they do have
control over their behavior and to a limited degree, control
over their environment. Behaviors and the environment over
which the lay person probably has the most control are those
related to the home. Because "household pests," as the
definition connotes, thrive within the domestic domain,
certain sociodemographic variables related to the home
likely play a role in both household pest infestations and
allergy to pests. If such variables can be controlled by
the people living in the affected environment, then
residents might be able to play a central role in their own
promotion of health and well-being.
Herein lies the guiding research question: What
existing human perceptions, behaviors, and household
environmental factors contribute to the notion that allergy
is a disease of modernization? Specifically, are household
pest infestations influenced by modernization of the home,
and to what degree do they contribute to allergy? From an
immunological perspective, it is suspected that the
relationship might be due to the likelihood and degree of
exposure to certain household pest species. Exposure to
household pest allergens primarily is dependent on two
factors: first, there must be a substantial population of
the pest for it to produce allergens (most typically
aeroallergens); and second, the domestic environment must be

8
conducive to the maintenance of the pest population and/or
the accumulation of the attendant allergens. It is apparent
that modernization of specific features of the home
increases the degree of pest infestations indirectly, by
providing a suitable habitat for the pest. Additionally,
cultural and socioeconomic characteristics unique to a given
population may accelerate the development of certain
architectural and sociodemographic features. The primary
objective of the following study was to identify these
features and to create a model for predicting the likelihood
of developing allergies to certain pests in the event that
these features are present.
The following paragraphs present an elaborated view of
the epidemiological transition of disease. Following this
presentation, the evolutionary perspective of allergy will
be discussed, so as to better understand the
interrelationship between the physiological and cultural
elements of allergy.
Defining the Epidemiological Transition
An interesting characteristic of many of the
contemporary, chronic diseases is that they are particularly
prevalent and "epidemic"-like in transitional societies, or
those populations undergoing the shift from developing to
developed modes of production. In developing countries,
many of the chronic diseases associated with the
epidemiological transition appear first in members of the

9
upper socioeconomic strata (Burkitt 1973) , probably because
of their access to Western products and practices. The
diseases typically share common, etiological factors related
to human culture, including diet, activity level, mental
stress, behavioral practices, and environmental pollution.
There are a number of contemporary chronic diseases
that may be used to exemplify the epidemiological transition
model. Biocultural anthropologists have investigated
dietary changes as an important etiological factor for the
development of many chronic diseases. Burkitt (1973) notes
that while the intake of fiber in British and American diets
between 1880 and 1960 fell by more than 90%, fat consumption
increased, and sugar consumption doubled. A low fiber, high
fat diet seems to have the greatest effect on the
development of noninfective bowel disease, including
diverticular disease, appendicitis, colon cancer, polyps,
and ulcerative colitis (Burkitt 1973). Similarly, high
serum cholesterol has been widely discussed as a major
factor in coronary heart disease (the number one cause of
death in developed countries) and gall-bladder disease
(Burkitt 1973). Obesity and high intakes of refined
carbohydrates are related to the increasing incidence of
heart disease and diabetes. Diabetes is particularly high
in groups undergoing the transition from traditional life¬
style to "modern"; certain urban groups of the Bantu in
South Africa have rates 40 times greater than their

10
counterparts in the rural sector (Pelto & Pelto 1983).
Similarly, many Amerindian groups, including Mexicans,
experience unusually high incidences of obesity, adult onset
diabetes mellitus, and gallbladder disease; this has been
termed the "New World Syndrome" of disease (Weiss et al.
1984). Obesity is considered to be the most common form of
malnutrition in developed countries (Burkitt 1973; Pelto &
Pelto 1983) and is a direct result of an increasingly
sedentary life-style (which reduces caloric needs) in
conjunction with steady or increasing caloric intakes.
Medical technology has succeeded in eliminating many of
the communicable diseases that reduced whole populations
(e.g., the Black Death in Europe, smallpox in the Americas),
and chemotherapies and immunizations have the potential to
control a majority of other infectious diseases. It has
been calculated that public health measures alone (e.g.,
clean water and sewage provisions) increase life expectancy
in a population to almost 65 years (Baker 1989). The
control of infectious and communicable disease, resulting in
increasing life expectancies, has paved the way for
degenerative disease.
A feedback effect of medical technology is a shift in
demographic trends, whereby the rate of fertility continues
at a steady state while mortality drops sharply. The
eventual matching of fertility rates with mortality rates is
referred to as the "demographic transition," and this is the

11
current pattern in most of the developed countries (Baker
1989). However, societies in transition are slower to
achieve the equalizing of fertility with mortality, probably
largely due to the suddenness of changes in mortality rates.
The continuing increase in population size in conjunction
with an increase in commercialization of agriculture—
characterized by a reduced need for workers in the rural
sector and malnutrition—has had particularly detrimental
effects on the urban environment in transitional societies.
These urban environments are characterized by over-crowded
living arrangements, underemployment or unemployment, and a
chronic state of infectious disease (e.g., tuberculosis,
filariasis) for which biomedical treatments are not always
available (Miller 1973), plus the introduction of many of
the chronic, "modern" diseases.
While degenerative diseases are characteristically
higher in persons of older age, they are not limited to that
population. Baker (1989) argues that degenerative diseases
are not necessarily an inevitable process of ageing, because
many of them (e.g., myopia, high-frequency hearing loss in
middle-age) are completely absent in some groups.
Similarly, while malignancies can be found in all human
populations, and for that matter, other animals, the types
and locations of malignancies vary from traditional
populations to "modern" populations (Baker 1989).

12
A unique characteristic of the chronic diseases is
their relatively recent appearance in human history as a
major cause of morbidity. According to Corruccini and Kaul
(1983), this is indicative of a strong environmental factor
in disease etiology. Indeed, all of the above disease-
causing factors are those created by humans and their
culture. While biological factors such as genetics are no
doubt important in determining who is most likely to succumb
to which disease, genetics alone cannot explain the rapid
spread of chronic disease. Our genetic systems simply do
not operate in selecting for or against certain
physiological features in such a short period of time.
When evaluating the epidemiology of a specific disease,
what we see in developed countries is the end result of the
epidemiological transition; at this level it is difficult to
identify specific socio-environmental variables that are
responsible for the disease process. By including in the
epidemiological analysis less-developed societies and their
socio-environmental variables, we create the "whole
picture," or the evolutionary perspective of that disease.
By analyzing the natural history of a disease in different
societies and the different human behaviors associated with
the distribution of that disease, we will be able to
identify disease-causing variables and predict
epidemiological outcomes. This information can then be
applied to health education, and preventive medicine may, in

13
the ideal setting, be used to minimize the effects of that
disease.
Allergy is an excellent example of a disease which is
part of the epidemiological transition. As heretofore
described, allergy is uncommon in traditional societies,
reaches epidemic rates in transitional groups, and is
increasing in developed populations where it is most common
overall. Prevalence of allergy is characterized by the
degree of modernization within a population, for reasons
similar to—and in some ways quite different from—the
typical chronic diseases.
Disease Ecology and the Evolution of Human Allergy
The theoretical framework most commonly used in
understanding the evolution of human disease is based on the
triad of host, pathogen, and environment. The current
ecological perspective places the most emphasis on the
environment and gives equal attention to both the physical
components (e.g., geologic, climatic, biotic) and the
cultural components (e.g., technological, social, and
ideological). The host represents both the individual and
the population and is responsive and constantly rallying to
maintain homeostasis. The pathogen is any insult against
the host.
The evolution of human disease has closely paralleled
the evolution of human modes of subsistence practice, and
this is probably why so many biocultural anthropologists

14
have referred to the different subsistence periods in human
history as a construct for analyzing disease evolution
(Cockburn 1971; Dunn 1977; Armelagos & Dewey 1978; Baker
1989; Armelagos et al. 1990). Subsistence modes dictate, to
a degree, biocultural factors such as demographics and
dietary practices.
Disease in Pre-State Society
Humans and their predecessors relied on hunting¬
gathering as a means of subsistence from about four million
years ago until the beginning of the neolithic, some 11,000
years ago. Hunter-gatherers utilize as many edible products
as possible, including a variety of protein and carbohydrate
sources as food, and have well-balanced diets. (There are
exceptions; for example, Arctic aboriginals have evolved
physiological and cultural mechanisms whereby they survive
on a diet with little variation, mostly composed of animal
protein.) Hunter-gatherers are mobile for the purpose of
finding new sources of food after a particular region has
been exhausted and are small in population size to
facilitate that mobility. Their mobility negates the
possession of many nonconsumable goods; therefore, their
living quarters are simple and constructed of the ecological
materials readily available to them. Because of the large
area of land needed to support their subsistence, there is
limited contact with populations outside of the immediate
group.

15
Due to the small population size of early hunter-
gatherers, there were a limited number of infectious
diseases that could have established a symbiotic
relationship with human hosts. This factor highlights
several epidemiological principles essential for
understanding the evolution of human disease. Pathogens (a
collective term used here to represent bacteria, viruses,
fungi, spirochetes, and the parasites, including protozoa,
helminths and arthropods) must, in order to survive, affect
low mortality among their hosts. An underlying principle
when determining the evolutionary association between a
pathogen and a host is that the more stable the host-
pathogen relationship, the longer the two likely have
coexisted. In contrast, more pathogenic relationships are
assumed to have been recently developed, because they
apparently have not evolved a stable relationship. The
elaborate relationship that helminths have developed with
human hosts is indicative of their long history with
hominoids. For example, no single helminth parasite is
limited to humans as a necessary host, and all of them have
avoided the development of complete immunity in the human
host. This lack of immunity probably is indicative of the
very low mortality caused by helminths and complete immunity
is therefore not essential for the host's survival (Kliks
1983). An exception to this principle are pathogens that

16
cause high mortality—such as tetanus—but do not require
the host for their survival.
Another epidemiological principle is that the more
pathogenic the insult by the organism, especially against
hosts of a pre-reproductive age, the greater the selective
pressure will be on the population (Kliks 1983). Diseases
that produce low pathogenicity or are chronic and therefore
affect the post-reproductive population will exert less
selective pressure. Physiological adaptation (e.g., in the
form of acclimation, accommodation, or acclimatization) is a
response to selective pressures by which a host improves
his/her chance to rally against pathogenic insults, and may
take the form of genetic changes or physiological responses
completed within a single life span. Cultural "adaptation"
includes responses by which information is transferred to
subsequent generations to enhance survival in a given
environment. Genetic changes are the slowest adaptations to
evolve and signify long-term coexistence.
Many of the infectious diseases require large host
populations and rapid transmission time for their survival.
This is referred to as the population "threshold level"
(Cockburn 1971). If a host population is not a minimal size
for pathogen maintenance, then the pathogen will die.
Typically with infectious diseases large host populations
are required; the acute communicable infections of cholera,
rubella, smallpox, mumps, and measles are examples. The

17
population threshold is not necessarily due to mortality,
because even pathogens that can live as commensals within
the host often will die in a small community (Cockburn
1971). Furthermore, organisms that are highly pathogenic
often elicit an immune response, that subsequently limits
the number of susceptibles in a small population.
Two types of infectious diseases have been recognized
as affecting early hunter-gatherers: those which had
existed among the prehominids and persisted in the hominids
and those that were accidentally encountered from other
animals (zoonoses) by means of vector, wounds, or
consumption of animals (Polgar 1964). Cockburn (1971)
listed a number of intestinal parasites, ectoparasites,
treponemal infections (including yaws), malaria, and several
viruses (herpes and hepatitis) that were present in primates
prior to the first humans. Many of the zoonoses were
acquired after eating infected or raw mammals, insects,
birds, and fish, the most common of which were probably
anthrax and botulism (Cockburn 1971). Zoonotic diseases
also were spread by arthropod vectors. Avian, or ichthyic,
tuberculosis was a disease of early humans (Cockburn 1971),
as was schistosomiasis (Baker 1989).
Hunter-gatherers rarely experienced malnutrition or
starvation, and chronic disease was infrequent (Dunn 1977).
Nevertheless, life expectancy was relatively short, rarely
longer than 30-35 years, with few living longer than 50

18
years (Baker 1989). It is believed that traumatic and
accidental death was the leading cause of mortality,
including falls, snakebites, and death by predators. Social
mortality involving infanticide, homicide, suicide, war, and
cannibalism was also a factor in mortality (Dunn 1977; Baker
1989) .
Disease in State Society
The shift to agricultural forms of subsistence some
10,000 years ago marked some of the most significant changes
in culture since humankind's emergence. Large-scale
production of food changed the nomadic life-style of the
hunter-gatherer to a sedentary one. This resulted in the
accumulation of goods and the advancement of technology,
thus promoting the division of class and trading and
communication with other populations. To plant and harvest
farms and to replace animal sources of protein lost after
clearing land for the farms, many groups domesticated and
herded animals.
All of the above either directly or indirectly
contributed to human disease, most notably infectious
disease. The concentration of large numbers of human hosts
in a permanent location provided the "threshold" population
level necessary for the communicable diseases as well as the
vector-borne diseases. The sedentary life-style resulted in
a build-up of human waste proximal to living quarters and
water supplies, which promoted disease from parasites such

19
as the ascarids and hookworms. Contact with other
populations facilitated the spread of infectious disease to
epidemic proportions by providing organisms with "virgin"
hosts. New zoonotic diseases were encountered with the
constant contact of domestic animals, including anthrax,
brucellosis, tuberculosis, and Q fever (Polgar 1964).
Unwanted peri-domestic animals such as rodents and sparrows
developed permanent habitats in and around human dwellings.
By 3000 B.C. cities with populations of 50,000 or
greater were established in the Near East (Armelagos et al.
1990). All of the characteristics of the earlier
agricultural populations were present, but on a much larger
scale. There were increasing difficulties with supplying
water and food and with managing human waste, resulting in
outbreaks of cholera (Armelagos & Dewey 1978). Increasingly
complex societies also resulted in a breakdown of
traditional social practices; one example is the increase in
sexually transmitted diseases as a result of sexual
promiscuity (Armelagos & Dewey 1978). The same communicable
diseases that affected earlier agriculturalists continued,
but for the first time the populations were sufficient for
maintaining an endemic form (Armelagos et al. 1990). Yet
what was endemic to one population was often detrimental to
another. Cross-continental trade and exploration resulted
in intense epidemics (Zinsser 1936; McNeill 1976; Laird
1989). Large-scale wars resulted in some of the most

20
serious epidemics in history. Following the introduction of
Rattus into Western Europe by the Crusaders and the
introduction of the Xenopsvlla cheopis flea by seaborne
vessels, the Black Death began to take its toll in Europe in
1347 and, three years later, had eliminated at least a
quarter of the European population (approximately 25 million
people) (Laird 1989).
With increasing developments in technology evolved the
germ theory. A better understanding of disease causation
has admittedly resulted in increasing control over
infectious diseases. With the discovery of immunization
came the eradication of smallpox, and most of the other
communicable diseases have diminished in distribution. The
decrease in infectious disease has resulted in greater life
expectancies, so that chronic, degenerative diseases have
become the focus of morbidity and mortality. It has also
resulted in higher fertility rates producing worldwide
population explosions and leading to overcrowding,
underemployment and unemployment, and subsequently all of
the diseases associated with poverty.
Recently, much attention has been focused on the
detrimental effects of industrialization on the
international environment, including water, land, and
atmosphere. Massive industrial production of commodities
has caused pollution of much more than human waste.
Increasingly, there is concern over the health implications

21
of contaminated water supplies, overuse of pesticides in
commercialized agriculture, atmospheric chemicals, and the
future effects of a depleted ozone on human health and food
production. Increasing incidences of cancer among young
people and the increase in respiratory disease has been
implicated in these environmental changes. While most of
our current chronic diseases and conditions most certainly
existed in early populations (e.g., dental malocclusion,
myopia, and allergy) they must have been rare in order for
those populations to have survived without the technological
compensations which we know today, and their relatively
sudden appearance on such a large scale suggests an
environmental causation (Burkitt 1973; Corruccini & Kaul
1983) .
Application of the Disease Ecology Model: Allergy
Clearly, human biological and cultural activities
interacting with the environment forged lasting yet dynamic
relationships between host and pathogen. However, the
effects are two-way. Until this point I have focused on how
human evolution has influenced disease, but at least as
important is the issue of how disease has influenced human
evolution. This has stimulated countless biological and
cultural adaptations so that the host—individual or
population—may be returned to a steady state of well-being.
In many instances these adaptations have feedback effects on
the disease ecology.

22
The effect of disease on human evolution can be
summarized as follows: as humans evolved from one stage of
subsistence to another, they increasingly altered their
environment, thereby promoting new diseases which did not
exert selective pressures on previous populations to the
same degree. These newly encountered diseases forced
biological and cultural adaptations on the population,
compelling society to alter or increase food production,
explore new territories for new resources, and advance
technologically to combat the insults. Because no two
environments or no two gene pools are identical, different
diseases evolved for different populations. With increasing
communication between groups, there was an increase in the
distribution of disease. This "evolution" is circular;
disease forced changes in the host and her/his environment,
changes were made, and new diseases arose, forcing more
change.
The evolution of human allergy is an excellent
illustration of this feedback effect. Allergy is an example
of how a disease response (hypersensitivity) possibly
evolved as an adaptation to another disease early in human
history and how this "adaptation" is currently causing
negative feedback effects on contemporary disease ecology.

23
The Influence of Disease on Biological Adaptation;
Parasitic Infestations and IoE
At the beginning of this essay it was noted that the
earliest diseases affecting humans were those which had
affected the prehominids and zoonoses. It was also noted
that one of the "epidemiological principles" is that the
more stable the host-pathogen relationship, the longer the
two have probably coexisted. Helminths were illustrated to
have evolved this type of relationship with human hosts, and
the very long history of that relationship and low mortality
are evident in that all of the helminths have avoided the
development of complete immunity in the human host,
indicating that complete immunity is not an essential
feature for the host's survival (Kliks 1983).
Given that parasites and humans coexisted for such a
long period, one would assume that the disease might have
influenced some sort of biologically adaptive means for
minimizing the pathogenic effects in the human host. We
already know, for example, some of these adaptive
mechanisms. Many of the parasites have evolved mechanisms
for assuring the survival of the host, as in concomitant
immunity, in which the adult worms prevent the survival of
subsequently acquired larvae of similar or different species
(Kliks 1983). The effects of more elaborate genetic
adaptations have also evolved (e.g., sickle cell trait),
which are specific to a parasitic species. Researchers
examining contemporary populations chronically infested with

24
parasites observe another common feature: stimuli that
cause some of the highest titers of serum IgE are the
protozoa and helminths (Johansson et al. 1968; Ito et al.
1972; Bazaral et al. 1973; Desowitz 1981; Sher & Ottesen
1988). Yet, while serum IgE is 10 times higher in people
with allergy than in normal people, IgE is 10 times higher
in people with parasitic infections than it is in allergies
(Sher & Ottesen 1988).
There are five immunoglobulins in the human immune
system: they are, in order of concentration, IgG, IgA, IgM,
IgD, and IgE. Immunoglobulins are more generally referred
to as antibodies and are produced from lymphocytes. Of all
the human immunoglobulins, the least is known about
immunoglobulin "E," referred to as IgE. Elevated IgE is
found only in two clinical conditions: helminthic
infestations and allergy. Allergy is the common name for
"hypersensitivity," or an inappropriate response to a
harmless antigen upon second contact with that antigen.
There are four types of allergic reactions, but "allergy"
generally refers to the Type I reaction, also called
immediate type hypersensitivity. The main mediator in Type
I hypersensitivity is IgE.
IgE is dispersed both free in the serum and bound on
the surface membrane of mast cells and basophils. Serum IgE
is very low in comparison to concentrations of other
immunoglobulins, typically ranging from 10 to 100

25
nanograms/ml, or, put another way, is less than 0.00001 of
all the body's total immunoglobulins (Johansson & Bennich
1985). IgE is unique among the classes of immunoglobulins;
although its normal concentration is extremely low, it may
increase several hundredfold following challenge to a
specific stimuli (Barbee et al. 1981).
Allergenic stimuli are referred to as allergens or
antigens. Antigens may be inhaled, injected, ingested, or
presented by dermal contact. When IgE comes into contact
with an antigen, it triggers the release of the contents in
the basophils and mast cells. These mediator substances
include: histamine, a vasodilator; slow-reacting substance
of anaphylaxis (SRS-A), a smooth muscle contractor; and the
eosinophil chemotactic factor of anaphylaxis (ECF-A), which
causes the accumulation of eosinophils where the interaction
occurs. The clinical feature of Type I hypersensitivity is
referred to as "atopy.'' Atopy can be manifested as asthma,
allergic rhinitis, or eczema, sometimes called dermatitis
(not to be confused with "contact dermatitis" which is a
manifestation of Type IV hypersensitivity). Atopic
individuals are, in the most extreme scenario, at risk of
anaphylaxis, a life-threatening reaction in which there is
vasodilation and constriction of smooth muscles,
particularly of the bronchus, thus interrupting the exchange
of metabolic gases.

26
The capacity for developing elevated levels of serum
IgE is largely determined by genetics. This predisposition
is controlled by the major histocompatibility complex, or
MHC (antigen-specific) and by a regulator gene (nonspecific)
(Menser et al. 1975; Marsh et al. 1981; Marsh et al. 1980b).
Prevalence of atopy is higher in non-European descendants
living in developed countries (Davis et al. 1961; Worth
1962; Orgel et al. 1974; Marsh et al. 1980a; Waite 1980).
While the functions of IgG, IgA, IgM and IgD are
relatively well understood, the physiological function of
IgE is less clear. IgE is important in facilitating fluid
transport across cell membranes, and it also functions in
fighting bacterial and viral disease, although to a much
lesser degree than the other immunoglobulins (Gerrard 1985;
Johansson & Bennich 1985). With increasing evidence of a
relationship between elevated IgE and parasitic
infestations, researchers began to determine what the
physiological relationship was between the parasite and the
immunoglobulin.
Animal studies demonstrated that serum IgE appeared to
function by minimizing the number of parasites in a host who
was chronically exposed to large numbers of parasites (Hsu
et al. 1974; Dessein et al. 1981). Dessein et al. (1981)
concluded that IgE-suppressed rats demonstrated
significantly less resistance to infection by Trichinella
spiralis than controls with normal IgE levels. Following

27
sequential challenges with Schistosomula iaponicum cercariae
to a rhesus monkey, hypersensitivity reactions were
determined using microscopic examination of skin biopsies
and macroscopic determinations (wheal and flare) (Hsu et al.
1974). The schistosomulae were destroyed in the dermis of
the primate approximately 12 hours after the challenge.
After numerous other laboratory and clinical studies,
contemporary immunologists concluded the following
protective mechanism of IgE against heavy parasitic
infections: upon entering the host, soluble parasitic
antigens diffuse across the intestinal mucosa and are
transported to the lymph nodes, where an IgE-mediated
response occurs. Mast cells migrate to the same lymph
nodes, are sensitized by the development of parasite-
specific IgE on their surface, and return to the intestinal
mucosa. Upon contact with the parasitic antigen, the mast
cells degranulate and release their mediators, which
subsequently attract to the site eosinophils, complement,
and parasite-specific IgG, all of which function to damage
and expulse the parasite (see Brothwell 1972).
Having reviewed the relationship between parasitic
infections and IgE, and with the understanding that the only
other manifestation involving elevated IgE is allergy, the
question is posed: is there any relationship between
parasitic infections and allergy? Unfortunately, this
relationship is much less clear than the helminthic-IgE

28
relationship. Before discussing what is known about this
topic, a review of the evolutionary history of IgE as an
adaptive process will be presented.
The Influence of Disease on Cultural Adaptation: The
Gradual Decrease in Exposure to Parasites
With the confirmation of a relationship between IgE and
both allergy and parasitic infestations, there have been a
number of suggestions as to a "cause-and-effeet”
relationship between the two. From an epidemiological point
of view, this information would be valuable in determining
the distribution of IgE-related disease in populations of
the past and predicting trends in contemporary societies.
The first evidence of a relationship between IgE and
parasites ironically came from a temperate environment
rather than the tropics, where parasitic infections are
typically endemic. D. Tullis (1970) declared that an unusual
epidemic of Ascaris lumbricoides. Trichuris trichiura.
Necator americanus. and Ancvlostoma duodenale in the Niagara
Falls vicinity had coincided with an alarming increase in
the prevalence of asthma. One-hundred and ninety-eight of
the 201 asthmatics were diagnosed with intestinal
infestations involving one or several of the above
parasites. Tullis' conclusion was that there was a definite
correlation between the development of bronchial asthma and
intestinal parasitic infestations. Following Tullis'
report, other immunologists published similar findings,

29
concluding that parasites caused allergy (Huntley 1976;
Joubert et al. 1980; Desowitz et al. 1981).
The investigation was taken to the tropics where
populations traditionally have experienced high levels of
parasitic infections. As expected, and similarly to the
previous studies, populations that were heavily infested
with parasites demonstrated extremely high levels of IgE
(Godfrey 1975; Warrell et al. 1975). However, one
researcher, Godfrey (1975), noted in his study that, among
those patients with the extremely high serum IgE and
parasitosis, allergy was practically nonexistent.
Furthermore, he added a socio-demographic variable,
concluding that parasitosis was highest in the rural region
and asthma was highest in the urban region, where there was
a low incidence of parasitosis. Similar experiments in
laboratory settings revealed the same results; allergy was
minimized or absent in persons with heavy parasite
infections (Phills et al. 1972; Hsu et al. 1974; Godfrey &
Gradidge 1976; Dessein et al. 1981).
Curiously, other studies indicated that there was no
relationship between IgE, parasitic infections, and allergy;
atopy was just as prevalent in persons with helminthic
infestations as without them (Alcasid et al. 1973;
MacFarlane et al. 1979). These studies did not, however,
take into consideration various socioeconomic and
demographic variables, such as urban or rural residence.

30
The prevailing conclusion is that, under certain
conditions, all three of the above scenarios may occur. But
in the majority of cases involving heavy parasitosis in
endemic regions, the incidence of allergy to both parasites
and exogenous allergens is low. The mechanism for that
suppression is believed to be one of the following two
theories. Chronic exposure to large numbers of parasites
stimulates the production of both specific and nonspecific
IgE antibodies, resulting in "saturation" of the IgE
receptors on the mast cells and therefore preventing the
cell from responding to additional "specific" antigens, such
as molds or arthropods (Godfrey & Gradidge 1976; Ottesen
1985).
A second—and currently more widely accepted theory of
mechanism—is a "blocking antibody" mechanism, in which
persons chronically exposed to helminths produce antigen-
specific IgG-blocking antibodies which inhibit to a degree
the mast cell or basophil degranulation process (Ottesen
1985). Similar to other mechanisms involving human hosts
and parasites, the potential role of these antibodies
appears to be more to limit the degree of hypersensitivity
rather than to eliminate the reaction completely (Ottesen et
al. 1981; Ottesen 1985). This mechanism is specific for
maintaining a low incidence of allergy to parasites rather
than exogenous allergens and is not recognized in atopic
disease (Ottesen et al. 1981). It is, interestingly, also

31
the principle for which desensitization therapy for allergic
disease is administered (Ottesen et al. 1981; Ottesen 1985).
The blocking antibody theory explains why allergy to
helminths usually is seen only in the early phases of
parasitic infestation. At the sites of initial parasitic
contact, such as the mucous membrane or skin, the antigen
concentration is too great to succumb to the effects of the
blocking antibodies, yet as the parasitosis progresses and
sufficient IgG-blocking antibodies are generated, the
hypersensitive reaction gradually would be controlled
(Ottesen 1985). Consequently, in regions where
helminthiasis is in an acute, epidemic stage (e.g., Niagara
Falls) allergic responses to the helminths would be
expected.
A blocking mechanism specific for helminths—but not
for other allergens—would also explain why helminthiasis
and allergy occasionally occur simultaneously. Populations
that have been chronically exposed to parasites have a
genetic predisposition for elevated IgE. It is likely that
the occurrence of both phenomena is reflective of
populations undergoing a transition from developing to
developed living conditions, as in rural to urban migrations
in tropical countries, where they are exposed to both
parasites and new and numerous exogenous allergens.
Clearly, there is a cause-and-effeet mechanism between
IgE and both helminthiasis and atopy. However, the sum

32
process is multi-causal. First, predisposition to develop
high levels of serum IgE is genetically-determined. The
fact that these elevated levels are higher in non-Europeans
than Europeans has already been mentioned. Presumably, the
selective advantage for a haplotype which is predisposed to
producing high levels of IgE—a key component the mechanism
for destroying invading helminths—would be highest in a
population chronically exposed to helminths. This
represents the protective role of IgE. Over millennia, and
following the cultural impact of widespread distribution of
once isolated gene pools, these haplotypes would also be
widely dispersed. Elevated IgE in populations chronically
exposed to parasites apparently did not produce adverse
health effects due to the check-and-balance mechanism of
IgG-blocking antibody and the control of the hypersensitive
state. This mechanism was advantageous to both the host and
pathogen. Without exposure to helminths, however, there is
apparently no IgG-blocking antibody and therefore no built-
in control over the immune response in the event of contact
with foreign allergens. This is the negative feedback
component of the immune mechanism. Traditional societies
exposed to many parasites—but few exogenous allergens in a
less complex environment—benefitted from the biological
adaptation of IgE; parasitosis was kept at a reasonable
state of low morbidity. Yet as humans evolved culturally
and biologically, they created an environment in which IgE

33
is not checked (e.g., no exposure to parasites) and in which
potential allergens abound.
In summary, it is apparent from this particular
illustration—IgE, helminths, and parasites—that disease
plays a major role in the adaptation of the human host, but
that many adaptations may in turn promote additional
diseases. A new trend in the ecological perspective of
disease is to shift our focus on adaptation as an "optimal"
mechanism to one of sufficiency. Gould and Vrba (1982)
argue that, in the case of evolution, the word "adaptation"
has been overused, because not all features that enhance
fitness were necessarily designed by natural selection for
their contemporary role. The authors suggest that
"exaptation" be used to explain certain characters that
either evolved for other purposes or for no purpose at all,
but were later "co-opted" for a contemporary purpose (Gould
& Vrba 1982) .
Although "exaptation" may not be an appropriate
description for the development of IgE, we cannot eliminate
it as a possibility. Perhaps IgE did originate for a
similar purpose as the other immunoglobulins, but was also
efficient in functioning as an anti-helminthic mechanism.
By adopting this approach, we may include in our analysis of
human evolution other traits which have previously received
little attention, because "complete" adaptation was not the
end result.

34
Influencing Biological and Sociocultural Factors
People who live in developing regions of the world do
not exhibit a high prevalence of allergic disease (Godfrey
1975; Warrell et al. 1975) presumably because of functioning
IgG blocking-antibody. This is probably because exposure to
parasites is chronic due to their traditional modes of
production and because they have limited sources of clean
water and sanitary provisions. When they shift to a more
developed, urbanized environment the incidence of allergy
becomes comparable to incidences in developed countries.
This is, however, an over-simplification of the allergy
model. A number of biological and behavioral factors
contribute to allergic disease, as will be demonstrated
below.
Genetic. MHC-related factor
The development of allergic disease in an individual is
multi-causal. Perhaps one of the most predictive factors
for the development of allergy is genetic predisposition;
some individuals are genetically predisposed to produce more
IgE than others (Willcox & Marsh 1978; Marsh et al. 1980b;
Gerrard 1985). The phenotype of elevated serum IgE is at
least partly dictated by a genotype controlled by the MHC.
The MHC is a region on chromosome 6 in humans that contains
a number of gene loci. A particularly important complex is
composed of the four human lymphocyte antigen (HLA) loci,
designated as HLA-A, -B, -C and -D. Each locus contains a

35
number of different alleles, or HLA antigens, resulting in a
high degree of polymorphism. A set of HLA genes (that
includes four HLA determinants) constitutes a "haplotype".
Certain HLA antigens—or haplotypes—have been correlated
with immune responsiveness to aeroallergens (Menser et al.
1975; Blumenthal et al. 1980; Marsh et al. 1980b; Marsh et
al. 1981; Brostoff & Hall 1989). For example, HLA-Dw2 is
highly associated (92%) with allergy to the short ragweed
allergen Ra5, in contrast to a poor association (22%) for
those individuals with HLA-B7 (Marsh et al. 1981).
Genetic. non-MHC-related factor
High IgE levels are also dictated by a regulator gene
that is not linked to the MHC; total IgE is partially
regulated by an autosomal gene in which the genotype that
controls for high serum IgE is recessive (rr) and low total
IgE is dominant (Rr or RR) (Marsh et al. 1974; Gerrard et
al. 1978; Willcox & Marsh 1978; Marsh et al. 1980b; Rao et
al. 1980). It is postulated that the dominant allele (R)
functions by limiting the number of IgE antibodies that
clonally expand in response to an allergen, resulting in low
total serum IgE (Willcox & Marsh 1978). While the MHC class
of immune response (Ir) genes are antigen-specific, this
second genetic mechanism involving the regulator allele "R"
is nonantigen-specific (Willcox & Marsh 1978; Marsh et al.
1980b).

36
Familial factors
Predisposition to allergy is associated with a positive
family history of allergy (Gerrard et al. 1976; Gerrard et
al. 1978; Marsh et al. 1980b), although the familial
environment might be a more important factor; members of a
family living in the same household and sharing the same
behaviors might all be at a similar risk of developing
allergies. Nevertheless, results from studies involving
twins conclude that serum IgE is genetically determined and
monozygous twins express more similar levels of IgE than
dizygous twins (Bazaral et al. 1974).
Ethnic factors
Prevalence of clinical allergy reportedly has been
higher in non-European descendants living in developed
countries, including the following: Chinese Americans (Worth
1962); West Indian Blacks in England (Davis et al. 1961,
Pearson 1973); American-born Filipinos (Orgel et al. 1974);
and Polynesians in New Zealand (Waite 1980). Similarly,
Iraqi, Iranian, and Yemini immigrants in Israel had higher
rates of asthma than other ethnic groups (Asch et al. 1973).
In contrast, some races exhibit a lower prevalence of
allergy than European-descendants; Herxheimer & Schaefer
(1974) reported that the incidence of asthma among Canadian
Eskimos was extremely rare. Asthma was also rare for North
American Indians despite their unusually high levels of
serum IgE (Gerrard 1985). It has been suggested that the

37
low incidence of asthma among Canadian Eskimos and North
American Indians may be related to the low frequency of HLA-
A8 haplotype in that population; white children with HLA-A8
have a particularly high incidence of asthma (Menser et al.
1975). However, Gerrard (1985) noted that serum IgE levels
were high in the Indian population; he hypothesized that
inadequate medical services meant that the North American
Indian was forced to rely more heavily on his/her own immune
system, possibly resulting in higher IgE levels.
Behavioral and nutritional factors
Similarly to other chronic diseases of modernization,
genetics alone cannot explain the rapid increase in the
prevalence of allergy. Just as the environment probably was
important for the development of IgE—that is, exposure to
an environment plagued with intestinal helminths—so the
environment must be important for the development of another
IgE-related manifestation: Human allergy. After all,
elevated IgE cannot manifest itself as a hypersensitive
reaction unless there is some aggravating allergen present
to elicit the response.
One factor characteristic of modernization and
important in the development of allergy is both biological
and behavioral, and that is breastfeeding. Breastfeeding is
believed to decrease the likelihood of developing allergy
indirectly by minimizing infection. Breast milk contains
factors that promote the maturation of the intestinal tract

38
of the newborn and also provides secretory antibodies to
assist in immunity at the intestinal surface (Ogra & Ogra
1978). Also, breast milk contains fewer foreign proteins
than bottled milk and it is believed that both the
introduction of foreign antigens (Johansson & Bennich 1985)
and infection during early childhood (Marsh et al. 1981) may
initiate allergic disease.
It is often difficult to differentiate between true
food allergies and genetically-based food intolerances (see
Lieberman & Barnes 1990). A number of the food intolerances
(e.g., celiac disease, G6PD-deficiency, and lactose
intolerance) have been managed by culture-specific
proscriptions and food preparation practices in regions
where they are most commonly distributed. However, when
individuals with food intolerant predispositions are exposed
to new foodways, either voluntarily or involuntarily,
adverse allergic-like reactions often occur. Newly
introduced sources of dietary proteins—particularly the oil
seeds and yeasts—as well as the chemical modification of
foods for large-scale commercialization have potentially
antigenic effects on persons predisposed to allergic disease
(Metcalfe et al. 1988). A well-publicized phenomenon is the
"Chinese Restaurant Syndrome," which is an adverse food
reaction to monosodium glutamate (MSG) (Man-Kwok 1968; Allen
& Baker 1988).

39
Miscellaneous behavioral factors
Other behaviors associated with modernization
contribute to the development of allergy. Cigarette smoking
is associated with elevated serum IgE (Gerrard 1985; Burrows
1989). Psychological stress has been implicated in at least
the exacerbation of allergy and possibly as a predisposing
factor (Graham 1967; Glazer 1969; Smith 1978). Stress is a
well-known insult in populations undergoing transitions from
rural to urban settings, immigration, and an increase in
complexity of modes of production (McElroy & Townsend 1985;
Goodman et al. 1988). The disproportionately high levels of
allergy among Iraqi and Yemeni immigrants into Israel was
partially attributed to psychological stress (Glazer 1969).
Population behavior and the macroenvironment
As the environment in which we live becomes more
complex and we become more mobile, we are increasingly
exposing ourselves to greater numbers of foreign proteins
that may function as allergens. Immunologists conducting
studies in tropical regions have found that prevalence of
allergy tends to be much lower in populations where
traditional means of living continue compared to prevalence
in more developed populations (Anderson 1974; Godfrey 1975;
VanNiekerk et al. 1979; Dowse et al. 1985). Specifically,
urban populations overwhelmingly present with higher rates
of allergy than rural populations, and this discrepancy is
most notable in developing countries; examples include the

40
Gambia (Godfrey 1975), Nigeria (Warrell et al. 1975), and
the Punjab (Corruccini & Haul 1983). With the process of
urbanization and modernization, populations are subjected to
new foods, ingested chemicals, and synthetic materials, as
well as chemicals and pollutants emitted into the
environment from factories and transportation vehicles.
Urban pollutants such as sulfur dioxide, sulfuric acid,
carbon monoxide, and particulate matter serve as irritants
to asthmatics (Lopez & Salvaggio 1978; Smith 1978; Hackney &
Linn 1985; Weiss & Speizer 1985).
Population behavior and the microenvironment
The role of the domestic environment—or rather,
"microenvironment”—was discussed at the outset of this
chapter. Specifically, some of what is known regarding
allergens and the microenvironment is related to the
presence of arthropods. Also important is the production of
molds (Burr et al. 1985; Brunedreef et al. 1989; Platt et
al. 1989; Dales et al. 1991) and fungi (Arundel et al. 1986;
May et al. 1986) secondary to excessive moisture levels in
the home. Inadequate ventilatory practices in housing
construction contribute to elevated relative humidity levels
(Arundel et al. 1986).
Conclusions and the Allergy Disease Model
Figure 1-1 illustrates the cultural and biological
factors sufficient—but not necessary—for the development
of allergic disease. The biological and cultural factors

41
are a result of interactions between the host population and
the environment; both factors influence each other, from the
host, and to the host. These interactions create elements
in the environment that subsequently produce allergenic
stimuli, or "insults", which in turn affect the host.
Depending on inherent features of the host, they may or may
not produce disease.
In summary, by reviewing many of the known factors for
the development of the hypersensitivity response, it is
evident that allergy is a disease characterized by human
modernization and urbanization. By using the construct of
the epidemiological transition we can predict the
development of allergy as a significant form of morbidity
due to changes which typically occur during the transition
of traditional living toward modern living. It is apparent
that populations in the middle of this transitional period
will experience an epidemic-like form of the disease due to
the sudden exposure to numerous allergens. Many of those
individuals may be more likely to suffer from allergy
because of their genetic make-up, although this is not a
limiting factor. Evaluation of disease patterns outside of
the Western world and into regions where the disease-causing
relationship begins will provide medical researchers with
new insights into the evolution of many human diseases—in
this case, allergy.

42
Notes
1. "Arboallergen" is a term used to denote any arthropod-
borne allergen. It is based on the hypothesis that a number
of specific epitopes are found in different arthropods, and
possibly occur in proteins associated with the production of
chitin and molting and/or in common digestive enzyme systems
(Brenner et al. 1991). The resulting clinical picture is
cross-reactivity (hypersensitivity) to different arthropods.

Cultural
Environment
bottlefeeding
commercialization of food'
non-traditionai foodways
sanitary & sewage provisions
unequal distribution of
goods and social services
immigration/emmigration
Organic
Inorganic
Cultural
Populatior
level
4
♦
Gene pool
level
I 4
*
Familial
level
\
Individual
level
Biological
Environment
mixed gene pools
v scarcity of food products
intestinal parasites
arthropod infestations
ornamental horticulture
factory waste products
in air, water, & land
meteorological/atmospheric
changes
automotive exhaust/fumes
occupational environment
construction of the
work place
domicile construction
rodent infestations
household pets
pesticides
Figure 1-1. The Allergy Disease Model in the Ecological Perspective.

CHAPTER 2
THE STUDY DESIGN AND RESEARCH SETTING
The Construct of Allergy and Modernization:
A Review of the Objectives
In Chapter One, allergy was defined as part of the
epidemiological transition of disease and both genetic and
behavioral factors were identified that are known to
contribute to the rising incidence of allergy on a worldwide
scale. It was suggested that a closer look at a population
in the midst of infrastructural transition may elucidate
factors that are playing a significant role in the incidence
of allergy in both societal settings—developed and
developing. Certainly, identifying etiological factors of
disease is more complicated in a developed society, after
the epidemiological transition has occurred, in that the
population as a whole has already achieved a certain degree
of adaptation in its effort to rally against the disease,
and it is therefore difficult to distinguish between causal
versus spurious co-variation of suspected independent
variables.
The overall objective of the study—identifying a
relationship between modernization of the domestic
environment and allergy to household pests—was presented in
Chapter One. The dependent variable in the study is allergy
to a given household pest at the individual level, a
44

45
biological measurement to be presented categorically; a
person is either reactive or nonreactive to a specific pest
allergen. To minimize variation in selection criteria and
symptomatology associated with atopy, only asthmatics were
chosen for the study. The independent variables in the
study are structural features of the domestic environment
and sociodemographic features of the household that may
contribute to the nutritional and reproductive needs of
various household pests, thus supporting a substantial
population of the pests. The presence or absence of these
various features will be correlated with the presence or
absence of a given pest allergy to support a causal
relationship. It is recognized that categorization of the
independent variables as a feature of modernization is
primarily a subjective process; however, an anthropological
presentation of the evolution of the Barbadian domestic
environment will elucidate the dynamic features of housing
in Barbados and illustrate the fact that Barbadians are
achieving a level of development similar to that of
industrialized countries such as the U.S..
This chapter presents the general materials and methods
relied upon to conduct the study. Following an ethno-
historical review of the development of land distribution
and housing in Barbadian society (Chapter Three)—which
ultimately affects the development of the domestic
environment and thus the presence of certain pests—specific

46
sociodemographic and housing variables will be identified
and analyzed in Chapter Four. Chapter Five presents
findings from the entomological survey as well as stated
behaviors, perceptions and attitudes about household pests.
Chapter Six is a presentation of the biomedical testing of
allergies to various household pests, including results and
discussion, and Chapter Seven concludes this dissertation
with a summary of findings and implications for future
studies.
The Research Site
Barbados was chosen as the research site for a number
of reasons. An important sociodemographic feature was the
fact that Barbados is the most heavily populated country in
the Western Hemisphere, at over 1500 persons per square
mile. Household infestations are a significant problem in
densely populated settings (Harwood & James 1979) and also
in the tropics (Marchand 1966; Pearson & Cunnington 1973;
Dowse et al. 1986; Lan et al. 1988). Because the Barbadian
population is almost equally divided between rural and urban
residence and because the island is so small—and therefore
easily accessible with clearly defined boundaries—Barbados
offered a unique opportunity to contrast the incidence of
allergy to household pests with crowded urban and rural
populations. Another sociodemographic feature was the
dynamic status of Barbadian housing. The level of
infrastructural development in Barbados and documented

47
health indicators assured that the epidemiological
transition from acute and infectious disease to chronic
disease had in fact taken place in Barbados, thus implying
the likelihood of a significant incidence of allergy in
general and asthma in particular.
The Rising Incidence of Asthma in Barbados
Despite the absence of any recent study on the status
of asthma in Barbados, it is unanimous among most
Barbadians—health care professionals as well as lay
persons—that asthma is on the increase. While exact
figures for the incidence of asthma is not known, PAHO
reports that the disease category
"bronchitis/emphysema/asthma" accounted for a crude death
rate (per 100,000 population) of 8.9 in 1988, or 23 persons
in Barbados; this figure correlates highly to the U.S. crude
death rate of 9.2 for the same category and year (1990).
The number of asthmatic attendances at the Accident and
Emergency (A&E) Department at Queen Elizabeth Hospital (QEH)
doubled within a 10-year period, from 3,503 visits in 1980
to 7,137 visits in 1990 (Figure 2-1). Annually, asthmatic
attacks account for more than 13% of all visits to the A&E
Department, averaging about 20 patients a day (Naidu 1988,
1990), and make up 12.5% of the Emergency Ambulance Service
(EAS) calls (Naidu 1992). A slight decrease in the numbers
of visits during 1989 and 1990, at 7,267 and 7,137,
respectively, suggested that the dispensing of free asthma

48
medications and the increase in public awareness and
educational programs were possibly stabilizing the incidence
of asthmatic attacks (McCarthy 1991a). But a record 7,808
visits in 1991 indicates a continuation in the trend of
rising incidence. Nearly half of all asthma-related visits
are children under the age of 15 (McCarthy 1991b).
The incidence of asthmatic attacks has a definite
seasonal pattern in Barbados. October is the month with the
greatest number of visits; Figure 2-2 illustrates the
dramatic increase from 1974 to 1991. There were an
unprecedented 936 visits in 1988, 899 in 1990, and a record
937 visits in 1991 (Naidu1, personal communication). Also
in 1990, two of the three asthma-related deaths occurred in
October (McCarthy 1991c). This corresponds to the rainfall
patterns in Barbados, in which the average monthly rainfall
peaks in August and October (Depradine et al. 1984).
Figures 2-3 and 2-4 illustrate the relationship between
asthma visits to the A&E department and monthly rainfall for
1990 and 1991, respectively. Note the unusually large
amounts of rainfall for the month of October—and the
exceptional amount of rainfall for November, 1991—
correlated with the highest numbers of asthmatic visits on a
monthly basis.

1980 1982 1984 1986 1988 1990
Figure 2-1. Asthmatic Attendances to the Accident & Emergency Department,
Elizabeth Hospital, in thousands, for 1980-1990.
Source: Naidu, personal communication.
Queen
vo

Figure 2-2. Number of asthmatics attending the Accident and Emergency Department,
Queen Elizabeth Hospital, for the month of October, 1974-1990.
Source: Naidu, personal communication.
1991

900
850
800
750
700
650
600
550
500
450
400
Jan Feb Mar Apr May Jim Jul Aug Sep Oct Nov Dec
1990
A, Rainfall —Asthamtic Attendances
in Inches
Figure 2-3. Monthly Asthmatic Attendances to the Accident & Emergency Department
Compared to Monthly Rainfall, 1990.
Asthamtic Attendances

-Tie- Rainfall
in Inches
1991
Asthmatic Attendances
Figure 2-4. Monthly Asthmatic Attendances to the Accident & Emergency Department
Compared to Monthly Rainfall, 1991.
ui
fO

53
The significance of the rising incidence of asthma in
Barbados is reflected in the facilities that have been
created in recent years to cope specifically with the
asthmatic patient. The current Minister of Health, Mr.
Branford Taitt, became particularly interested in asthma and
health care, due in part to the number of deaths from
asthmatic attacks and to the apparently overall increasing
incidence of asthma. A policy was instituted in which
polyclinics would have nebulizers, peak flow meters, and
oxygen available at all times, and asthma drugs would be
available in all polyclinic dispensaries. In 1990 the A&E
Department was remodeled and included a new "asthma bay"
designed especially for asthmatic clients. The bay is
situated directly in front of the nursing station, thus
allowing full-time observation. An important consideration
in understanding the increasing number of hospital visits
due to asthmatic attacks is a greater reliance on the A&E
Department than in previous years. Naidu suggests that this
trend may represent an increasing dependence by the public
on the A&E Department as a primary care center for the
treatment of asthmatic attacks (1990). It has also been
suggested that the decrease in reliance on home remedies and
increasing preference for A&E medical treatment is
responsible in part for the increase in attendances
(Ferdinand2, personal communication; Naidu, personal
communication).

54
Unfortunately, there are few physicians in Barbados who
specialize in asthma disease. One allergist conducts
allergy testing and desensitization therapy in his private
clinic, but the cost of his services are prohibitive to the
average Barbadian. A few physicians, both in the private
and public sector, who specialize in internal or respiratory
medicine, have earned a reputation as "asthma specialists"
and are preferred by asthmatics and parents of asthmatics
over polyclinic physicians. In 1990, medications for the
treatment of asthma were made free to all asthmatics through
the Barbados Drug Service. For the period between October
1989 and December 1990, 5,310 asthma therapy prescriptions
were filled at the QEH pharmacy and 7,892 were filled at
other government pharmacies, for a total of 13,202
prescriptions (Prescod3, personal communication). Money
spent on asthma medications actually decreased by 4.5% from
BDS4 $261,039 (note: all monetary figures in this thesis
will be presented in Barbados dollars, except when indicated
otherwise) between July 1988 to June 1989, to $249,435
between July 1989 to June 1990; this factor has been
attributed in part to the efficiency of the Drug Service
program (Prescod, personal communication).
In June, 1989, the Asthmatic Association of Barbados
was founded, following suggestions for the organization
during a "national asthma week" seminar provided by the
Barbados Drug Service. As of 1991 the organization boasted

55
some 150 members, most of whom were adult asthmatics or
parents of asthmatic children, although the meetings are
open to any interested person. The association meets once a
month and the primary objective is to disseminate
information on the control and management of asthma, usually
via a guest speaker5.
Infrastructure: The Developed Nature of a Developing
Country
In 1991 the United Nations revised the human
development index and declared Barbados the leading
"developing" country among all developing nations (United
Nations 1991), a step that Barbadians fear will eventually
reduce their eligibility for international aid. The
classification is supported in part by an estimated per
capita income of US $6,020, higher than the Republic of
Korea or oil-rich Venezuela (United Nations 1991). Thus,
according to the U.N., Barbados ranks ahead of its neighbors
in the Eastern Caribbean in human development; Table 2-1
illustrates the disparity of GNP (gross national product)
per capita within the Eastern Caribbean nations.
Barbados health indicators demonstrate a quality of
life more comparable to industrialized countries than
developing countries (Table 2-2). Great strides have been
made in Barbadian health care; between 1920 and 1922, life
expectancy was only 31.9 years for women and 28.5 years for

Table 2-1 GNP per capita (1980), in U.S. dollars in
the Eastern Caribbean.
56
Country
GNP per capita
Barbados
6,010
Antigua & Barbuda
3,690
Trinidad & Tobago
3,350
St. Kitts & Nevis
2,630
Grenada
1,720
Dominica
1,680
St. Lucia
1,540
St. Vincent
1,200
Jamaica
1,070
Source: United Nations 1991.
men (Dann 1984). This is in stark contrast to the average
of 75 years as of 1990 (United Nations 1991). In a "quality
of life" survey, sociologist Graham Dann found that "health"
received the highest score of the seven life satisfaction
domains (1984), indicating that Barbadians are content with
the status of their health and health care delivery. The
leading causes of death in Barbados are similar to those of
industrialized nations, and include: heart disease,
malignant neoplasms, cerebrovascular disease, diabetes
mellitus, and "other" circulatory system diseases (PAHO
1990).
Education in Barbados ranks as the leading priority in
government spending, at over one fifth of the national
budget, or, about $1 per person per day (Dann 1984). Table
2-3 compares educational indicators in Barbados with other
Eastern Caribbean countries. As illustrated, there is a 99%
literacy rate and education is compulsory for 11 years. It

57
has been argued that Barbadians are perhaps over-educated
for the jobs available, as unemployment for new graduates is
higher than in any other age group (Dann 1984). Recently
there have been efforts by the Ministry to design a
curriculum that would prepare students for the three
mainstays in Barbadian economy—tourism, manufacturing, and
agriculture, but this move has been sharply criticized by
certain nationalists as "encouraging a 'mental attitude of
subservience'" (Goddard 1991, p.6).
Barbados was controlled by Britain for some 350 years,
and at the time of Independence (1966) the British legal and
parliamentary system was adopted. Barbados is classified as
an independent, liberal-democratic state with competitive
parties, has the highest rating for political and civil
rights (according to the Freedom House Index) and a strong
emphasis on economic and social reforms (Stone 1985). There
is a network of approximately 860 miles of paved roads and
public transportation is available in all of the 11
parishes. PAHO (1988) reported 100% coverage of drinking
water supplies and sewerage or excreta disposal services in
Barbados, which no doubt contributes to the overall good
health of the nation. (See Chapter Three for a full
description of Barbadian economy).
The Health Care Delivery System
Barbadians enjoy an efficient socialized health care
system, reflected by the health indicators previously

58
illustrated. Government health expenditure per person in
1987 was US $230.58 and the percentage of total government
expenditure on health was 13.13 (PAHO 1990). The primary
resource centers for receiving health care in Barbados are
QEH6, including the hospital and polyclinics; the
distribution of these services is depicted in Figure 2-5.
The concept of polyclinics and public health care came
into existence in the mid-1970s. Initially the clinics were
serviced by General Practice (GP) doctors who maintained
both government and private offices and visited the clinics
several times a week. At that time, only patients who
passed a "means" test by the welfare department could visit
the free clinics or the hospital. In 1985 the government
began employing GP's full-time and regular GP sessions
commenced in the polyclinics. The "means" test was
eliminated and services became available to all residents.
While the exact number of persons attending private
physicians is not known, 135,810 attendances were recorded
in 1990 to the eight public polyclinics and five outstations
(see Table 2-4) (Sergeant7, personal communication).
According to R. Naidu, Director of the A&E Department at
QEH, the introduction of the polyclinic system has reduced
the number of visits to the A&E Department, except in the
parish of St. Michael, where there is still a
disproportionately high number of attendances when compared
to the percent of the population living in that parish

59
(Naidu 1988). The Barbados Drug Service provides free
prescription medications to all persons under the age of 16
years and those over 65 years and to any patient needing
medications for venereal disease, cancer, hypertension,
diabetes, glaucoma, and, as of 1990, epilepsy and asthma.
Dispensaries are available at each of the polyclinics.

Table 2-2. Health indicators for the Eastern Caribbean
Life
expectancy
at birth,
in years
1990
Population
with
access to
health
services(%)
1985-87
Population
with
access
to safe
water (%)
1985-88
Population
with
access to
sanitation
(%)
1985-88
Fertility
rate
1990
Infant
mortality
rate per
1,000 live
births,
1989
Barbados
75.1
100
100
•
1.8
11
Trinidad
& Tobago
71.6
99
96
99
2.8
15
Antigua &
Barbuda
72.0
•
100
•
•
22
Dominica
76.0
•
•
•
•
18
Jamaica
73.1
90
72
91
2.5
16
Grenada
71.5
100
•
•
•
34
St.Kitts
Nevis
67.5
100
100
100
3.6
•
St. Lucia
70.5
•
67
•
4.2
21
St.Vincent
70.0
•
•
•
•
25
Guyana
64.2
89
61
87
2.6
54
Source: United Nations
1991.

Table 2-3
Profile of education in the Eastern Caribbean
Adult
literacy
rate
(%)
1985
Combined
primary &
secondary
enrollment
ratio
1986-88
Percent of
total
public
expenditure
on education
1988
Compulsory
education
duration
(years)
1988
Barbados
99
11
20.1
11
Trinidad & Tobago
96
6
11.5
6
Antigua & Barbuda
90
11
14.4
11
Dominica
80
10
14.1
10
Jamaica
98
6
11.0
6
Grenada
85
11
12.5
11
St. Kitts & Nevis
80
11
12.5
11
St. Lucia
83
10
16.8
10
St. Vincent
82
•
11.6
•
Guyana
95
8
3.0
8
Source: United Nations
1991, pp.138
,146,148.

62
Figure 2-5. Distribution of Outpatient Health Care
Facilities in Barbados.

Table 2-4. Polyclinic/outstation attendances, 1990
Polyclinic
Parish
Total
number of
patients
Total
attendances
Average
monthly
attendances
Daily
range
Edgar Cochrane
St. Michael
4,350
10,865
900
53 - 57
Six Roads
St. Philip
4,113
10,561
880
35 - 50
Gall Hill
St. John
2,548
7,707
642
26 - 34
Maurice Byer
St. Peter
5,981
18,863
1,572
61 - 80
Horse Hill
St. Joseph
774
2,027
169
15 - 27
Warrens
St. Michael
5,545
12,835
1,070
40 - 66
St. Thomas
St. Thomas
697
2,257
188
16 - 28
Belleplaine
St. Andrew
804
2,013
170
17 - 24
Black Rock
St. Michael
9,042
21,491
1,791
74 - 93
Holetown
St. James
437
1,509
126
14 - 23
Randall Phillips
Christ Church
7,544
19,298
1,608
58 - 93
Glebe
St. George
5,105
14,661
1,222
50 - 69
Sir Winston Scott
St. Michael
5,193
11,723
2,099
80 - 111
Total
92,133
135,810
12,442
519 - 755
Source: Sergeant
, Ministry of
Health, Barbados.
1991. Personal communication.

64
Sampling and Methodology
The Survey Schedule
The asthma study was conducted in Barbados from January
to December, 1991. The project was divided into 2 phases.
The principle objectives of Phase I were the following: (1)
to qualify the household pest species in the major
topographical regions of the island; and (2) to conduct an
ethnographic survey, primarily using the techniques of
participant observation and informal interviewing, for the
purpose of designing an appropriate questionnaire for the
study sample in Phase II. These separate operations were
conducted simultaneously; while the trapping was taking
place in one region, the ethnographic data were collected in
the selected households. Three to four weeks were spent at
each site during the dry season and two weeks were spent at
the sites during the rainy season.
Topographical considerations
Unlike its volcanic neighbors, Barbados is composed of
a coral limestone formation, resulting in a relatively flat
but terraced landscape, with a series of deep gullies as
well as vertical cliffs, the remnants of old coral reefs.
The coral limestone base contributes to a good drainage
system and a fluctuating but reasonable supply of water,
depending on the region, yet negates the presence of rivers
or streams. Although there were at one time a number of
coastal swamps on the leeward coast, the only remaining

65
swamp—and the only true body of water on the island at
present—is the Graeme Hall Swamp, situated in suburban
Christ Church.
The Town and Country Development Planning Office (1988)
has divided Barbados into nine topographical areas (Figure
2-6). In the northern cap is the flat St. Lucy Plain (1).
Below the First High Cliff area (2) lies almost the entire
western beach coast, 20-25 meters (66-82 feet) above sea
level. Below the Second Cliff area (3) the region is
divided into three sub-regions of terraces. About 35 meters
(116 feet) above sea level is St. George's Valley (4), a
synclinal structure and relatively small component of the
island, and to the east of that lies St. Philip Plain (5), a
very flat and poorly drained region. To the north and in
the center of the island is the Upland Plateau (6), with
dramatic variations of gullies and low terraces to
elevations from 130-330 meters (430-1090 feet). An
anticline of over 130 meters (430 feet) makes up the
southern Christ Church Ridge Unit (7). Finally, there is
the Scotland District (8 and 9) in the northeast, the most
distinctive of the regions, due to the heavy erosion and
subsequent exposure of underlying geological formations
consisting of shales, sands, silty clays, and marl (see Town
& Country Development Planning Office 1988).

66
Figure 2-6. Geophysical Subdivisions of Barbados. Numbers
correspond to the following regions: (1) St. Lucy Plain,
the flat, northern cap of the island; (2) First High Cliff
area, below which lies the western beach coast, 20-25 meters
(66-82 feet) above sea level; (3) Second Cliff area, divided
into three sub-regions of terraces; (4) St. George's
Valley, 35 meters (116 feet) above sea level; (5) St. Philip
Plain; (6) Upland Plateau, with elevations from 130-330
meters (430-1090 feet); (7) Southern Christ Church Ridge
Unit, an anticline of over 130 meters (430 feet); (8) & (9)
Scotland District. Figure adapted from map obtained with
permission by Town & Country Development Planning Office
1988.

67
There is significant variation in annual and seasonal
rainfall and, because of the terraced structure of the
island, rainfall varies considerably from region to region
(Figure 2-7). The Barbados Society of Technologists in
Agriculture compiled a list of monthly and total rainfall
figures in Barbados from 1847 to 1983 and found an annual
low of 39 inches in 1947 to a high of 91.5 inches in 1901
and an average annual rainfall of 59.68 inches (1984).
Seasonally, however, rainfall averages a low of 1.90 inches
in March and over seven inches per month from August to
November, during the "rainy season" (Barbados Society of
Technologists in Agriculture 1984). Figure 2-7 illustrates
the variation of rainfall within the different regions of
Barbados, showing the greatest amount of rain falling in the
central portions of the island (an average of 80 inches) and
the lowest amount in the southern Christ Ridge region and
St. Philip (an average of 45 inches) (Plantations Trading
Co. Ltd. 1989). Areas with the lowest rainfall correlate
with the three areas with the least fertile soil, the west,
south, and southeast coasts, and these are also the regions
that are the most densely populated (Town & Country
Development Planning Office 1988).
It is apparent from the above discussion that, although
Barbados is divided into 11 parishes, parish boundaries do
not necessarily represent the topographical boundaries. The
Leeward side of the island—or West and South coast—is the

68
most heavily populated and comprises the four major urban
centers of Barbados: Speightstown, Holetown, Bridgetown,
and Oistins. Within the metropolitan boundaries of Greater
Bridgetown live 45% of the national population and the
majority of governmental operations and industry. The area
between Bridgetown and Speightstown is predominantly devoted
to tourism, as resorts line the length of the coastline.
Speightstown is a semi-urban fishing town, populated by
Barbadians rather than transient tourists. The region south
of Bridgetown toward Oistins is also a tourist region,
though this area is mixed with residential areas and
businesses and is the seat of the main fish market.
Recently there has been considerable urban tourist-related
growth in a southeasterly direction, encompassing the parish
of St. Philip. The major center in this region is Six
Roads. Although the eastern portion of Christ Church and
the parish of St. Philip are increasingly the focus of
growth for industry, the region is still largely
agricultural. The northeastern Scotland District is the
most sparsely-populated region on the island.

69
Figure 2-7. Annual total rainfall by region, in inches,
based on data from 1887-1986. Compiled by Barbados Society
of Technologists in Agriculture. Figure adapted from map
obtained with permission by Plantations Trading Company
Ltd., 1989.

70
Selected entomological and ethnographic research sites
After conferring with members of the Ministries of
Health and Agriculture, it was decided that five general
areas would be systematically selected in order to represent
the major topographical regions of Barbados. Villages
included the following:
1) Chapman Street Village - in the center of
Bridgetown, representing the most densely-
populated, urban region;
2) Oistins - Christ Church, representing a semi-
urban, coastal population;
3) Cotton Vale - a rural tenantry, north of Six
Roads, representing the St. Philip Plain and
agricultural sector;
4) Chalky Mount - another rural tenantry, but
situated in the northeast Scotland District of St.
Andrew;
5) Rose Hill - a semi-urban village, below the
Second Cliff area, just south of the St. Lucy
Plain and north of Speightstown, St. Peter.
Once a village was selected, the houses were mapped,
numbered, and listed. From that list four homes were
randomly selected. The adult present at the time of the
visit was asked to participate in the study. If a
consenting adult was not home, two subsequent visits were
made in an effort to include the household in the study. If
after the third visit no adult was home, or if that adult
declined to participate, another house was randomly
selected. This continued until four households in each of

71
the five villages agreed to participate. Figure 2-8 depicts
the location of the five sites for Phase I.
Entomological samples were collected during both the
"dry" season (January-May) and the "wet" season (September-
December). The methods and materials are presented in
Chapter Five, after which the results and discussion of
trapping are addressed.
Participant Selection and Resources
In order to select the sample population for the
biomedical testing, the following persons were consulted:
the acting Chief Medical Officer, a Ministry of Health
epidemiologist, Medical Directors of six polyclinics, the
Director of the A&E Department at QEH, a Respiratory
Medicine Specialist at QEH, and a private Internal Medicine
physician in St. Michael. With the assistance of these
persons, three major health care resource centers were
selected for choosing the sample population and included the
following:
1) five polyclinics and one outstation, the total
of which serviced patients from all regions of the
island;
2) a private practice clinic, situated in the
urban district of Greater Bridgetown and servicing
patients from all of the 11 parishes;
3) and the A&E Department at QEH, servicing the
entire Barbados population.
Figure 2-9 illustrates the resource centers used for
selecting the sample population. Notice that two of the

72
polyclinics selected were located in the parish of St.
Michael to account for the large proportion of the
population living in that parish, and two of the other
polyclinics—Sir Randall Phillip and Maurice Byer—were
located in the urban "belt”, in the major towns of
Speightstown and Oistins, respectively. Maurice Byer
services patients from the northern region of the west
coast, north of Holetown, the northern cap of St. Lucy, and
the northeastern Scotland District. The remaining rural
residents in the southern Scotland District region are
serviced in part by the Gall Hill outstation in St. John.
The private physician's clientele were mixed; many were from
the lower socioeconomic strata, who preferred to use a
private physician rather than a polyclinic and others were
middle- and upper-income clients, many of whom lived in the
suburban terraces and heights8.
Three-hundred and fifty children between the ages of
five and 18 years were systematically selected from the
health care centers. Each asthmatic patient attending one
of the selected clinics was asked to participate until a
total of 175 asthmatics was obtained; in the event that the
parent/guardian agreed to participate, the next non¬
asthmatic child attending the clinic that matched the
asthmatic by age and sex was selected, until 175 controls
were obtained. Because of the systematic selection process,
if the patient to be seen was accompanied by siblings or

73
relatives, asthmatic or non-asthmatic, the other children
were asked to participate as well. The only exclusion
criteria was that the child must either be an asthmatic or
non-asthmatic; other types of atopies were not included
(e.g., hay fever). Selection of asthmatics was based on a
positive history and physical examination and criteria
included previous attacks, diagnoses and treatment for
asthma. The history and physical are the primary means for
diagnosis of asthma in Barbados; diagnostic tests such as
serum titers, bronchial challenge tests, and skin tests are
not practiced routinely, largely due to prohibitive costs.
A "selection criteria" form was designed, approved by the
acting Chief Medical Officer, and completed for each child
(asthmatic and control) to confirm or eliminate a diagnosis
of asthma.
At the time of selection the parent/guardian of the
child read and signed a written informed consent and was
assigned an appointment for the allergy testing at one of
the six chosen polyclinics. The parent/guardian was asked
to choose the polyclinic that was closest to the child's
home and instructed to withhold antihistamines, ephedrine,
or asthma medications 24 hours prior to the testing. In the
event that medications had to be administered, the
appointment was rescheduled. Parents were reminded of the
appointment by telephone 24-48 hours before the test. If

74
that household did not have a telephone, the nearest
relative or neighbor with a telephone was contacted.
Clinical Testing and the Interview Schedule
The allergy test included skin testing (scratch and
intradermal) to various household pests (note: details of
the skin test procedure are described in Chapter Six).
Controls did not undergo the skin test due to the difficulty
in recruiting non-asthmatic participants for this aspect of
the testing; the skin test involved a battery of 11
extracts, requiring a minimum of 11 scratches and
potentially 11 injections. Receiving no personal benefit
from undergoing this procedure, parents and non-asthmatic
children were unlikely to volunteer as controls and it was
deemed unethical to subject them to the procedure. To
assure validity of the test within the asthmatic population,
a negative control was used in both the scratch and
intradermal test. Exclusion of non-asthmatics from the skin
testing procedure was further substantiated by the overall
objective of the study, which was to determine which
features of the domestic environment were contributing to
the likelihood of asthmatics developing allergies to certain
pest species.

75
Figure 2-8. Location of selected communities for the
entomological and ethnographic surveys.

76
Figure 2-9. Resource centers for the asthma study sample
population.

77
The questionnaire, designed from ethnographic data
collected during Phase I, was pre-tested on a randomly
selected population (N=10) prior to operationalizing Phase
II and included informants who were parents of asthmatic
(N=5) and non-asthmatic children (N=5) from the five
villages in which Phase I was conducted, but not from the
same households. The questionnaire was revised and pre¬
tested again on another randomly selected population (N=10),
equally divided between parents of asthmatic and non¬
asthmatic children and also from the five villages.
Following the pre-testing phase, the final
questionnaire was divided into two sections so as to
minimize the risk of informant fatigue and annoyance during
the interview. The first section was administered in the
clinic prior to the allergy testing and serum collection.
An appointment was made in the clinic for a home visit so
that the second section of the questionnaire could be
administered. In the event that a home visit was not
possible due to time constraints, a telephone interview was
conducted.
The questionnaire included three general topics:
sociodemographic information on the child's residence and
structural information on the dwelling; the informant's
perceptions, knowledge, and behavior associated with health
and illness in general and asthma in particular; and the

78
informant's perceptions, knowledge, and behavior associated
with household pests and pest-related disease.
Sub-Setting the Sample Population
As described, the overall objective of the study was to
determine the relationship between sociodemographic and
architectural independent variables with the dependent
variable, hypersensitivity to individual household pests.
Seven asthmatic children and eight controls were eliminated
from the study after the trials and interviews because
either their classification of "asthmatic" or "control" was
questionable, or a follow-up interview could not be
administered. The group of asthmatic children who underwent
skin tests to determine the pests to which they were
allergic comprised the "asthma population" (N=168).
Controls (N=167) were used to compare informant responses
regarding perceptions, knowledge, and behavior related to
health care and asthma. The combination of asthmatics and
controls made up the total "study population" (N=335).
To conduct bivariate analyses on the sociodemographic
and structural variables and to construct a socioeconomic
index to be included in these bivariate analyses, it was
necessary to reduce the total study population to the
household level. The rationale for this breakdown is the
fact that 72 informants had more than one child in the
study; therefore, the weight of that informant's response
would be greater than that of an informant with only one

79
child in the study, resulting in a "pseudoreplication" of
responses and misleading correlations.
Consequently, one child from each household was
selected randomly from the total population, regardless of
his/her classification as asthmatic or control, using the
Q&A database program (Symantec Corp. 1991), and data on that
child and his/her household was entered into a subset
referred to as the "household sample". The total household
sample size was 177 (after disqualification of cases with
insufficient or ambiguous data). Bivariate analyses on all
of the independent variables were first administered on this
sample population to identify correlations and selection of
the appropriate independent variables that would later be
analyzed for the asthma population.
Identifying and Classifying the Independent Variables
The word "modernization" connotes the up-grading of
standard of living at both the population and the household
level. Standard of living at the population level is
typically measured by socioeconomic indices such as per
capita income, quality of housing, and quality of life
factors, including health. In this respect, Barbados fares
well according to U.N. standards.
Standard of living at the household level may vary
tremendously within a population and can be used to
represent the degree of class disparity in a given society.
While Barbados enjoys a high standard of living compared to

80
other developing countries, in no way is Barbados a
"classless society", as there clearly exists a significant
degree of class consciousness and stratification (Dann 1984;
Potter 1983a,1986). For example, nearly a quarter of the
population lived below the poverty line between 1980 and
1988 (United Nations 1991). In order to classify
respondents according to socioeconomic status, an attempt
was made to create a socioeconomic index variable.
Designing a Socioeconomic Indicator
Graham Dann, a Barbadian sociologist, conducted a study
entitled "The Quality of Life in Barbados" (1984), in which
he addressed a number of socioeconomic and sociodemographic
issues in contemporary Barbados. He discussed the weakness
of most studies in the Caribbean prior to his own study, in
that the classification of socioeconomic status was usually
based on a single indicator, such as income or occupation,
thus failing to recognize "...that social class is multi¬
faceted" (1984, p.30). In response, Dann constructed a six-
item index for measuring socioeconomic status among his
sample population, which included the following: (1) social
mobility (based on the improvement of residential location
and real income); (2) income group (reported monthly income,
grouped into quintiles); (3) occupation (5 categories, in
ascending levels of skill); (4) home ownership; (5)
amenities, (household possessions); and (6) education
(primary, secondary, and tertiary). Dann's index was

81
integrated into the asthma study questionnaire, but during
the analytical phase of the project, certain weaknesses were
realized regarding the application of this scale to the
asthma study.
Income
Reported income as a measure of socioeconomic status in
the Caribbean is unreliable for several reasons. One
problem is the predominance of a working class, which is
quite different than that seen in industrialized countries
(Dann 1984). Particularly in Barbados, credence must be
given to the importance of remittance as income secondary to
large-scale emigration (Roberts 1955; Cumper 1959; Ebanks et
al. 1979). Other influencing factors in household income—
and often undermined—are contributions from the informal
sector, underemployment, and the seasonality of’jobs. For
example, Dann (1984) reported that, of the 6,900 - 7,000
laborers in the sugar industry, 2,500 - 3,500 were seasonal
crop workers.
Not surprisingly, and probably due to a combination of
these factors and others, failure to report combined family
income was relatively frequent in the asthma study
population; 17 informants (9.6%) gave no information
whatsoever when asked what the monthly income was for the
household. Twenty-eight informants (16%) stated that she/he
had "no idea" what the entire household earned on a monthly
basis and could only report her/his own or one or more

82
family members' income, but not the entire household. Thus,
only 132 informants out of 177 (75%) reported what they
believed to be a combined monthly income for the household.
In this particular study, informant inaccuracy was
compounded by another complication, but historical in
nature. The year 1991 was one of the most turbulent in
Barbadian history at the econo-political level, as the
unstable world economy, inflation, and the alleged financial
mismanagement in the public sector resulted in a seemingly
irreparable debt crisis, necessitating the request for a
loan from the International Monetary Fund. The subsequent
Letter of Intent mandated a number of economic reforms, such
as civil pay cuts, job cuts, inflation, and threats of
devaluation, sometimes resulting in dramatic changes in
household income during the period of July to December,
precisely when Phase II of the asthma study was being
implemented7.
Occupation
Dann (1984) included type of work, or "occupation", in
his social index. He classified occupation according to the
type (unskilled manual, skilled manual, white collar, and
professional/managerial). Similar to the problem of
reported income, a weakness in relying on occupation as a
measure of socioeconomic status is the relatively high
frequency of underreporting in the informal sector (e.g.,
cottage industry) and the seasonality of certain jobs.

83
Therefore, it was decided not to rely upon this variable in
the socioeconomic index. Underreporting of occupation was
in fact empirically evident in the study. In one case, an
informant reported that her husband was employed as a
postman. During the home visit, the author noted that the
informant's husband, after changing out of his postal
uniform, apologized for not being "more sociable", but he
needed to "get to work at [his] second job", as a seamster,
in the adjacent room. The informant had only reported that
her husband was a postal worker; the informal job, and no
doubt a significant contribution to their monthly income,
was not reported.
In other cases, informants appeared embarrassed to
report employment that was not traditionally "formal." For
example, it was not discovered until the home interview that
an informant's brother was a jet skier who sold jet ski
rides to tourists; he had been classified as unemployed by
the informant in the clinic. Remittances as a form of
household income were never documented on the questionnaire,
but were sometimes revealed during casual conversation with
an informant.
Amenities
The degree to which people spend their money on
nonessential household items reflects the amount of "extra"
income available to the household. Tallman & Ihinger-
Tallman (1979) concluded that people living in developing

84
countries that have reached an advanced stage of
modernization tend to focus on material attainment more than
their less developed counterparts. Comparing families in
four rural Mexican villages to blue collar Mexican
urbanites, the following was noted: "...whereas the village
children sought primarily to make as much money as they
could, the Michoacan urban children sought high status jobs
and the opportunity to spend the money they earned on
consumption items" (1979, p.231). Further, persons living
in developed societies focus less on material gains
altogether than they do on fostering interpersonal relations
(Tallman & Ihinger-Tallman 1979). It was believed that
Tallman and Ihinger-Tallman's study applied, to a degree, to
the Barbadian population and "amenities" was considered in
the index.
Dann (1984) included "material possessions" in his
socioeconomic index by creating a 10-item Guttman scale.
Items were arranged in order of decreasing popularity. Dann
found statistically significant correlations between
"consumer durables" and occupation, income, and social class
and concluded that material possessions were highly
associated with Barbadian social standing (1984). After
completing the participant observation phase of the asthma
study, Dann's amenities list was adjusted slightly and
incorporated into the questionnaire and included 22
different items.

85
A bivariate analysis was performed on all of the items
to determine which amenities were strongly related to each
other. Amenities that were correlated to only a few other
items, or weakly correlated to most items, were discarded.
Frequency distributions were calculated for the remaining
nine items, and these items were then arranged in order of
declining popularity. Table 2-5 illustrates the number of
households that owned one or more of each amenity item.
Table 2-5. Frequency distribution of amenities by
household (N=177).
Amenities
Number of
households
owning at
least one
Percentage
distribution
of amenities
for total
TV (color/black & white)
167
94.4
Radio
165
93.2
Refrigerator
160
90.4
Telephone
135
- 76.3
Clock
114
64.4
Automobile
54
30.5
Washing machine
42
23.7
Solar heating
20
11.3
Burglar proofing
9
5.1
After determining the frequency distribution of the
nine amenities, the items were weighted according to their
order, creating a nine-item Guttman scale, then totaled.
The result was a potential range of zero (in which case the
informant had none of the items) to 45 (the informant owned
all nine items).

86
Monthly expenses
In addition to household income, informants were asked
to calculate monthly "cost of living" expenses, which
included the following list of 20 estimated expenditures per
month:
- water
- electricity
- telephone
- bottled gas
- other gas
- furniture - high purchase/credit8
- appliances - high purchase/credit
- other high purchase/credit
- cable/satellite television
- bus fares
- car/motorbike expenses (gas, insurance)
- food
- land rent
- house rent/mortgage
- domestic labor
- child's educational expenses
- medical expenses (visits, prescription
medications, non-prescription medications)
- pest control service
- rat/mice baits/poisons
- insecticides, sprays, coils, vape mat (mosquito
control), baits
The sum of this list equaled the "total monthly expenses"
variable and ranged from $165 per month to $3,196 per month.
The "total monthly expenses" figure was assumed to be the
minimal monthly expenditure for the household and therefore
the minimal monthly income required to support these
expenses. A frequency distribution was plotted and divided
into quintiles (Table 2-6) .

87
"House-related" variables
Because the primary objective of this study was to
determine which independent variables associated with
modernization of the home were most important in predicting
the development of allergy to household pests, it was not
possible to include any factors
Table 2-6. Distribution of total monthly expenses in the
household sample (N=177).
Expense range
($ per month)
Frequency
Percent
165 - 569
33
18.6
581 - 789
37
20.9
812 - 1,040
36
20.3
1,043 - 1,276
35
19.8
1,295 - 3,196
36
20.3
associated with the house in a socioeconomic index. This
included variables of structure, ownership patterns,
household density, and geographical location (urban/rural).
Each of the following "house-related" variables were
identified as separate independent variables and correlated
against each other and against selected socioeconomic and
sociodemographic variables. The variables include the
following:

88
1. geographical location (urban/rural)
2. parish
3. demographic region
4. home ownership
5. land ownership
6. building material for the foundation of the
house
7. building material for the walls of the house
8. presence of a crawl space under the house
9. proportion of a finished ceiling
10. presence of carpeting
11. number of windows
12. number of rooms in the house
13. presence of an indoor toilet
14. presence of an indoor shower
15. total number of indoor water taps
16. ratio of total number of occupants by the
total number of bedrooms
17. age of the home
The results of the bivariate analyses for "house-related"
variables are presented in Chapter Four.
Creating the wealth index
Having eliminated all possible variables except for
amenities and total monthly expenses for the purpose of
creating a wealth index similar to that presented by Dann
(1984), a bivariate analysis was performed on these two
remaining variables. While a correlation coefficient gave a
statistically significant outcome (r=0.38, p=0.05), a
general linear model (GLM, SAS Institute 1988) indicated
that only the fifth quintiles of the "total monthly
expenses" distribution differed significantly (Tukeys means
separation) from all other quintiles when compared to
"amenities."
In order to identify the most predictive elements of
the "monthly expenses" variable, a bivariate analysis was

89
conducted for each expenditure on the list of monthly
expenses by the amenities score and by each of the ’’monthly
expenses" variables. No single variable for "monthly
expenses" was consistently predictive (at the p=0.05 level);
however, relatively high correlation coefficients were
evident for a few of the variables. These correlations were
not appropriate because they were strongly influenced by
only a few high values, and when they were tested by
"TableCurve" (Jandel Scientific 1991) the best fit equations
exhibited such low r2 values that the variables were deemed
predictive for only a few observations and not for the
entire population.
Although the variable "monthly house rent/mortgage" had
a very low correlation coefficient, when all of the
"expense" variables were viewed on a scatterplot against the
variable "amenities", the best relationship over the range
of amenities was "house rent/mortgage." This relationship
was then modeled using a nonlinear regression analysis
(TableCurve v3.10) (Jandel Scientific 1991). Figure 2-10
illustrates the analysis. The model only accounted for 33%
of the variability and again, only reflected those
observations at the high end of the "amenities" score.
In conclusion, it was decided that a wealth index could
not be created for the asthma study sample by collapsing any
of the traditional socioeconomic variables into one index.
The only "monetary" variable used in the study was

90
"amenities”, although construction materials (e.g.,
concrete) are, indirectly, representations of both social
and financial status in Barbados and therefore a very strong
indicator of wealth. Failure to delineate participants into
"class" reduces the risk of imposing subjective values upon
the construct of "modernization", recognizing modernization
as a process rather than an achievement. Having exhausted a
number of methods of analysis on all of the income-related
variables, it was concluded that households could
objectively be classified according to socioeconomic status
based on "amenities." Consistency of the "amenities"
variable is evident (mean=16.6, median=15, mode=15).
"Amenities" was correlated with a number of sociodemographic
indices, including the following: gender (higher scores
associated with male informants) (t=2.33; df=175.0, equal
variance; p=0.02), age (higher scores associated with older
informants) (r=0.21, p=0.005), and education (higher scores
associated with a higher degree of education) (f=4.59; df=2,
174; p=0.01). The variable was also weakly correlated to
the percent of employable adults in the household currently
employed (r=0.13, p=0.07).

monthly house rent/mortgage
1200
100C
800
600
1
v.
i
i
r
L
â– 
r
L
â– 
â– 
â– 
â– 
â– 
â– 
r
â– 
u a
â–  i
i
i
1 i
i
i
1 ,
â– 
â– 
r i
H â– 
â–  â– 
â–  â– 
i
i â– 
â–  â– 
h**iJ
400
200
0
0
10 15 20 25 30
Amenities
35 40 45
house rent/mort.
Y Predicted
Figure 2-10. Non-linear regression analysis demonstrating the relationship between
the variables "monthly house rent/mortgage" and "amenities." The model equation of
y=63.148-0.328xy+.014x3 has a coefficient value of r2=0.34.
VO

92
Demographic Characteristics of the Sample Population
Spatial Distribution
Ninety-six (54.2%) informants lived in the urban sector
and 81 (45.8%) lived in the rural sector. Figure 2-11
depicts the distribution of households by parish,
demonstrating an under-representation in the very rural
parishes of St. Andrew and St. Joseph at 2% and 1.7%,
respectively, but an overall representation of the rural
parishes of St. Lucy, St. Andrew, St. Joseph, and St. John
at 21%. A combined rural population of nearly 46% is, in
fact, higher than the national estimated 38% rural sector
based on data from the Town and Country Development Planning
Office (1988), and conversely, the 54.2% urban population is
less than the estimated 62% urban sector. A closer
examination of breakdown by demographic region is
illustrated in Table 2-7.
Table 2-7. Distribution of residences by demographic
region (N=177).
Region
Frequency
Percent
Densely populated (within
2 miles of Bridgetown)
44
24.9
Semi-urban
39
22.0
Peri-urban (in urban district,
visible agriculture)
11
6.2
Suburban height/terrace
5
2.8
Rural tenantry
75
42.4
Government housing, rural
1
0.6
Mixed rural (tenantry/NHC)
2
1.1
Total
177
100.0

93
Figure 2-11. Spatial distribution of households by parish,
for the asthma study population.

94
For the total population, 55.4% of the asthmatics were
urban compared to 51.5% urban controls. Table 2-8 depicts
the spatial distribution of the total population. The
majority of the children were chosen from the polyclinics
(N=263), (59.5% of the asthmatics and 97.6% of the
controls). Fifty-seven (34.0%) of the asthmatics and four
(2.4%) of the controls were chosen through the private
physician's office, and only 11 (6.5%) of the asthmatics and
no controls were selected from the A&E Department. There
are several reasons for the heavy concentration of controls
selected from the polyclinics. By virtue of the volume of
children seen each day in the polyclinic, the opportunity
was greatest there for asking persons to participate.
Secondly, the private physician and the A&E Department
director both felt it was unethical to do more than mention
the study to potential controls at other health facilities,
because the patient and parent/guardian had exerted a
special effort to attend these clinics for specific health
care needs and were usually preoccupied with resolving that
need. The low number of asthmatics recruited from the A&E
Department was partially due to the fact that usually the
children attending the asthma bay were in status
asthmaticus. and all efforts were concentrated on resolving
the immediate crisis—an asthmatic attack—rather than
discussing the study.

Table 2-8. Spatial Distribution of the Total Asthma Study Population (N=335).
Reaion
Asthmatics
Frequency Percent
Controls
Frequency
Percent
General:
Urban
93
55.4
86
51.5
Rural
75
44.6
81
48.5
Parish:
Christ Church
14
8.3
4
2.4
St. Philip
13
7.7
9
5.4
St. John
20
11.9
25
15.0
St. George
6
3.6
5
3.0
St. Joseph
3
1.8
0
0
St. Andrew
3
1.8
5
3.0
St. Lucy
6
3.6
5
3.0
St. Peter
20
11.9
19
11.4
St. James
16
9.5
17
10.2
St. Michael
58
34.5
69
41.3
St. Thomas
9
5.4
1
0.6
Demographic region:
Densely populated
39
23.2
52
31.1
(within 2 miles of
Bridgetown)
Semi-urban
40
23.8
25
15.0
Peri-urban (in the
urban district,
visible agriculture)
12
7.1
5
3.0
Suburban height/
terrace
5
3.0
0
0
Rural tenantry
69
41.1
85
50.9
Mixed rural (height/
terrace, government
housing, tenantry)
3
1.8
0
0
Total:
168
100
167
100
Total
U1

96
Personal and Socioeconomic Characteristics
The mean age was 9.7 years for the asthmatic population
and 9.9 years for the controls. There were 78 girls (46.4%)
and 90 boys (53.6%) in the asthma group and 87 girls (52.1%)
and 80 boys (47.9%) in the control group.
Of the 177 informants, 165 (93.2%) were female and 12
(6.8%) were male. The mean age of informants was 35.6 years
(median=34, mode=28). The range was 17 years to 81 years.
In two cases the informant was also the patient; these
informants were a 17-year-old female and an 18-year-old male
and were deemed capable of providing reliable household and
health-related information because they both were reportedly
responsible for the other members in the household (mother
and grandmother, respectively). All informants were black
except for one male who was Caucasian and one female who was
East Indian. All children in the study were phenotypically
black.
Marriage and family patterns have been well-described in
the Caribbean in general (Clarke 1957; Solien 1960; Smith
1962; Rubenstein 1977) and in Barbados specifically (Byrne
1966; Nag 1971; Ebanks et al. 1974; Dann 1984, 1987). As in
other Caribbean cultures, conjugal relationships in Barbados
are not dichotomous in nature; even the census bureau
recognizes this characteristic by delineating "union status"
as either married, common law, visiting, separated/divorced
from married partners, separated/divorced from common law

97
partners, and never married or never in a common law
relationship (1980/1981 Population Census 1985). Legal
marriage typically occurs later in life; for example, from
the 1980 census, 41% of women between 14 and 44 years were
married and 59% of women over 44 years were married
(1980/1981 Population Census 1985). Currently in Barbados
the number of children born to unwed parents is approximately
75%, but more importantly from a socialization standpoint is
the fact that over 38% of households are headed by a single
female (Dann 1984).
In the asthma study, 61 (34.5%) of the informants
reported that they were single and 88 (49.7%) were married or
in a common-law union. Table 2-9 illustrates the breakdown
of unions by informants.
Table 2-9. Frequency and Percent of Types of Unions per
Informant (N=177).
Type of Union
Frequency
Percent
Single
61
34.5
Visiting
19
10.7
Common-law
51
28.8
Married
37
20.9
Widowed
3
1.7
Separated/divorced
Separated/divorced,
and living with
5
2.8
another person
1
0.6
Total
177
100
Dann found that marital status was positively correlated to
both income and age (1987). Similarly, in the asthma study,

98
marriage was positively correlated to the "amenities" score
(f=4.73; df=6, 170; p<0.001) and to age (f=6.92; df=6, 170;
p<0.001).
As previously discussed, little credence was given in
this study to the relationship between socioeconomic status
and classification of occupation type9, although it is
worthy of mention that occupation of the informant and the
"amenities" score were strongly correlated (f=15.03; df=7,
169; pcO.OOl). Not surprisingly, occupational status of the
informant was also positively correlated to gender (f=7.65;
df=l, 175; p=0.006) (with the relatively few male informants
being employed in the higher-ranking jobs), to education
level at the 0.10 level (f=2.78; df=2, 174; p=0.06), and to
the percent of all employable adults in the household who
were currently employed (f=14.02; df=7, 169; pcO.OOl). Only
29.4% stated that all adults living in the home were
employed, and 16.4% of the informants stated that less than
half of the adult household population was currently
unemployed. In eight of the homes no employable adults were
formally employed at the time of the study.
Analysis and Presentation
Data from the entomological surveys in Phase I and
interviews and biomedical tests in Phase II were coded and
entered into a database program (Symantec Corp. 1991). A
data set was created from the database and frequency
distributions, bivariate (Pearson's R, Chi-square, t-tests,

99
and ANOVA) analyses, and regression analyses were produced
for further interpretations, using logistic analysis
procedures for personal computers (SAS Inst. 1988).
Summary
In summary, this chapter has illustrated the make-up of
the sample population chosen to test the hypothesis that
modernization of the domestic environment provides a better
habitat for certain household pests, which in turn are
etiological factors in the disease asthma. The design of the
2 phases in which data were collected was outlined, and the
focal independent and dependent variable(s) were described.
A review of the infrastructure of contemporary Barbados
illustrates an overall "representativeness" of the sample
population. The next step in the process of proving or
disproving the null hypothesis is a review of the evolution
of the setting for this study—the Barbadian home.
Notes
1. R.P. Naidu, M.D., Director of the Accident and Emergency
Department, Queen Elizabeth Hospital, Martindales Road, St.
Michael, Barbados. Personal communication.
2. E. Ferdinand, M.D., Acting Chief Medical Officer in
1991, Ministry of Health, Jemmott Lane, St. Michael,
Barbados. Personal communication.
3. L. Prescod, Director of the Barbados Drug Service,
Ministry of Health, Jemmott Lane, St. Michael, Barbados.
Personal communication.
4. The international value of the Barbados dollar (BDS) is
fixed to the U.S. dollar at a rate of BDS 1:US 2.

5.M. Carter, President, Asthma Association of Barbados,
St. Michael, Barbados.
100
6. Services at QEH include inpatient, outpatient, and
casualty, plus eight polyclinics and five outstations,
centrally-located in each parish and easily accessible via
primary and secondary roads. In addition to the public
sector, Barbadians have the option of utilizing the private
health care sector. The 539-bed public hospital began
servicing the population in 1964. In 1990, 18,767 inpatient
admissions were accommodated and 6,590 inpatient surgeries
were performed (Sergeant, personal communication).
7. M. Sergeant, Project Implementation Design Unit,
Ministry of Health, Jemmott Lane, St. Michael, Barbados.
Personal communication.
8. Residential sub-divisions are referred to as "terraces"
and/or "heights" in Barbados. Usually they are built on
larger lots than are the lower socioeconomic homes in the
urban sector and village tenantries, ranging from 4,000 to
8,000 square feet. Terraces and heights are representative
of Barbadian suburbia, and are discussed in detail in
Chapter 3.
7. Due to the 1991 crisis, informants were requested to
report, to the best of their knowledge, household financial
information that applied to the period of time prior to the
national debt crisis of October, 1991.
8. "High purchase" is a method of acquiring household items
by credit. Items purchased via high purchase range from
kitchen appliances, furniture, carpeting, fans, even bicycles.
Particularly expensive items, such as large appliances (e.g.,
washing machine, stove) typically require a one-third cash
payment at the time of purchase, followed by monthly payments.
In 1991, Courts, one of the largest appliance stores on the
island, based high purchase payments on the cash price of the
item plus 37.7% interest. On all purchases the payment
schedule varies, but it is usually on a monthly basis for up
to two years.
9. "Occupation" was categorized using the following scale:
(1) unemployed (2) student/housewife; (3) retired; (4)
unskilled labor; (5) skilled and semi-skilled manual; (6)
skilled and semi-skilled non-manual; (7) white collar; (8)
semi-professional; and (9) professional/managerial. This
format was adapted from the Census categorization and the
study by Dann (1984).

CHAPTER 3
SETTING THE STAGE FOR A CASE STUDY: BARBADOS LAND TENURE
PRACTICES AND EVOLUTION OF THE BAJAN HOUSE FORM
A Historical Review of Land Distribution
Perhaps what makes the development of the domestic
environment in Barbados particularly unique is the role that
Barbadian social history has played—and continues to play—
in its evolution. It is specifically this historical factor
which the author believes to be most significant in
understanding the trend in Barbadian housing. In the
following paragraphs I will demonstrate this significance by
first reviewing the peopling process and subsequent
stratification of classes in early Barbados and the pivotal
role that the economy, particularly the sugar industry, has
played in these processes. Land distribution in Barbados
will be addressed, to serve as a thorough preface for
Chapter Four, an analysis of the traditional house forms.
This review, in addition to findings for the sample
population (presented in Chapter Four), will identify
specifically what elements in the Barbadian house form are
being "modernized," which, in the process, will allow the
author to qualify the term "modernization."
101

102
The Birth of Barbadian Society: The Pre-Emancipation Period
The first permanent settlement in Barbados was
established in 1627, by a group of English merchants. In
the immediate years to follow, a political squabble ensued
between the Earl of Carlisle, who obtained legal
proprietorship from the King of England and the original
merchants. By the mid-1640s Barbados was an established,
profitable English colony, engaged in a monoagricultural
industry just as its sister colonies. Focusing on the
successful Virginia colony to the north, the original
Barbadian merchants began producing tobacco, an industry
that was short-lived due to the glutted London market in
1631 and the notoriously poor quality of Barbadian-produced
tobacco. In the early 1630s the planters shifted to cotton,
followed by indigo in the 1640s; both of those markets
collapsed from oversupply, just as tobacco had in the early
years.
In 1640 sugarcane monoculture was introduced by Dutch
entrepreneurs driven out of Brazil. Sugar would dominate
the economy until the 1950s when attempts were made to
diversify agriculture and expand the manufacturing, tourism,
fishing, and government sectors, and to a lesser degree, the
production of crude oil. The establishment of the sugar
industry in Barbados marked a turning point in Barbados both
economically and socially. By the 1660s, Barbados was
perceived as the "most precious jewel of the British Crown"

103
(Williams 1970, p.114). A 500-acre plantation that sold for
400 pounds in 1640 soared to a value of 7,000 pounds by 1648
(Williams 1970). By the late 1600s, sugar exportation from
Barbados was reportedly worth 6,195,200 pounds, more than
the total exports of the American colonies (Roach 1984). In
Beckles' words, Barbados had transformed from a "struggling
frontier community to a wealthy sugar economy" in less than
half a century (1990, p.23). By the mid-1650s a planter
aristocracy had been established in Barbados, thanks to the
successful sugar industry.
Land Allocation and Stratification of the Planter Class
Until the rise of the sugar industry, Barbados was a
small farm economy. The earliest records of land
allocations between 1629 and 1638 reveal a total of 707
grants, totaling 67,929 acres, at an average size of 96
acres (Campbell 1984). These figures, however, do not
include grants to the original settlers, most of which were
100 acres or more. In 1645, the less than 100,000 arable
acres in Barbados were divided among 18,300 white men, and
of those, 11,200 were proprietors, most of whom held less
than ten acres of land (Williams 1970). The reference of
"ten acres" bears significance. In the first land grand of
1630, the governor at that time, under the direction of the
Earl of Carlisle, distributed parcels of 100 acres per "ten
men", which reflected a law stating that a landowner was
required to employ "one man for every ten acres which he

104
possessed" (Campbell 1984, p.119). The law was designed to
insure that all indentured servants would receive their due
parcel, ten acres, at the termination of their servitude,
thereby assuring the colony a large white population. The
law actually set a precedent in which only men owning ten
acres or more were considered "freeholders" and could vote,
as opposed to those owning less than ten acres, or
"freemen," who could not vote. The important point,
however, is that within five years after the introduction of
sugar monoculture, and less than two decades after the
original settlers, all of the arable land on Barbados was
parcelled. Single-minded business ventures focusing on
monoculture industry—first tobacco and eventually sugar—
necessitated the swift and thorough removal of rain forest
vegetation. By 1670, the relatively flat island was
virtually transformed into a 166 square mile cane field, as
all arable land was under sugar cultivation (Beckles 1990).
An important determining factor as to who would become
a successful sugar planter with the introduction of cane to
Barbados was the size of the land holding a proprietor owned
prior to the introduction of cane agriculture. Sugar cane
required three times the labor force and livestock needed
for other plantation crops. In comparing average sugar
plantations versus nonsugar plantations in Jamaica in 1774,
Williams concludes that the sugar plantations had two and a
half times more acres, more than five times the labor force,

105
and twice as much livestock as the nonsugar-producing
plantations (1970). Furthermore, because of the investment
necessary in labor, livestock, and equipment for sugar
processing, more acres were required for the return in
capital. The tobacco farmer who owned only 20 or 30 acres
of land had to purchase his neighbor's property and increase
his landholding if he wanted to become a competitive
plantocrat, or sell off his small parcel to a wealthier
landowner and leave the sugar business altogether (Watson
1970). It has been calculated that a profitable sugar
plantation required up to several hundred acres, depending
on the topographical location of the land, and as much as
one laborer for each acre of cane, or at least a ratio of
1:2 (Dunn 1972). An interesting feature in the Barbados
case was the subdivision of particularly large properties
into smaller, more manageable estates of 300-500 acres
(Beckles 1990). This is in contrast to other sugar-
producing colonies in the West Indies; for example, the
average size of a sugar plantation in Jamaica was 441 acres
and a number of Jamaican plantations were larger than 2,000
acres (Williams 1970).
Substantial land consolidation did occur between 1650
and 1665, but Beckles (1990) warns that the degree of
consolidation has been exaggerated in the literature. For
example, Williams (1970) noted that by 1667 there were only
745 plantation owners, with holdings ranging in acreage from

106
200 to 1,000 and an average size of 300 acres. While the
acreage estimates are accurate in this summary for the most
prominent planters, the total number of land owners is
seriously underestimated. Census data from 1680
demonstrates that there were in fact 2,639 property holders
and the majority of those were small farmers, with a mean
farm size of 29 acres (Dunn 1972). That same census
included a classification of Barbadian property holders,
divided into 175 big planters (those with 60 or more
slaves), 190 middling planters (those with 20-59 slaves),
and small 1,041 planters (those with 10 or more acres, and
zero-19 slaves) (Dunn 1972). The number of "freeholders"
totaled 1,125 and freemen totaled 1,186 (Dunn 1972).
Dunn (1972) refers again to the 1680 census in his
discussion of the emerging planter elite. Although those
175 "big planters" represented only 7% of the total property
holders, they owned 54% of all property. This factor alone
was not unique to colonial West Indian plantocracy; in fact,
it was quite typical. But what made the Barbadian
plantocracy unique was the fact that many of the big sugar
magnates of the eighteenth century could trace their
ancestry to the earliest settlers of the 1630s and 1640s,
and this, they believed, gave them the inherent ability to
politically and economically control Barbados (Watson 1979).
In fact, only 20% of the 175 biggest planters from the 1680
census arrived in Barbados after the development of the

107
sugar economy in the 1650s. Watson (1979) explains that, by
reviewing land ownership, military rank, and public offices
held, approximately 120 families can be identified as the
most dominant and influential in Barbadian history, and many
of these families are still considered the "high whites" of
Barbados today. From 1675 to 1685, 109 of the 175 big
planters held at least one office, the more important
offices being limited to men owning larger portions of land
(Dunn 1972) .
Another historical difference between Barbados and its
counterpart colonies is that it never experienced the same
degree of absenteeism as did, for example, Jamaica, although
the financial ability to act as an absentee planter was an
aspiration of most planters and was practiced on a small
scale. Absenteeism was initially deterred in Barbados by
seventeenth century laws that restricted re-election to
prestigious offices to men currently residing on the island
(Dunn 1972) . A significant constraint for most planters was
the relatively small size of their land holding, a factor
that limited absenteeism since profits were insufficient to
maintain a life of luxury back in England. Beckles (1990)
attributes low rates of absenteeism to the "patriotic
consciousness" of the planter elite that climaxed during the
American Revolution, as Barbadian demands for greater
political autonomy ensued. Indeed, absenteeism remained
quite low between 1700-1825; Watson (1979) notes that, from

108
a list of 54 prominent planters over the 125-year period,
only 3 were absentee-owned for that span of time.
Another factor contributing to the low rate of
absenteeism—and indirectly to the creation of a stable
white upper class—was a sort of "permanent" mentality among
the planter elite, a notorious attribute of which they
received much comment and even ridicule. To Barbadians, the
fact that they were Barbadian-born and could trace their
ancestry to the earliest settlers evoked a greater sense of
pride than did their English ancestry. As Karl Watson
notes, this emotion was and still is viewed by the outsider
as a "...somewhat ludicrous... emotion which borders on
xenophobia for what is, after all, a rock in the ocean..."
(1979, p.34). Nevertheless, it can be argued that the
permanent white plantocrats contributed significantly to the
stability of Barbadian society in their effort to recreate
the elite country lifestyle of England and in their
perseverance to succeed for generations in the production of
a crop that was both suitable and profitable for the island.
A series of boom periods and disastrous episodes served
to forge a cohesive class of planter elite and further
solidified their allegiance to Barbados. By the end of the
seventeenth century profits from sugar lowered, secondary to
competition from other West Indian countries who had
successfully penetrated the large-scale sugar economy
(Beckles 1990). Declining yields and soil erosion

109
contributed to losses in profit and served to further
marginalize the small planter (Beckles 1990). Beckles
(1990) explains that, while Barbados contributed nearly 42%
of the total sugar exports to England in the years 1700 to
1704, their share dropped to less than 6% by 1779. War
throughout the eighteenth century resulted in losses at sea
and a shortage of investment funds for the colonies, and
natural disasters such as the yellow fever epidemic of 1703,
the hurricane of 1731 and again in 1780, and the drought of
1733-1734 took a toll on human life as well as the
infrastructure in general (Hoyos 1978; Beckles 1990). But
these disasters were interspersed with brief moments of
prosperity, including the damage to sugar industries in
Guadeloupe and Martinique during the Seven Years War, a
sudden rise in prices between 1789 and 1794, the slave
revolution in St. Domingue, and relaxed trading with the
United States by the end of the century (Beckles 1990).
A substantial white middle class had emerged by the
mid-eighteenth century, constituting some 25% of the total
white population (Watson 1979). This group was subdivided
into an upper and lower middle class and stratification was
based on land ownership. Many of these planters were
engaged in the cultivation of cotton and a number of the
larger of these middle class planters were propelled into
the elite class in the following century. The "lower"
middle class yeomanry concentrated on cotton, livestock,

110
ginger, vegetables and ground provisions (Watson 1979).
Despite the seemingly high number of small landholders
operating in the 1680s, a large number of white laborers and
small planters emigrated from Barbados in the 1660s and
1670s (Chandler 1986; Alleyne & Fraser 1988). By 1682 the
large-scale movement had carried nearly 30,000 people away
from Barbados; whereas the white population had equalled the
slave population in the 1650s, the ratio in the 1680s was
just under 20,000 whites to 60,000 black slaves (Chandler
1986).
Indentured Servitude and a White Lower Class
Initially, Barbados was peopled by merchant
entrepreneurs and indentured white servants. During the
1630s and 1640s, indentured servants comprised more than
half of the white population (Beckles 1990). In general,
the white servants were Scotch, Irish, and English. They
included the following: voluntary servants who, for various
reasons, migrated under the Indenture System and contracted
their services for a period of five to seven years;
convicts, sold into hard labor, or "Barbadoed," for a usual
period of 10 years, in lieu of the death penalty; and
political prisoners or prisoners of war.1
Even after the introduction of sugar and the concurrent
demand for large-scale labor, Barbadian planters preferred
white indentured servants over African slaves,2 at least
initially. Beckles (1981) contends that the reasoning

Ill
behind this preference had to do with the literacy and
technological skills necessary for the sophisticated process
of sugar manufacturing, skills with which they were probably
already familiar due to the agro-industrial revolution in
England. In fact, in the 1660s, the English mercantilists
were complaining about the "technology drain" resulting from
the servant trade to the West Indies (Beckles 1981).
Increasingly was the problem of what to do with
servants at the end of their term, due to limited
subsistence options secondary to land scarcity and the
prohibition of colonial manufacturing, as decreed by the
Crown. Despite the policy of the 1630s, the emerging class¬
conscious plantocracy prevented land distribution to freed
servants by misinforming the governor of the number of
servants that they actually owned, thereby allowing the
planters to continually enlarge their own estates, which
ultimately increased their political and economic hegemony
(Beckles 1980). The planters succeeded in this deception by
giving the 10 acre plots to their children, who would appear
in the census as freemen. Consequently, freed servants
became overseers, wage workers, and artisans, but did not,
on the whole, engage in subsistence farming; only the highly
skilled artisans eventually accumulated enough capital to
become landowners. Their servitude was often prolonged
following the passing of the 1661 Servants Act, an act to
extend the length of servitude and designed to maintain an

112
adequate labor force by penalizing servants for every minor
offense (Watson 1970; Beckles 1981).
The gradual replacement of white servants with African
slaves,3 coupled with the scarcity of land, contributed to
a new social strata—a white wage proletariat. These
peasants were restricted to the rab lands of the east and
north coast parishes, regions that were topographically
undesirable for the production of sugar and marginal in
their capacity for subsistence farming (Watson 1970, 1979;
Roach 1984). The rab lands where most of the poor whites
settled were the hilly regions, and the parish of St. Andrew
was increasingly referred to as the "Scotland District."
While it has been inferred that these freedmen settled in
the Scotland District because of its physical resemblance to
their homeland (Roach 1984), a more plausible explanation is
the fact that the marginal soil of the eastern parishes was
the only land that they could secure, as the plantocrats had
little use for it. The poor whites were often described as
living in conditions at least as bad, if not worse, than the
black slaves, and they were despised equally by white and
black Barbadians.4 In fact, they typically incurred a
lower standard of living in the transformation to freedmen
because their wages were less than those of indentured
servants.5 According to Roach, "...[t]he provision allowed
to the indentured Red Leg was five pounds of salt fish or
salt meat per week and a few yams or sweet potatoes. After

113
working for 5 or 7 years some of these servants received the
princely sum of 1-15.0 pounds" (1984, pp.138-9).
Subsequently, indentured servants became the lower class
whites of Barbados, an anomaly in West Indian social
history.6
African Slaves: An Alternative Labor Source
A nominal number of African slaves were introduced to
Barbados with the first English settlers. Prior to the
introduction of sugar, Barbados had a ratio of one African
slave to three white men (Williams 1970). By 1700 that
ratio was reversed—there were 15,400 whites and 50,100
blacks (Beckles 1990). The point in time in which the
African population apparently reached significant numbers7
is evident in the passing of the "Act for the better
ordering and governing of Negroes" in 1661 (Dunn 1972). The
1661 Code was revised in 1688, and the new Code legally
suppressed cultural behavior such as the use of drums and
other instruments and re-classified slaves as real estate
rather than chattel, thus eliminating their right to own
property (Dunn 1972).
By the end of the seventeenth century a significant
free black population existed in Barbados. Freedom was most
often granted from masters by will and deed; between 1650
and 1725, 201 slaves were manumitted by means of their
masters' wills (Hoyos 1978; Beckles 1990). Free blacks
usually established themselves as tradesmen, tavern

114
attendants, and petty hucksters in the urban sector, and a
few gained prominence within the business community (Handler
1974; Hoyos 1978; Beckles 1990). Generally, agricultural
work was shunned because of the subservient status that it
implied (Handler 1974). Furthermore, it was difficult for
freedmen to acguire substantial portions of land, although
there were no legal restrictions against doing so; Handler
notes that when freedmen did acquire land, the spots were
generally quite small—73.3% were less than three-quarters
of an acre—and they were usually house spots in the
metropolitan region (1974).
It was not uncommon for white planters to bequeath
small plots of land to their manumitted slaves, typically
between one to ten acres, and usually—but not always—
accompanied with instructions to return the land, upon the
death of the manumittee, to the testator's white heirs
(Hughes 1981). A unique case resulted in the creation of a
entire black freehold village, which came to be known as
"Sweet Bottom Village," situated in one of the prime sugar-
producing parishes, St. George. Upon the death of Francis
Butcher in 1777, a 20-acre parcel of land was bequeathed to
seven slaves, four of whom were the mulatto children of
Butcher, and instructions for their manumission were
included. Instructions included the following:

115
Having freed 7 slaves and provided for the freeing of 2
more by Hollingshed, Francis Butcher went on to provide
for their material support. He ordered his executors
to buy 20 acres of land near Golden Ridge...The land
was to be divided into 5 equal parcels of 4 acres each.
Shingled stone houses 12 feet by 25 feet and
partitioned into 2 rooms were to be built on each 4-
acre lot. The owners of each lot were to be given
livestock and the right of access to a supply of water
from Golden Ridge... (Hughes 1981, p.270).
This Act was unprecedented, but was repeated in 1832 by a
Christ Church planter who bequeathed 36 acres to his seven
colored children and again in 1833, when the owner of
Warner's Plantation, also in Christ Church, left 29 and a
half acres to 16 colored persons (Hughes 1981). Similar
cases followed in the mid- and late-nineteenth century,
contributing in small part to a growing landed peasant
society (Dann 1984).
Acculturation of the Classes
Despite class consciousness, the increasing ratio of
black African slaves to a small, permanent white population
resulted in the inevitable process of acculturation. During
the initial stages of the sugar boom, indentured servants
worked in field gangs with African slaves on the larger
estates and played a part in teaching the slaves the
technical aspects of cane cultivation (Watson 1970; Beckles
1981). Young white creoles were exposed to African mores
and values from the time of birth, and by 1750 the fourth
and fifth generation Barbadians were commented upon by such
visitors as George Washington, who noted that "the Ladys

116
generally are very agreeable but by ill custom...affect the
Negro style" (Watson 1979, p.42).
Watson observes that it was the lower class whites who
facilitated the acculturation process in Barbados, by
serving "...as a buffer group against the enslaved
population" and the upper class whites, thus functioning
"...as a filter for African culture on the island and, as
such, were an extremely important agent in the creolization
process" (1979, p.59). On the other end of the spectrum,
"...as the white group closest to the slaves, they were
crucial to the diffusion of European culture" (1979, p.59).
The relatively small number of African-born slaves at
an early point in Barbadian history resulted in a weakening
of African traits and practices. Beckles (1990) laments
that these ethnic divisions were lost by the eighteenth
century, and by 1817, only seven percent of Barbadian slaves
were African-born, resulting in a colony with the largest
creolized slave population in the West Indies.8 Conversely,
the 1817 slave census of Jamaica reported that the African-
born slave population was 36% of the total slave population
(Watson 1979), more than five times the proportion for
Barbados. A high degree of creolization is perhaps most
evident in the area of linguistics; compared to the other
West Indian islands, Barbados has the least-developed Creole
language and the lowest percentage of African survivals.
Creolization was accelerated no doubt by a system that

117
rewarded those with the least-African traits, thus fostering
contempt among slaves for that which was in fact their own9
(Watson 1979; Beckles 1990).
By the end of the period of slavery, Barbadian society
was well-formed and highly stratified. Social
stratification had significant bearings on land distribution
that would continue to restrict class mobility and which
would ultimately set the precedent for standards of living
and housing practices among the various classes. In pre¬
emancipation society, the white planter elite controlled the
largest land holdings, while the middle class white yeomanry
held the smaller holdings. In contrast to other West Indian
islands, a significant poor white proletariat emerged, who
was landless, similarly the black slaves, and was unable to
hold property. Increasingly a freed black and colored
population developed, some of whom were landowners. With
emancipation, there was some modification of this class
structure, but very few changes in regard to land
distribution and subsequently standard of living.
Emancipation and the Landless Proletariat
In 1834, the imperial campaign for an end to slavery
materialized into the Emancipation Act, and as of August 1
of that year, all slaves under the age of six years were
declared completely emancipated, while those over six years
would be freed after a four year apprenticeship. The total
number of freed slaves in 1834 was 83,150, and Beckles

118
(1990) calculates that this resulted in a total of 501
apprentices per square mile, making Barbados the most
densely populated island in the Commonwealth.
In response to the Assembly's Act of 1838 for the
abolition of the Apprenticeship System, the Barbados
legislature instituted the Masters and Servant Act, later
known as the Contract Law, designed to maintain political
and economic control over the freed blacks. The Contract
Law stated that any worker who provided continuous labor for
five days or more was thus hired for one year, and one
month's notice was required by either party for a legal
dissolution (Beckles 1990). The worker was entitled to live
on the plantation and reside in a cottage provided by the
planter, but once the contract was dissolved, he was to
leave the property and was only entitled to the value of
crops that he planted, a value to be determined by the
parish Justice of the Peace (Beckles 1990). Furthermore,
the worker could be evicted from his job and cottage without
wage compensation if his behavior was deemed "insubordinate"
by the planter and he could be imprisoned for crimes as
petty as foul language (Beckles 1990; Fraser et al. 1990).
In an attempt to modify the Contract Law in favor of
the laborers, the Governor ordered a modification in 1840
that lessened the contract from one year to one month,
forced the planter to reduce rent on cottages, and required
workers to pay rent rather than use labor in exchange for

119
cottage occupancy. But these modifications only served to
strengthen the planter's position by transforming the free
wage worker into what Beckles (1990) terms a "located
plantation tenant," since laborers were forced to work
exclusively for the estate on which the lived.
In short, very little had changed for the black laborer
in the transition from slavery to emancipation. The planter
class continued to dominate most of the arable land in
Barbados and the price of land was prohibitively high for
the wage proletariat. While planters did allocate marginal,
rab land to workers in return for their labor, residency
usually was dependent on the worker's allegiance to a
planter and the land was not perceived as his own. There
were, increasingly over time, instances of ex-slaves
becoming leasehold users of land on estates for which they
did not work, although the number of these cases were
proportionately small (Beckles 1990). The very small
population of black freeholders were usually from the
artisan sector, persons who had accumulated savings enough
to purchase small pieces of land. This group was small,
however, totaling only 4,982 by 1878 (Beckles 1990). Thus,
the tenantry system limited the emergence of a peasant
class; the planter class succeeded in legally establishing a
landless proletariat and maintaining their absolute control
over a stable labor force.

120
One response to the restrictive Contract Law was mass
emigration of laborers to destinations such as Trinidad and
Guyana. Of even greater importance was the period between
1859 and 1914, during construction of the Panama Canal, when
as many as 20,000 Barbadian men emigrated (Schofield 1991).
This period was one in which remittances from Canal workers
made up the largest proportion of foreign currency, and a
number of families seized the opportunity to purchase their
own land (Schofield 1991). Between 1904 and 1921, at least
70,000 Barbadians emigrated to the Canal, North and South
America, depleting the population by 2.3% each year
(Lowenthal 1957). Thus began the pattern of short-term
emigration and remittance in Barbados, a practice that would
play a role in family economy well into the twentieth
century.
A restructuring of land ownership by the upper class
whites occurred during the economic depression of the 1880s
and 1890s, in which the plantocrats were joined, and in many
cases marginalized, by the newly-formed merchant elite.
Intermarriage and dependence on merchant financing for an
indebted sugar economy resulted in the increasing takeover
by urban merchants of the rural sugar estates and the
subsequent diversification of the merchants' economic basis
(Watson 1979). These changes probably served to solidify
the minority white upper class and better prepare them for
the tumultuous decades of the mid-twentieth century, in

121
which Crown reforms and eventual Independence would pave the
way for acquisition of political control by the once
oppressed black Barbadians.
Steps Towards Reform
The post-emancipation period resulted in a majority
landless proletariat population, who did, ironically, tend
to own their own homes (to be discussed). Lowenthal (1957)
noted the curious scenario in which the highest proportion
of land owners lived in the most remote parishes of St. Lucy
and St. Andrew, the "poor soil" parish of St. James, and the
arid parishes of Christ Church and St. Philip; paradoxical
when one considers the importance of land ownership to a
West Indian and that such prestige should belong to those in
some of the poorest areas of the island. The suggestion
that land in St. James, Christ Church, and even St. Philip
was considered "poor" is another paradox in view of the
extreme importance they would bear in the blossoming tourist
and manufacturing industry in the twentieth century.
Some of the most dramatic changes in land distribution
and housing occurred during the Tom Adams administration
between 1976 and 1985. In 1980, the Tenantries Freehold
Purchase Act gave all tenants occupying land on tenantries
the opportunity to buy their house spot. A qualified tenant
was one who, at the time of the Act and thereafter, had been
residing on the lot for five consecutive years, or for five
years out of seven, and who had used that spot for his/her

122
own habitation or for the habitation of his/her spouse,
child, sibling, or parent (Tenantries Freehold Purchase Act
1980). Moreover, allowances were made for tenants who, for
the purpose of work outside of Barbados, had undergone
occasional absences. In the 1980 Act, 193 plantation
tenantries were included in the legislation (Tenantries
Freehold Purchase Act 1980). For plantation tenantries, the
price was set at $1 per square meter, with a minimum
purchase price of $300, and for nonplantation tenantries,
the price was based on what could be expected if the land
was on the open market (Potter 1986). In some cases,
tenants could purchase their spot for as little as ten cents
per square foot (Hudson,10 personal communication). An
amendment was submitted in 1989, allowing for the purchase
of land on nonplantation tenantries of five lots or less
(Tenantries Freehold Purchase (Amendment) Act 1989).
Similarly, the Tenantries Development Act of 1980 was
designed to assist in the overall objective of the
Tenantries Freehold Purchase Act—to improve national
housing standards, as promised by the Adams administration—
by gradually improving those tenantries that required
upgrading or even installation of electricity, piped water,
and roads (Potter 1986).
During the 1960s and 1970s, economic growth and the
desire to improve personal housing standards were
represented by an increase in commercial bank loans for

123
housing and land; the percentage of loans issued for this
purpose increased from 7.9 in 1969 to 22.8 in 197711 (Nurse
1983).
In summary, a historical review of land distribution in
Barbados illustrates limited access of land for ownership to
the majority working class, a phenomenon that emerged with
sugar monoculture. The fact that land was limited to the
social elite set a precedent; throughout the remainder of
Barbardian history, owning land was synonymous with social
status. This factor would play a significant role in the
evolution of the house form and contemporary aspirations for
housing, or, "modernization." At this point, a review of
contemporary land distribution patterns will be presented.
The Contemporary Spatial Distribution of Land and People
The Impact of Twentieth Century Reforms
Barbados is and throughout most of its history has been
one of the most densely populated countries in the world.
As Lowenthal simplistically stated, "[t]he island is crowded
today partly because it always has been crowded" (1957,
p.449). According to the 1990 census, the total population
is 257,083, which yields a density of 1,549 persons per
square mile (unpublished data). The rate of growth has
actually declined in recent years; the average annual
increase was 0.4% between 1970 and 1980 (Town & Country
Development Planning Office 1988) and that figure is

124
expected to remain unchanged by the year 2000 (United
Nations 1991). The reasons for this stabilization in growth
are primarily a declining fertility rate and continuing out¬
migration (Roberts 1955; Nag 1971; Ebanks et al. 1979).
But, what has changed dramatically within the last four
decades is the distribution of the population rather than
the density, and this is dependent on a host of factors,
including sociohistorical, topographical, and economical.
A comprehensive social history heretofore has been
presented so as to illustrate stratification of the
Barbadian population prior to the mid-twentieth century and
the economic basis for that stratification—sugar. The
nature of the labor system required for large-scale sugar
production demanded a work force too large to guarantee
adequate land and housing following the collapse of the
systems on which it was based—indentured servitude,
slavery, and post-Emancipation tenantries—and resulted in a
majority population of landless proletariats; this in turn
led to a social revolution in housing reform. The decline
of a monoagriculture industry and the emergence of urban-
based economies, in addition to the inevitable integrative
process into the "new world order," brought about by
expanded trade following Independence, international
communications, and acculturation secondary to large-scale
emigration, have all served to redirect the focus on the
urban sector rather than the rural sector.

125
These revolutionary changes have had a major impact on
the ideology of the "preferred place of residency" in
Barbados. In addition, a relatively new feature in ideology
of residency has emerged, and that is the importance of
topography. Prior to the decline of sugar, topography
played only a marginal role in choice of housing, since most
of the arable land was cultivated for cane and because
tenants, forced by the planter to reside on designated rab
lands, had little choice as to where they could live. With
a decline in the sugar economy, Barbadians are probably
choosing house spots based on the topographical merits and
not simply availability of land.
Barbadian Economy and Its Role in the Urban/Rural Sector
Population demographics in Barbados cannot be
understood without first discussing the economic transition
that has occurred within the twentieth century. The pattern
is similar to that found throughout the developing world—a
rapid decline in the rural, agricultural sector, and
uncontrolled and poorly planned urban growth. Yet the
effects on a very small island, whose population density
exceeded that of most other countries prior to the economic
transition, deserve special mention, particularly in the
context of defining "what is urban" and "what is rural."
The most significant variable in the Barbadian economic
transition is the decline of sugar as an industry. It is a
controversial topic, and continues to foster racial

126
divisiveness between what is left of the estate white
planters and black politicians. The spark was ignited when
Prime Minister Barrow made his "cane blade speech", on May
Day, 1967, which was designed to promote the diversification
of the island economy and encourage women to venture out
into nontraditional modes of production, such as
manufacturing. The prime minister stated that he lived for
the day when he no longer could see one blade of cane on
Barbados. J.C. Hudson of Carib Agro-Industries notes that
the comment was taken out of context and capitalized upon by
extremists wanting to end agriculture altogether because of
the stigma of subservience and slavery; Hudson contends that
Barrow was in fact an avid supporter of the mechanization of
agriculture and the continuation of sugar as a major
contributor in the economy (personal communication).
In 1963, the sugar industry accounted for 24% of the
gross domestic product (GDP), but it fell drastically by
1972 to 8% and to 6.6% in 1976, putting sugar behind tourism
in GDP (10.3%) (Nurse 1983). The year of greatest output
ever recorded was in 1967, but output declined by 50% in
1975 (Nurse 1983). Declining output was compounded by a
steady decline in yields of cane per acre, which was
probably a result of several factors, including poorer
varieties of cane, compaction of soil secondary to
mechanization equipment, cane fires, falling acreages as a
result of urban development and land use changes and,

127
perhaps most importantly, a decline in rainfall for that
period (Nurse 1983). The small size of agricultural
holdings and subsequently the small yield in agriculturally-
based profits for the small farmer are no doubt another
factor in the declining sector.
Internal complications with the sugar industry were
compounded by external factors, most notably the eroding
world market, in which prices peaked in 1967, but dropped
below production cost in 1970 (Nurse 1983). The cane
harvest of 1992 has been the worst in 100 years, at 54,000
tons, yielding only $50 million and necessitating the
unprecedented importation of sugar to Barbados in order to
meet sales demands (Hudson, personal communication).
Currently there are approximately 100 working plantations,
and of those, 60% are bankrupt (Hudson, personal
communication).
Another factor contributing to the decline of the sugar
industry—and a curious one—is the increasing labor
shortage. This situation has actually spawned the need to
import labor into the island. Migrant crop workers have
traditionally come from neighboring St. Vincent and St.
Lucia, but in recent years, most have come from Guyana
(Schofield 1991; Hudson, personal communication). In 1990,
106 of the 108 foreigners granted work permits for cane
cutting were Guyanese (Schofield 1991). This importation of

128
labor is in spite of the fact that the unemployment level
continues to rise.12
The first documented labor shortage appears to have
occurred in the 1960s, due to large-scale emigration and
increasing disenchantment among young Barbadians to work on
plantations13 (Schofield 1991) . A new factor in the
shortage—and evidence of disenchantment among the youth—is
the increasing average age of cane workers (57 years in
1990) (Schofield 1991). An elderly couple in Bridgetown,
discussing the "unfortunate" decline of agriculture,
lamented that young Barbadians are "embarrassed" to see a
parent working in the fields and will deny their parent's
occupation when asked. Another elderly woman attributed a
"get rich quick attitude" among the Bajan14 youth as
responsible for the decline in the agricultural labor force.
"Young men want ta wear a coat an' tie now... de too good
for cuttin' cane".
Tourism15 and manufacturing experienced substantial
growth in the 1960s and into the 1970s, followed by a period
of negative real growth in 1974 and 1975, and a rebound
again into the 1980s (Town & Country Development Planning
Office 1988). Of recent years, general services, government
services, and retail and wholesale trades business have been
major contributors to the economy. Table 3-1 illustrates
shifts in the GDP between 1970 and 1980.

129
Table 3-1. Percentage of gross
by sector.
domestic product
Sector
1970
1980
(%)
(%)
Sugar
9.3
6.3
Other Agriculture & Fishing
4.6
3.3
Mining & Quarrying
0.6
0.9
Manufacturing
8.7
12.7
Electricity, Gas & Water
1.7
1.5
Construction
9.1
7.0
Wholesale & Retail Trades
29.4
21.4
Tourism
9.3
11.7
Transport, Storage &
Communication
5.6
5.8
Business & General Services
7.0
14.8
Government Services
14.7
14.6
Gross Domestic Product
Factor Cost
100.0
100.0
Source: Town & Country Development Planning Office
1988.
The Over-Development of the Urban Sector
Similarly to the other Eastern Caribbean islands, the
Leeward side of Barbados was the site chosen for the capital
city and the urban sector in general.16 Speightstown and
Holetown, the two main settlements north of the capital, and
Oistins, the main settlement to the south, were founded
early in Barbadian history and, together with Bridgetown,
formed a ribbon of urban development that would burgeon into
the twentieth century. Recently the urban belt has extended
to the southeastern-most parish of St. Philip, and in 1980,
62% of the total population, or 152,000 people, lived within
the urban boundary (Town & Country Development Planning
Office 1988). With the growth of Bridgetown as a chief

130
seaport, the capital's population mushroomed from 28% of the
nation's total in 1844, to 42% in 1970 (Potter 1983a), and
nearly 45% in 1990 (PAHO 1990).
Conversely, there has been a continuous population
decline in the most eastern and rural parishes of Barbados.
The move from the rural to the urban sector has mirrored the
national transition from a predominantly agricultural
producer to urban-based tourism and manufacturing. Potter
(1983a, 1983b) observed significant socioeconomic disparity
between the urban and rural sectors, noting more
professional employees, car ownership, and higher income in
the western and southern coastal parishes than in the
eastern and northern ones. In 1980, 67-70% of all job
opportunities were within the Greater Bridgetown area
(Potter & Wilson 1989).
Inter-Migration and Changes in the Spatial Distribution
Figure 3-1 illustrates the changes of population in the
11 parishes over a 20-year period. In the Physical
Development Plan of 1986, four major zones of population
decrease were identified and found to be better indicators
of shifts than the parish boundaries. The regions of
decline include the following: (1) the sugar-belt region in
the Christ Church ridge and St. George's Valley; (2) the
Scotland District, excluding the Belleplaine area; (3) the
western coastal strip from Speightstown to Oistins; and (4)
the old sections of Greater Bridgetown (Town & Country

131
Development Planning Office 1988). Migration out of the
sugar belt and Scotland District were primarily due to
changes in the agricultural industry and the lack of
alternative modes of production in those regions, while
changes in the coastal strip were due to the marginalization
of residential units by the tourism industry (Town & Country
Development Planning Office 1988). The decline in the
Bridgetown population represents the growth of suburbia and
the quest for a higher standard of living. Similarly,
suburbanization is largely responsible for increases in the
northernmost coastal belt between Cave Hill and
Speightstown, St. Philip, western St. George, parts of St.
Lucy, and an eastern sector of Greater Bridgetown (Town &
Country Development Planning Office 1988).
Demographic Decentralization and the Development of Suburbia
In keeping with the British urban decentralization
ideology and in response to the piecemeal development of the
urban sector, the Barbados Office of Town and Country
Planning was established in 1959, following the Town and
Country Development Planning (Interim Control) Act of 1959.
The original objective of the Act was to control the
development of the 3 to 5 km wide strip of land along the
west and south coasts as well as the stretch of land on the
east coast between the villages of Belleplaine and Bathsheba
(Potter & Wilson 1989; Potter 1983b).

132
Following the Town and Country Planning Act of 1965 and
Independence in 1966, the Chief Town Planner was given the
task of preparing the physical development plans for the
island, which included a hierarchical decentralization and
rationalization plan, with services and projects radiating
from the capital city, to regional urban centers, followed
by district centers, and lastly village centers (Potter &
Wilson 1989). In theory, the plan would assist in the
economic and community development in areas poorly served in
the past, as well as regulate the growth of the capital
(Potter & Wilson 1989).
Potter & Wilson (1989) contend that the original plan
of 1970 was "almost utopian" and not practical in the
immediate future. A revised plan of 1983 recognized the
unbridled process of suburbanization surrounding the
metropolitan area, rather than the growth of planned
settlements envisaged a decade before and redirected its
energy toward the controlled development of an urban
corridor stretching from the far northwest to the extreme
southeast, thus integrating the already existing urban
areas. In short, the 1983 plan clearly defined what is
"urban," delineated an axis of urban growth and centers for
expansion and identified rural settlements with the
potential for growth (Potter & Wilson 1989). Figure 3-2
illustrates the demarcation for urban development and
indicates areas for projected development.

133
Figure 3-1. Inter-migration patterns by parish, 1970-1990.
Source: Town & Country Development Planning Office 1988,
1990 Population Census (unpublished data).

Figure 3-2. Settlement and Land Use Policy of Barbados. The broken line indicates the
urban/rural demarcation according to the Physical Development Plan of 1986.
Reprinted with written permission from the Town and Country Development Planning Office.
1983, p.137.

SETTLEMENT AND LAND USE POLICY
AGRICULTURE
REGIONAL CENTRE
CENTRE WITH RESTRICTED GROWTH
SUBURBAN CENTRE
PREDOMINANTLY URBAN RESIDENTIAL
RURAL SETTLEMENT
RURAL SETTLEMENT WITH POTENTIAL GROWTH
CENTRAL PLACE ACTIVITIES
TOURISM AND RECREATION
MAJOR INDUSTRIAL ANO/OR WAREHOUSING
MAJOR INSTITUTIONAL
MAJOR RECREATIONAL AND/OR OPEN SPACE
AREA FOR SPECIAL ENVlRONMEfiTAL CONTROL
POTENTIAL IRRIGATION AREA
WATER PROTECTION ZONE I -- -
AIRPORT
L|mOF URBAN ZONE -o-o-
NATIONAUfARK BOUNDARY
AXIS OF URBAN QROWTH -«*•-«-
A/
NATIONAL CENTRE
CENTRE FOR EXPANSION
DISTRICT CENTRE
NATIONAL ARTERY
PRIMARY URBAN ROAO OR HIGHWAY
SECONDARY URBAN ROAL OR HIGHWAY
PROTECTION OF CLAY RESERVE
PROTECTION OF SAND RESERVE
PROTECTION OF SAND AND CLAY RESERVE
TOWN AND COUNTRY DEVELOPMENT PLANNING OFFICE
MINISTRY OF FINANCE AND PLANNING
GOVERNMENT Of BARBADOS 1983
20
135

136
The concept of "sub-divisions" in Barbados is not a new
one and, as Nurse (1983) explains, really began following
emancipation, with the formation of village tenantries on
plantations, situated on the "rab" land and inhabited by the
growing peasant farming class. The government began
regulating sub-division activities with the Public Health
Act of 1908, for the purpose of managing the growth of
already-existing tenantries, the development of waterworks,
and determination of land value for tax and sales purposes,
and in 1965, with the Town Planning Act, the Board of Health
yielded these responsibilities to the Town and Country
Planning Development Office (Nurse 1983).
In recent decades, Bridgetown proper has undergone a
slight decline in population growth; percentage of the total
population decreased from 41.76% in 1970, to 40.15% in 1980
(Potter 1983a) . In view of the continuing decline of the
rural population in the northern and eastern parishes, there
is an apparent increase in the suburban sector. Between
1970 and 1980, the fastest growing parishes in terms of
population and housing were St. James, Christ Church, and
St. Philip, respectively (Town & Country Development
Planning Office 1988). Table 3-2 illustrates the census
findings over a 10-year period, indicating a slight decrease
in the rural and urban sector and an increase in suburban
sector.

137
Table 3-2. Percentage distribution of the Barbadian
population by socio-geographic zone, from the
Government Statistical Department Census for 1970 and
1980.
Zone
1970
1980
rural
33.4
32.2
suburban
25.2
27.6
urban
41.4
40.2
Source: Dann, 1984, p.24.
In recent years there has been an increase in the
development of suburban sub-divisions in Barbados; sub¬
divisions are defined by the Development Planning Office as
housing development areas of ”10 or more lots" (1988, p.43).
This increase appears to be an effort by land speculators to
make a profit out of agriculturally idle land, a failing
sugar economy, and to keep up with the demand of a landless
population wanting to improve their standard of living.
Their appeal to the higher income population is evident in
the increasing size of the lots being developed; the
majority of lots fall in the "greater than 10,000 square
feet" range and there is an increasing number of homes with
greater than five rooms (from 5,630 in 1960 to 15,169 in
1970) (Nurse 1983). There seems to have been an over¬
estimation in the demand for sub-divisions; from 1965-1977,
only 55.8% of the lots developed had been sold and homes had
been built on only 13% of the lots (Nurse 1983). A
relatively large proportion of the land sold (21.5%) went to

138
overseas owners, presumably Barbadians living abroad (Nurse
1983) .
Most sub-divisions tend to be located in only a few of
the 11 parishes; 70% of the lots are situated in St. Philip,
Christ Church, and St. Michael, which are in fact the
parishes with the least rainfall and those areas most
affected by drought, cane fires, and declining sugar cane
production (Nurse 1983). They are also regions most
accessible to the urban district. It should be noted,
however, that a significant number of sub-divisions lie in
the most fertile region of the country, particularly—and
for reasons poorly understood—in the parish of St.
George.17
Nurse concludes that benefits of the intense sub¬
division outweighed the costs, since the process provided
improved housing stock in both quantity and quality, created
employment through land development companies and service
industries and served as a source of profitable investment
(1983). Such benefits, however, appear to have benefitted
only the wealthy; as a previous minister of housing from the
opposition party noted, "...none of these poor agricultural
workers who have given their sweat and tears for generations
at Cottage Plantation would now be able to buy one square
foot of that land which is being sold at a very high price:
over $6 a square foot" (Clarke 1991, p.llA).

139
It is difficult to estimate the average cost of land in
Barbados, since value depends on a number of factors.
According to the Valuation Department, a small residential
lot between 4,000 to 6,000 square feet probably costs $4.00-
$7.00 per square foot (Hurley,18 personal communication).
However, tenantry land still sells for $1.00 per square
meter and funds for financing purchase of tenantry land are
available through the General Workers Loan Scheme and the
Tenantries Loan Scheme (Town & Country Development Planning
Office 1988).
One element in standard of living which has no doubt
contributed to the development of suburbia in Barbados is
the increase in private automobile ownership, which rose by
114% between 1966 and 1977 (Nurse 1983). According to the
Chief Licensing Officer at the Ministry of Transport and
Works, there are over 41,000 registered private vehicles in
Barbados, plus 1,682 private motor cycles and 2,137 motor
vans, comprising a total of 53,619 registered vehicles
throughout the country (Broome,19 personal communication).
This element has afforded the wealthier Barbadians the
option of moving out of the urban sector while maintaining
their urban-based occupations. It has also changed the
ideal of residential location. Proximity to work is less a
priority than what is perceived as "a nice place to live.”
This is referred to as ”going back to the village” and is

140
reflective of the American theme of "moving out to the
country."
The Continuation of Tenantry Residency
Regardless of growth in the suburban sector, nearly
one-third of Barbadian households are in tenantries;
according to the Permanent Secretary of the Ministry of
Housing and Lands, as of 1991, 30% of Barbadian homes
(approximately 20,000 dwellings) were located in tenantries
(Barrow,20 personal communication). It has been estimated
that 465 tenantries, previously on plantation land, are in
the urban sector, primarily St. Michael (Town & Country
Development Planning Office 1988). A breakdown of the
spatial distribution of tenantries is illustrated in Table
3-3.
Table 3-3. Spatial distribution of tenantries by parish,
1990.
Parish
Number of
Units
Number of
Tenantries
St. Lucy
28
449
St. Peter
32
541
St. James
14
196
St. Andrew
11
297
St. Thomas
37
710
St. George
52
1,272
St. John
34
1,090
St. Joseph
22
395
St. Philip
49
1,023
St. Michael
10
309
Christ Church
27
597
Total
316
6,879
Source: Ministry of Housing & Lands. 1990, p.74.

141
The Physical Development Plan of 1986 outlined the
following problems related to urban tenantries: (1) poor
access and street layout; (2) absence of space for community
and recreational activities; and (3) problematic shape and
unacceptably small size (Town & Country Development Planning
Office 1988). The Planning Office's minimum standard size
for residential lots is 225 square meters (2,422 square
feet) and 25% of these urban tenantry lots are smaller than
the minimum standard (Town & Country Development Planning
Office 1988). Many, in fact, are 1,000 square feet or less
(Hurley, personal communication).
It would appear that little ground has been gained by
the average peasant regarding land ownership, since only
2,557 plots had been purchased between the passing of the
Tenantries Freehold Purchase Act in 1980 and December 1990;
for the year 1990 alone, only 223 plots were purchased
(Barrow, personal communication). However, since the
average cost of rented land on plantation tenantries is a
mere 10 cents to 25 cents per week (Barrow, personal
communication), it is not surprising that tenants do not
purchase the plot on which they live. Another incentive to
continue renting rather than purchasing land is the fact
that tenants have been protected from unreasonable rent
increases on tenantry land since the time before the
Freehold Act (1980). via The Security of Tenure of Small
Holding Act (1955) and the Tenantries Control and

142
Development Act (1965). Also, although tenantry land is to
be sold at $1 per square meter, when land tax is taken into
account, there is little incentive to purchase the lot if
income is a serious constraint.21
External overcrowding (distance from the nearest
neighbor) is greater in the rural sector than in the
suburban sector; there are an estimated 10,000 "small
holdings" in the rural district of less than 5 acres of
land, with an average size of less than half an acre (Town &
Country Development Planning Office 1988). External
overcrowding is highest in the urban sector (Dann 1984).
While the typical lot sizes in tenantries average 3,000
square feet, private developers build on lots ranging from
4,000 to 8,000 square feet, depending on the location
(Barrow, personal communication). From this statistic, one
can infer that overcrowding is more of a characteristic of
tenantries than suburban heights and terraces.
"Overcrowding" is relative; the average height/terrace lot
that is typically a maximum of 8,000 square feet seems
almost small when one considers that one-quarter acre, a
size that many suburban Americans probably enjoy, is over
10,000 square feet.
In summary, contemporary land tenure and distribution
has changed in the twentieth century. The decline of the
sugar industry and an increase in urban-based economies has
fostered migration into the urban sector, a new phenomenon

143
in the scope of Barbadian history, since prior to the
decline of sugar, overall residency was rural in nature
(agricultural). With migration into the urban sector there
has been an increase in urban crowding, and this factor has
stimulated the growth of sub-divisions, or a "suburban"
sector. Yet these housing developments have been aimed at
the upper class and have done little to relieve the tenantry
status of the working class. In fact, despite the glut of
sub-divisions and passing of Acts aimed at increasing land
ownership, a relatively small number of residents have
purchased land. Nevertheless, a new econo-political order
is in place, and presumably an increase in land ownership
will continue and result in general up-grading of the
domestic environment.
A Closer Look: Evolution of the Barbadian Home
In this section I will focus on perhaps the most
controversial of the variables involved in the relationship
between asthma and household pests, and that is the house
itself, or rather, modernization of the house ("house" in
this sense refers to any domestic dwelling). Certain
aspirations in housing, once realized, will at least in part
create an environment conducive to the proliferation of
highly allergenic species of arthropods and other animals,
collectively referred to in this thesis as household pests.
These developments in housing, coupled with the meteorologic
and economic conditions such as those found in a tropical,

144
developing country, challenge the traditional meaning of the
term "modernization." Indeed, a rather paradoxical
situation evolves: in an effort to better the living
standards in a given culture, members have actually
compromised their health status despite their achievements.
Again, referring to the "epidemiological transition," we
have observed this scenario time and again. No one would
argue that dependable food supplies, conveniently available
to all members in society, is beneficial and therefore a
step towards "progress." But convincing the public that
overnourishment is as dangerous as undernourishment (e.g.,
heart disease, obesity, diabetes) has proved difficult, and
efforts to do so are compounded by the fact that chronic
disease is often less impressive to the public than acute
disease.
Traditional House Forms
Housing in the pre-emancipation period
The house form of the black slaves is surprisingly
well-defined, despite the fact that only a few of those
original structures still exist in Barbados. An
archeological investigation by Jerome Handler reveals the
following:

145
...throughout the slave period the most common type of
house was something one doesn't see today and this was
a house made out of organic materials, which we call
wattle and daub. It was a small hut, made by inserting
poles or posts vertically into the ground, and then
inter-lacing the poles horizontally with vines or twigs
so as to form a latticework; these latticed walls were
then plastered with clay or mud...The roofs of
these...were thatched with materials such as cane
trash, palm branches, or plantain leaves...Houses were
normally partitioned into two rooms, sometimes
three...and it wasn't until late in the slave period
that wooden plank floors were used... (1972, p.68).
Houses were crowded, sparsely furnished, and typically
clustered into small villages, referred to as "the Negro
yard", situated near the plantation yard, close to the
planter's house (Handler 1972). Proximal to the Negro yard
were garden plots, water supplies, and burial grounds. A
German servant noted in 1652 that "...Around the plantation
yard stand the slaves' small houses. These are made of
inferior wood, look almost like dog-houses, and are covered
with the leaves of trees that they call 'Blandin'..."
(Gunkel & Handler 1970, p.92).
Towards the end of the slave period "stone huts" began
to replace the wattle and daub huts, although most slaves
still lived in the organic houses at the time of
Emancipation. The stone huts, in fact, are believed to have
been constructed mostly by indentured servants (Fraser et
al. 1990). Hudson notes that these permanent structures
often referred to as "slave huts" were the predominant house
form in villages created out of plantations for freed
slaves, indentured servants, and militia men who decided to

146
stay on in Barbados (personal communication). Sometimes
these "slave huts" (perhaps a misnomer) were referred to as
"trash huts," because they were roofed with trash; roofs
were replaced with galvanized iron sheets in the twentieth
century (Fraser et al. 1990). The stone huts were a
relatively cheap solution to the flimsy nature of the wattle
and daub huts of the slaves, as coral limestone could be
quarried anywhere in Barbados. The addition of a low hip¬
roof (with slopes on all four sides) made the stone hut
considerably more resistant to tropical storms and
hurricanes than its wattle and daub predecessor (Fraser
1990). Their rarity can be accounted for by the land tenure
practices of their time; being constructed of stone, they
were permanent fixtures and necessitated tenure of the land.
Yet only a small population of landowning peasants at that
time held long-term titles to land. Uncertain land tenure
resulted in a much different house form—the chattel house.
Emancipation and the chattel house
A new phenomenon in housing emerged following
emancipation—the development of the chattel house. The
chattel house would become the most prominent of house-types
in Barbados and would dominate until the late twentieth
century. The word "chattel" means, literally, a moveable,
personal possession. The most significant attribute of the
Barbadian chattel—and the reason for its predominance—was
its moveability. As previously described, due to the

147
tenuous status of residency on plantation tenantries, it was
necessary for workers to move their few possessions and
their family with little warning and immediately upon
notice. With the chattel, the house could be taken apart
and loaded onto an oxcart within hours, moved to another
tenantry, and reconstructed.
Style and construction. The origin of the style of the
chattel is both south English and West African; according to
Potter (1989), folk houses in both environs were rectangular
in shape (a ratio of 2:1), typically two-roomed, a
symmetrically placed main door on the long wall, and a
gabled, thatched roof. This style was conducive to
expansion; additional units could be constructed behind the
front unit. Throughout the Caribbean, the structure was
raised off of the ground, supported by lose rock piles, to
minimize the effects of insects, such as ants, termites, and
rodents, and to allow for ventilation. The rock pile
foundation had the added advantage of being relatively
sturdy, low cost, and dispensable in the event that the
house was moved. An additional climatic adaptation in the
development of the chattel was the orientation of windows
and doors with respect to prevailing winds (Potter 1989).
Windows come in a number of styles. The traditional
window is either the Demerara window22 or the wood jalousy,
or louvre, though glass panes are common, usually in panels
that "swing" out. Currently, more common than the wood

148
jalousy is the glass louvre window, identical in principal
but improved in durability, and glass louvres have the added
advantage of allowing light into the room even when closed.
The "tray" ceiling was designed out of practicality for
ventilation purposes; the roof is sealed at one to two feet
above the level of the walls, giving it the appearance of an
"inverted tray with sloping sides" (Fraser 1990, p.86). In
many instances, there is no ceiling at all, allowing for
ventilation and the exchange of fresh air in and out of the
gaps between the roof and wall. The chattel roof was
usually either the sloping, pitched gable type, clad with
wood shingles and nailed down, or "hip", relatively
resistant to hurricanes and ideal for ventilation.
A variety of decorative touches add to the charm of the
Bajan chattel. Fretwork barge-boards decorate gables and
pedimented porches, and bell pelmets (bell-shaped hoods),
shade the windows. Fraser (1990) notes that porches are "a
very English thing," although of practical value, and are
rarely found in the folk architecture elsewhere in the
Caribbean. A common practice used to give an enlarged
appearance to a chattel is to add a veranda to the structure
(Fraser 1990); Potter (1989) notes that the incorporation of
Georgian23 verandas and terraces is also uniquely
Barbadian, although Georgian architecture in general has
been incorporated into other Eastern Caribbean house forms.
Technically a veranda enclosed by jalousy windows is a

149
"gallery," and considered a separate room, but it is common
for Bajans to refer to any porch or veranda as a "gallery,"
a characteristic that denotes pride and status, in that such
an elaboration exists and could be afforded in the first
place (personal observation).
Houses are painted in a variety of bright or pastel
colors, typically trimmed in white, and fresh coats are
replaced frequently, usually during the Christmas season
after receiving the "Christmas bonus," and in preparation
for holiday guests.24 Decorative horticulture in the front
of the house, incorporating a variety of tropical plants,
(e.g., hibiscus, oleander, and poinsettias), is reputedly an
"English" tradition (Fraser 1990); at the least, it is a
source of pride that requires minimal financial investment
on the part of the householder (due to the favorable
climate), yet yields as much attention as a fresh coat of
paint. Interestingly, all of the attention and care is
given to the front of the chattel, not unlike the interior
of the house (to be discussed), and the sides and back are
typically enclosed in unkept "pealing" (corrugated iron
sheets), with little attention to vegetation.
Another Bajan tradition is the naming of one's house.
As one editor lamented, "Nowadays with all these heights and
terraces we live in, some houses are beginning to carry
numbers. I really hate it. It all seems so impersonal to

find someone by the number on their house" (Hoyte 1991,
p.11A).
150
Spatial distribution. Significant changes were made in
the spatial distribution of housing following emancipation.
As described, slave quarters were situated close to the
factory yard and planter's house during the pre-emancipation
period. However, following emancipation, tenantries were
moved to the rab lands, or outskirts of the plantation, as
far away as possible from factory yard. Hughes25 contends
that both groups—the white planters and the black freedmen-
-preferred this arrangement, to be as far away as possible
from each other (personal communication). Secondary to the
placement of tenantries on the marginal plantation rab
lands—marginal both in size and in quality of soil—
tenantries took on a somewhat "urban" characteristic because
of crowding. As Lowenthal aptly depicted:
...The villages, which focus around crossroads where a
few shops, a street lamp, and maybe a chapel are to be
found, are extraordinarily compact; houses touch, or
almost touch, and many have only a few square yards for
a yard or a garden. This extreme degree of clustering,
together with the tendency of the people to place their
houses directly on the highways, sometimes gives one
the impression that Barbados is a continuous village.
(1957, p.471-472).
Other house forms and modifications of the chattel house
Until recently the typical Bajan home was represented
by one of four general prototypes. The chattel house was
the most common by virtue of the fact that the majority of
the population was landless. Other house forms included the

151
West Indian plantation great house (primarily constructed of
coral limestone and Georgian in design), the suburban villa
(also constructed of coral limestone), and the urban town
house. All forms were shaped by the influences of
sociopolitics, economy, the availability of building
resources, and climate.
While the chattel house evolved for pragmatic reasons—
suitable for the tropical climate and for the insecure
nature of the tenantry system—it is truly a vernacular art
form. If the structure emerged from the tenantry system,
the style emerged out of the Georgian architecture of the
larger suburban and plantation houses. It would appear'
that, rather than eliminating certain architectural features
from the construction of a house, builders in the lower
socioeconomic strata simply scaled down features, so as to
replicate the architectural pattern of the planters and
merchants—the island elite. This contention is supported
by the presence of symmetrical facades, hooded windows and
jalousies, gables, porticos and verandas, as well as the
countless decorative touches, such as barge boards and
French doors.
Fraser & Hughes (1986) explain that the architectural
pattern of the planters was very much dependent on the
financial state of the island throughout Barbadian history.
Richard Ligón, who wrote the well-known "True and Exact
History of the Island of Barbadoes" in 1657, was appalled at

152
the hasty means by which the planters of the early years
erected their homes and their lack of consideration for
ventilatory principles (Fraser & Hughes 1986). Gosner
explains that the earliest West Indian homes in general
reflected a working class' interpretation of the folk
architecture of their native home, rather than the
Renaissance ideals of the gentry (1982). Indeed, the first
residential dwellings were first "make-shift", followed by a
simple medieval style copied after their own in Europe,
though completely unsuitable for the tropics due to its
emphasis on "the vertical" and small windows (Gosner 1982).
With the incorporation of the Georgian style—and a re¬
interpretation of that style to fit the Caribbean—
architectural practices were increasingly better suited for
the warm and humid tropical environment. Fireplaces and
chimneys were eliminated, except in the outdoor kitchens,
and to allow for maximum time spent outdoors in the shade,
galleries and verandas were used as dining and living areas
(Gosner 1982). Status was sacrificed for economy and
improved ventilation and the heavily-taxed glass windows
were largely replaced with louvres (Gosner 1982). Although
the landless proletariats were limited to light-weight,
movable timber for their homes, the plantocrats took
advantage of the abundant coral limestone and constructed
structures virtually impermeable to tropical storms and even
hurricanes, as well as insects such as the termite. Storm

153
shutters, low hip roofs, and a maximum of two levels plus a
basement added to the hurricane-resistant design.
Town houses were the merchants1 version of the Great
House. These urban structures provided space for the
business on the ground floor and housed the merchant and his
family upstairs. They were borne of a central urban
environment, characterized by narrow streets and oddly-
shaped lots. Because they were located at the center of
international trade and the headquarters for the European
power, they were cosmopolitan in nature and depicted the
least "national" traits of house forms in the colony (Gosner
1982). As Gosner explains, referring to Caribbean
townhouses in a general sense, the West Indian townhouse
"owe[s] something to the shop-dwellings of Spain's
Mediterranean seaports; the graceful iron balconies are
French in inspiration; [and] the arcades go back to Italian
Renaissance cities..." (1982, p.22).
An outgrowth of the urban town house was the suburban
vernacular house, a response to a burgeoning primate city in
the nineteenth century and the need to devote maximum space
to commerce in the urban sector. Fraser & Hughes summarize
its design as follows:

154
...perfect symmetry, both in external walls, gables,
decoration and floor plan; a low, hurricane resistant,
rectangular shape; a front gallery usually enclosed by
serried ranks of wooden jalousy windows and Georgian
glass sash windows; a central front porch with a small
pediment supported by "turned" wooden posts adorned
with delicately carved friezes and sometimes wooden
tracery; a double staircase approaching the porch with
the principal rooms on an upper level in larger houses;
a stone parapet staircase separating the roof of the
front gallery from the gable behind it... (1986, p.60).
The primary objective of the suburban design was
coolness (fostered by gable roofs, jalousies, and living
rooms on the first floors), but many of the details were
purely for aesthetic purposes. With the continued
development of suburbs into the twentieth century, the
suburban vernacular style continued and was in fact
gradually incorporated into renovations of the plantation
Great Houses and into the design of upgraded chattels. Like
the chattel, this vernacular house form is believed to be
unique to Barbados (Fraser & Hughes 1986), and it appears to
have been influential in the design of the "single house" of
Charleston, South Carolina.26
Acworth contends that by 1840, Caribbean architecture
in general was well-developed and each island was
incorporating its own vernacular art form into residential
construction:

155
...Though still looking for inspiration from England,
the Islands had each of them developed building habits
of their own and had, indeed, gone far towards
establishing an architectural tradition. Shingles and
fish-scale tiles, timber and brick, cut-stone and
Spanish-walling, windows and jalousies, hoods and solid
shutters, gave ample scope for variety in architectural
treatment; and each island had by this time made its
choice. The choice was not altogether a free one—it
was conditioned by the availability and relative
cheapness of materials as well as by the circumstance
of geography, but there was still plenty of room for
the play of fancy; and, by and large, the colonists
made good use of their opportunity... (1949, p.35).
In summary, the Georgian style of architecture was
integrated into the Barbadian house form almost immediately
after colonization. At least among the lower socioeconomic
strata, West African traditions were probably incorporated
as well. The style was an adaptation to the tropical
environment and different types of structures reflected the
financial means of the class for which they were built, via
size, materials of construction, and spatial distribution
(e.g., the small, timber chattel for the working class, the
stone great house for the planter). Emulation and imitation
of the upper strata house form is evident in the design and
detail of the working class chattel; this suggests that the
"ideal” house form has always been one constructed of a
permanent material (stone), relatively large, and most
importantly, constructed on a piece of property that was
owned by the householder. Alternatively, it could be that
the desire to own land—and to exploit that ownership by
constructing a dwelling that expresses ownership (a concrete

156
or stone house)—supersedes what is actually preferred at
the structural (architectural) level. This suggestion
indicates that "modernization” of the home has less to do
with the desire for particular features in the domestic
environment than does the social status associated with
modernization and that a much greater force than convenience
is operating in the evolution of the home.
Trends in Contemporary Housing
The Role of Ownership
Perhaps because of the symbolic importance that home
and land ownership has played in the social history, housing
has been a volatile political issue throughout much of the
twentieth century. As reported by The Advocate.
housing is dear to the hearts of all Barbadians, and to
own one's home is probably the single most attractive
goal shared by this country's nationals. Barbadians
have a long-standing reputation of being house proud
and even the most humble chattel dwelling is a source
of pride to its owner... (Thursday, June 17, 1982).
The etiology of the imbalance between land ownership
and home ownership has been discussed. As was presented,
even legislation that enables tenants to purchase land is
only benefiting the working class at a slow pace. No doubt
the delay in what was predicted to be a housing development
boom can be attributed to the economic crisis of the past 2
decades. Nevertheless, the stage is set for significant

157
changes in Barbadian housing, and some of those changes have
already taken place.
Increasing rates of land ownership, or at least intent
for land ownership, are evident in three housing trends: (1)
a decrease in the incidence of housing relocation; (2) the
increasing integration of concrete into previously all¬
timber structures, or the construction of new, exclusively
concrete structures; and (3) the increase in installation of
plumbing and utility provisions. All three of these factors
demonstrate an element of permanency and, in theory, should
ultimately lead to an improvement in the overall standard of
living. Not unrelated to the three trends is the elevation
of self-esteem and pride and the sense that the average
Barbadian is finally overcoming the historically-based
social stigma of a landless proletariat.
Certainly a situation in which a tenant has virtually
no latitude for home improvement is one in which both the
dwelling and land are rented. Therefore, it comes as no
surprise that apartment living is unattractive to
Barbadians, despite the appeal among Barbadian youth for
materials and practices that are "Euro-American." As Graham
Dann27 notes, "...it's the 'house being your castle' idea"
that deters even the young Bajans from apartment residency
(personal communication) and therefore strengthens the
extended family living pattern. Furthermore, most of the
apartments for rent in Barbados are priced and marketed with

158
tourism in mind and rent is subsequently beyond the means of
most Barbadians (personal observation).
A form of rental that is prevalent out of necessity
rather than preference is low income housing; 4,048
Barbadians lived in low income housing apartment or housing
units provided by the government in 1991 (see Table 3-4 for
breakdown by parish) Babb,28 personal communication). W.
Babb of the National Housing Corporation (NHC) reported that
the profile of the average renter was as follows: the
average tenant is female, 25 years old, usually employed as
a domestic servant, and earns approximately $150.00 weekly
(Babb, personal communication). The NHC reported that the
average two-bedroom unit cost $20.00 per week, and a three-
bedroom unit cost $30.00 per week (1991) (Daisley,29
personal communication).
The Town and Country Development Planning Office
reckoned a need of approximately 1,700 dwellings annually
between 1980-1985 to account for the following: "(i)
Formation of 440 new households per year; (ii) [r]eplacement
of 75 units lost annually in fire and 20 units lost due to
change of land use; (iii) [and the n]eed to build 1.8% of
the stock or 1,209 units annually due to the accumulated
back-log demand to replace obsolete temporary
structures,..." (1988, p.45). However, as of 1981, the
Ministry of Housing and Lands only had 4,000 units to
accommodate the greater than 10,000 applications that had

159
been back-logged for 11 years (Dann 1984); note that the
reported ”4,000 units” of 1981 are not significantly
different from what was available 10 years later, at 4,048
units.
Table 3-4. Tenants living in National Housing
Corporation units by parish, 1991.
Parish
Number of tenants
St. Michael
2,813
Christ Church
669
St. Thomas
52
St. Peter
36
St. Andrew
29
St. John
18
St. Philip
38
St. James
337
St. Joseph
15
St. George
41
Total
4,048
Source: National Housing Corporation, unpublished
data for 1991 (Babb, personal communication).
Nevertheless, the majority of Barbadians enjoy a very
high degree of home ownership—47,124 (70.2%) households in
1980 owned their dwelling (Potter 1989). There is notable
disparity between home ownership from district to district
varying from 24.7% to 98.0% (Potter 1988). There is also a
general decline in home ownership with the degree of
urbanization and along the urban south and west coasts
(Potter 1988). Table 3-5 illustrates the breakdown of
dwelling tenure by parish for 1980, demonstrating the
disparity of ownership by region; heavily urbanized St.

160
Michael shows the lowest percentage of ownership and rural
St. Andrew, St. Joseph, St. John and St. Lucy show a very
high percentage of ownership.
A decline in relocation
As previously defined, the chattel house was originally
constructed in a manner in which it could be dismantled
within hours, loaded onto an ox-cart (later, a flat-bed
truck), relocated and reconstructed, all in the same day.
M. Hurley at the Valuation Department recalls: "...When I
was a boy, every Sunday morning you saw them moving on
trucks, big trucks" (personal communication). The houses
are dismantled in sections and walls and gables are stacked
on top of each other, then pieced back together at the new
location. The coral rock pile is left behind and another
one is created at the new site.
The rate of relocation is declining annually. In 1980,
700 chattels were moved, mostly from the rural to the urban
sector (Potter 1986; Town & Country Development Planning
Office 1988) and in 1989 the number of relocations was 636;
this figure was up slightly from 1988, in which 580
dwellings were moved (Ministry of Housing & Lands 1990).
Table 3-6 demonstrates the trend in relocation by parish
over a nine-year period. Relocation is viewed as a sign of
home improvement, since two of the reasons given for
relocation are the change in status from tenant to owner and

161
participation in development projects and urban renewal
(Ministry of Housing & Lands 1990).
Upgrading the chattel and creating new forms
A somewhat standard, step-wise process of development
in the contemporary Barbadian home has been described in the
literature (Potter 1989; Fraser 1990; Fraser et al. 1990)
and can readily be observed in Barbados. The "typical"
chattel is approximately 10 by 20 feet (3 by 6 meters) and
divided by a partition into a living area and sleeping room.
This is reminiscent of the medieval house plan, or "hall-
and-parlor," 2-room plan, in which two rooms were side-by-
side, with an entrance relatively centered on the long wall,
leading into the larger of the two rooms (Gosner 1982).
Typically there is a 6-12 inch space between the partition
and ceiling, if there is a ceiling. In most of the simplest
chattels the rafters are exposed, and if a ceiling is
present, it is only in the front living area.
With an increase in family size or availability of
capital, the household may decide to upgrade the chattel,
creating more space. Potter (1989) has defined the
upgrading of a wooden chattel as follows: the addition of a
unit (including a second bedroom and separate dining area)
to the back of the house creates a "bipartite chattel." The
construction of yet another unit, affording a third bedroom
and subsequently a separate kitchen, dining, and living
room, is referred to as a "tripartite chattel" (Potter

162
1989). This last unit to be added is also referred to as
the "shed roof," probably because, historically, it was not
raised off the ground, as in the case of the front units, it
was typically smaller than the other units, and it was
covered with a sloping, flat roof rather than a gable or low
hip-roof. It housed—and in many cases continues to house—
the kitchen and an informal dining area. In the event that
ownership of land is secured, the family may add a concrete
toilet, shower and kitchen behind the front units, replacing
the shed roof, or, if and when the capital is available,
they may build an entirely new concrete structure around the
old wood structure, then gut the wood when the new exterior
is completed. A household may purchase the concrete blocks
in increments, when cash is available, over a period of
several years. Actual construction may take place in
increments as well. Figures 3-3a-c illustrate the layout of
the traditional chattel, the "tripartite chattel," and the
modified chattel with concrete additions in the back of the
house. Figures 3-4a-c illustrate the exterior appearance of
this step-wise progression of the chattel.

Table 3-5. Dwelling tenure (owned, government rental, or other) by parish, 1980. "Other"
status includes rental, rent free, squatted, and not stated. Figures given as both
frequency and percent of the total for each parish.
Government
Parish
Owned
Frequency Percent
rented
Frequency Percent
Other
Frequency Percent
Total
Christ Church
7,544
66.63
505
4.46
3,273
28.91
11,322
St. Philip
3,940
82.41
56
1.17
785
16.42
4,781
St. John
2,133
86.95
22
0.90
298
12.15
2,453
St. George
3,593
84.52
45
1.06
613
14.42
4,251
St. Joseph
1,426
81.86
52
2.99
264
15.15
1,742
St. Andrew
1,396
88.02
35
2.21
155
9.77
1,586
St. Lucy
2,025
84.80
2
0.08
361
15.12
2,388
St. Peter
2,313
81.99
4
0.14
504
17.87
2,821
St. James
3,455
72.17
237
4.95
1,095
22.87
4,787
St. Michael
17,024
60.17
2,300
8.13
8,971
31.71
28,295
St. Thomas
2,275
83.89
58
2.14
379
13.97
2,712
Total
47,124
70.19
3,316
4.94
16,698
24.87
67,138
Source: 1980/1981 Population Census 1985.
163

Table 3-6. Number
of houses relocated by
parish,
1981-1989.
Parish
1981
1982
1983
1984
1985
1986
1987
1988
1989
Christ Church
119
97
95
85
83
81
74
91
• 91
St.
Philip
67
65
46
39
63
42
38
44
61
St.
John
30
30
31
26
43
29
30
27
46
St.
George
68
50
53
52
34
62
61
57
62
St.
Joseph
15
11
11
21
24
25
26
28
27
St.
Andrew
20
20
31
16
13
15
15
21
23
St.
Lucy
17
19
36
31
30
23
40
38
35
St.
Peter
41
29
42
48
15
31
33
30
34
St.
James
53
51
50
44
55
57
45
41
45
St.
Michael
167
222
179
182
182
157
168
171
167
St.
Thomas
45
31
34
32
36
37
40
32
45
Total
642
625
608
576
578
559
570
580
636
Source: Ministry of Housing & Lands. 1990, pp.63-65.
164

165
ft
Figures 3-3. Chattel house floorplan. (a) traditional
chattel house; (b) tripartite chattel house; (c) modified
chattel house with concrete addition.

166
Figures 3-4. Sketches of the three stages of the chattel
house. (a) traditional chattel house; (b) tripartite
chattel house; (c) modified chattel house with concrete
addition.

167
Somewhere between the traditional chattel house and the
suburban villa emerged an intermediate house form, which the
author refers to as a "modified chattel." These homes
probably make up the largest proportion of structures
classified as "wood and concrete together" in the census
report. Fraser gives brief attention to these "wooden
suburban" structures, which he also refers to as a "chattel
house of stone", noting that the only difference between
these newer structures and a chattel is that they are not
movable, since they typically rest on a concrete foundation
rather than loose rock, at least in the front portion of the
house (1990, p.13).
But the modified chattel is different from the
traditional house form in a number of features. It bears
much less respect for symmetry in its design and
incorporates a mixture of that which is traditional and that
perceived as "modern." Not unlike its predecessor or any of
the other Bajan house forms, it also presupposes access to
certain materials, in regards to cost and availability.
Again, this strikes a familiar chord with the medieval folk
house counterpart, which was dynamic rather than static, not
created as a single entity, but grew with the addition of
ells and wings, resulting in an asymmetrical, irregular
form, that did not bother the medieval builder in the least
(Gosner 1982). Thus Bajans have come full circle, from
first evolving their own vernacular art form of housing

168
based in part on what was architecturally sanctioned for the
period—the Georgian—but modified to fit the climate and
resources. Currently, at the end of the fourth century of
their existence, the process is continued by recreating the
haphazard style of the late twentieth century under new
social and economic circumstances. Nevertheless,
architectural appreciators lament:
in recent years appreciation of both the chattel house,
the suburban vernacular and everything in between
appears to have been lost, [since] [t]he symmetry, the
gables and the decorative carvings are disappearing as
these houses are destroyed and replaced by crudely
designed houses that are purely utilitarian yet without
the thoughtful and valuable features of the traditional
house (Fraser & Hughes 1986,p.70)
The transition from wood to masonry
In the 1950s, nearly 90% of all homes in Barbados were
built entirely from wood (Lowenthal 1957). According to
Dann (1984), little had changed since the 1891 and 1921
censuses, in which 86.6% and 83.2% of the homes were
reportedly of wood, respectively. In 1970 that figure fell
to approximately 75% (Dann 1984), and in 1980, just over
half (57%) of the homes were built entirely of wood
(1980/1981 Population Census 1985).
As Potter (1989) explains, the national figure for the
number of all-wood dwellings is deceiving, since there are
in fact marked spatial variations; in one urban enumeration
district, all-wood dwellings made up 91.2% of the total
housing stock. On average, however, the rural parishes have
a larger proportion of timber homes than the urban and

Table 3-7. Number and ]
percentage
of dwellings by
type of
material,
for each parish
, 1980.
Wood
Masonry
Mixed
Other
Total
Parish
Number
Percent
Number
Percent
Number
Percent
Number
Percent
Christ Church
5,269
46.5
4,549
40.2
905
8.0
599
5.3
11,322
St.
Philip
2,933
61.3
1,072
22.4
548
11.5
228
4.8
4,781
St.
John
1,671
68.1
294
12.0
368
15.0
120
4.9
2,453
St.
George
2,674
62.9
801
18.8
590
13.9
186
4.4
4,251
St.
Joseph
1,241
71.3
166
9.5
260
14.9
75
4.3
1,742
St.
Andrew
1,293
81.5
112
7.1
139
8.8
42
2.6
1,586
St.
Lucy
1,635
68.5
427
17.9
217
9.0
109
4.6
2,388
St.
Peter
1,888
66.9
397
14.1
348
12.3
188
6.7
2,821
St.
James
2,344
49.0
1610
33.6
629
13.1
204
4.3
4,787
St.
Michael
15,707
55.5
7,690
27.2
3,530
12.5
1,368
4.8
28,295
St.
Thomas
1,822
67.2
446
16.4
274
10.1
170
6.3
2,712
Total
38,477
57.3
17,564
26.2
7,808
11.6
3,289
4.9
67,138
Source: 1980/1981 Population Census. 1985, p.174-193.
169

170
"suburban" parishes; Table 3-7 depicts the distribution of
dwellings according to "material of construction." Not
surprisingly, the parishes with the fewest number of timber
homes are suburban Christ Church and St. James, at 46.5% and
49.0%, respectively, while the highest number of timber
homes are in remote St. Andrew and St. Joseph, at 81.5% and
71.3%, respectively. Looked at from another perspective,
for the same year, 1980, the number of households that
applied for and received approval for renovation of their
dwelling were overwhelmingly from urban St. Michael (Table
3-8). Similarly, the parishes with the greatest number of
sub-divisions, Christ Church, St. George, and St. James,
underwent a good deal of renovation also. "Renovation," of
course, likely represents the addition of concrete to the
existing structure.
Table 3-8. Applications approved by the Town & Country
Development Planning Office for renovation of dwelling
units, by parish, 1980.
Parish
Number
Percent
Christ Church
19
12.9
St. Philip
6
4.1
St. John
2
1.4
St. George
10
6.8
St. Joseph
1
0.7
St. Andrew
6
4.1
St. Lucy
1
0.7
St. Peter
8
5.4
St. James
14
9.5
St. Michael
75
51.0
St. Thomas
5
3.4
Total
147
100
Source; Ministry of Housing & Lands. 1990, p.38.

171
Table 3-9 presents the number of applications approved
by the Environmental Engineering Division of the Ministry of
Housing and Lands for new dwellings and the number of
applications for renovations on existing dwellings, over an
eight-year period. From the figures it is apparent that the
majority of households, upon deciding to build an entirely
new home, are building in concrete exclusively. It is
interesting that, while the number of renovations on
concrete homes and the construction of new concrete homes
has steadily increased, the construction and renovation of
exclusively wood homes seems to have peaked and is now
tapering off. These data presented from the three tables
indicate an overall trend in construction of masonry
dwellings, particularly in the more densely populated
regions of the country and in the regions with access to
better resources. Based on policies from the Town & Country
Development Planning Office and the shift in the population
to the western parishes, there appears to be little
incentive for residents in the very rural regions to upgrade
their homes (note: data were not available from the final
1990 census and therefore could not be included in the
review).
According to various building contractors, the
estimated life span of a wood home in a tropical climate is
roughly 20 to 30 years. Nurse (1983) suggests that one
reason for the boom in land acquisition and construction

172
during the 1960s and 1970s was the fact that, according to
the 1970 Census, 49% of the homes were 20 years old and
over, thus creating a need for home improvement, or new
construction altogether. There is institutionalized
dissuasion against the use of wood in home construction by
both the loan agencies, which limit mortgages on timber
structures, and by developers, who restrict the use of wood
in their sub-divisions by creating building standards that
favor concrete (Nurse 1983). In addition, homeowners'
insurance for wood structures is higher than for concrete
structures because of the hazard of fire (Edghill
Associates, Ltd.,30 personal communication). For example,
since in 1989, 43 of the 64 homes completely destroyed by

Table 3-9. Number of new and renovated dwellings by house type, approved by the
Environmental Engineering Division, Ministry of Housing & Lands, 1982-1989.
Year
Wood
New
Dwellinas
Total
Wood
Renovated
Dwellinas
Masonrv Mixed
Masonrv
Mixed
Total
1982
2
1,111
5
1,118
8
141
23
172
1983
7
1,056
19
1,082
10
203
43
256
1984
49
1,083
54
1,186
11
290
43
344
1985
30
519
30
579
47
203
59
309
1986
89
810
181
1,080
176
397
85
658
1987
232
1,824
366
2,422
209
565
421
1,195
1988
110
1,301
291
1,702
40
459
310
809
1989
80
1,851
195
2,126
82
711
149
942
Source:
Ministry
of Housing & Lands. 1990,
pp.32-34,
46-48.

174
fire between 1989 and 1990 were timber (Ministry of Housing
and Lands 1990).
A "wall” home ("wall" is colloquial for concrete) is to
a degree an unspoken symbol of wealth, since only wood homes
can be built on rented property. But concrete homes are
also perceived as being better-built and are therefore
preferred. "Mr. King" of Chalky Mount, St. Andrew,
explains: "...a wall house is more expensive, but ya do not
have to do anything to it. A wood house ya have to paint
ev'ry year an' board it up. People prefer a wall house over
board—it last longer. But, ev'rybody cannot afford it! On
hills, ya can't build a wall house—it too hard." Thus the
peasant landowners of the rural parishes are constrained by
cost and topography in upgrading their homes.
There are some members in Bajan society who consider a
well-built wood house to be of greater value than a concrete
house and, depending on the type of timber, the wood house
can actually be more expensive. A Bajan surveyor noted the
following:
wood houses can be as nice and more expensive than wall
houses. You can have pine which is very cheap, usually
imported from Canada, or you can have yellow heart or
purple heart—that's very expensive, imported from
Guyana. But it lasts. Termites can't touch it.
Early decimation of the rain forest and cane
monoagriculture resulted in a scarcity of wood and
necessitated the continuous importation of this material

175
throughout Barbadian history. In the late 1980s the Arawak
Cement factory, jointly owned by Barbados and Trinidad and
Tobago, commenced operation, followed by the opening of two
cement block companies and a company producing the galvanize
sheeting. As a result, Barbadians have greater access to
sturdy raw materials than they did in the past. Curiously,
greater access does not necessarily mean cheaper prices; in
fact, a common complaint, in the words of a particular
building contractor, is that the Arawak plant "[has] made
concrete more expensive! It use to be they could import the
cement from other Caribbean countries for a lot less money.
The Arawak Company is government-owned though, and we have
to buy from them, and they charge more".
Little has changed in the overall construction of
chattel houses from the earliest building techniques, with
the exception of the fact that one can purchase "pre-fab"
chattel walls from building construction suppliers, and
chattel builders frequently use correlated zinc-coated iron
sheets, which Bajans refer to as "pealing", for the gabled,
shed, or low hip-roofs. Galvanize is also used on the roofs
of masonry homes. A new type of galvanize is called
"permaclat," which is supposedly sturdier. The optimal and
newest type of roof is called "closed board ceiling," and
is one in which the exterior is covered in clay tiles, or
shingles, and the interior is finished with ceilings of wood

176
planks, close together, and attractive enough that ceiling
panels are not necessary (personal observation).
Window styles have changed considerably, largely
influenced by a building supply company that seems to have a
monopoly on the island. Window preference has transformed
from the wood jalousies to substituted glass louvres, to the
three- or four-pane awning windows (simply referred to as
"Oran," after the company that produces them, Oran Ltd.31),
to the currently popular aluminum sash windows with screens.
But these darkened sash windows are preferred more for
aesthetic purposes than for practicality:
in the newer houses you see screens, but people really
don't like them. Cuts down on the breeze, ya see. I
saw one brand new house...the family moved in and just
tore out all of the screens! You really don't need
screens here...Besides, we have clean mosquitoes.
One tenant stated that, in her "dream house," she would
prefer the aluminum sash windows with screens, because "they
look so sexy." As a rule, nowhere except in the tourist
apartments and hotels can one find screened windows in
Barbados (personal observation).
The problem of construction in the informal sector
In the Sunday Advocate, it was noted that the old
"timber house," or chattel, was built with the most reliable
architecture in mind in regard to roofs and tropical weather
(Greenidge 1991). In short, the low hip roofs and high
gable roofs—ideally with a pitch of 30 to 40 degrees—have

177
a lower windload than the increasingly popular flat roofs
and were better at withstanding serious storms. The editor
noted that the faulty trend in architecture is attributed to
"do-it-yourself builders" and small contractors who are
increasingly involved in the building of private homes
(Greenidge 1991).
Notice was given to the increasingly scant attention
paid to practicality in architecture with the advent of the
concrete home in the late 1950s. One observer, in his
discussion of the grace, quality, endurance, and ventilatory
principles in the traditional Caribbean Georgian style
noted:
The pleasing quality of this architecture bears no
comparison with the houses or, more often, bungalid
excrescences erected today whose thin walls, steel
windows, low ceilings and verandas supported by pillars
unknown to any order of architecture, offer neither
shady nor cool rooms and whose protection from
hurricanes is somewhat doubtful. (Connell 1959, p.172).
Although in theory the architecture of the wooden
chattel may have been superior to the modified concrete
versions of contemporary Barbados, attention must be given
to the fact that, in the hurricane of 1955—the most recent
of truly devastating hurricanes to hit Barbados—more than
1,000 chattels were completely destroyed and 15,000 were
seriously damaged (Lowenthal 1957).
Fifty-two contractors are listed in the 1991 Barbados
telephone directory. There are no statistics available to

178
determine what percentage of the population relies on
professional building contractors to remodel or build their
homes, versus those who build themselves. According to the
building contractors, a range of 40% to 75% of the
population would contract a professional. Construction in
sub-divisions is performed exclusively by professional
builders, but empirically speaking, construction in the
tenantries tends to be carried out by the residents and
family members or friends, with the exception of the
company-owned truckers that haul in the marl, concrete, or
lumber (personal observation).
The price of concrete blocks depends on the thickness;
blocks for building houses are typically 16" long, 8" wide,
and available in 4", 6", or 8" thickness. According to the
building contractors who were interviewed, they invariably
build with the 8" blocks, which cost $2.00 a block, while
the "do-it-yourselfers" tend to purchase the 6" blocks.
Overall, the difference in cost for a timber house versus a
concrete house is substantial; in 1986, a two- and three-
bedroom timber house cost $11,700-$18,000 and $14,200-
$24,000, respectively, while a 110m2 concrete house—and
only the house, not the lot—cost $66,000-$88,000 (Town &
Country Development Planning Office 1988,p.46). The lot for
that house ranged from $10,500-$13,500 (Town & Country
Development Planning Office 1988, p.46).

179
The contractors interviewed all stated that concrete
homes were built year-round, without concern for relative
humidity and the problem of thorough drying. The
professional contractors contend that the only problem with
moisture and construction is in the older homes built of
coral limestone, since the material is so porous and retains
water. Construction of the average house, according to
contractors, takes anywhere from four months to one year.
A number of building codes have been established to
minimize damage to houses from tropical storms and termites.
One such code that is apparently heeded to rather
stringently is the code for laying a concrete foundation.
First the foundation is dug, then filled with marl.
Afterwards a vapor barrier (also called a "wind" barrier, or
heavy polyethylene sheet) is laid over the marl, followed by
a fabric reinforcement sheet, and finally the concrete is
poured. Traditionally the soil was treated with an
insecticide against termites before the marl fill and
repeated before the vapor barrier was laid; however,
recently the government banned the traditional chemical used
against termites and the alternative is 10 times the old
price, increasing treatment costs from 15 cents per square
foot to more than $1.00 (Edghill Associates, Ltd., personal
communication). Vapor barriers are not used on the concrete
walls.

180
Construction in the poorer sectors is not so
methodical. For those timber structures in which a concrete
section is being added, a foundation such as that prescribed
by contractors may or may not be constructed. For example,
one family in the study, whose house was situated on a
slope, simply constructed block stilts and then laid the
floor over the blocks. If a household does choose to follow
the foundation code, the benefit of termite-prevention
spraying and the use of vapor barriers to prevent moisture
are likely negated by the fact that the new section is
joined to an older wood section, probably resting on
moisture-retaining coral limestone rocks. Similarly, the
foundation may be laid months or even a year before enough
capital is available to complete the new section entirely
(personal observation).
By law all building construction on the island must
first be approved by the Town & Country Development Planning
Office, regardless of who is doing the work. But one
contractor noted a weakness in the system:

181
Here are no stringent building laws. The people that
do the Town Planning...are more concerned with how
close the structure is to the main road, the fact that
you're going to build a domestic in an area that is set
up more for business or agriculture...There is no
strict building code....The government won't say
'that's wrong', 'this is wrong'...They're very strict
about your plans, and where it's located, and yet the
quality of materials you use—there's no regulation.
But if you build ya have to have certain codes, or
standards. Especially if you have a contract...you
have to have the specification in the contract, so you
can't wiggle out of it...It's an ethic that builders
and architects use, similar to the U.K. and the U.S..
Elaboration of the indoor environment
The average cost of carpeting is $54.00 per square
meter, and most people buy carpet via high purchase32.
Typically, a household that carpets a 12' x 24' room—almost
without exception the living room—would pay approximately
$60.00 per month over two years. Although carpeting is now
common in Bajan homes, very few households own a vacuum
cleaner (personal observation).
All of the attention to detail in the house is focused
in the living room, where the family spends the majority of
their time together and where guests are entertained.
Furniture is very standardized in Barbados across the
socioeconomic strata; it is almost without exception a
mahogany frame with removable seat and back cushions, the
cushions being made of crush velour fabric and filled with a
two- to three-inch thick piece of foam. "More is better"—
quantity is more reflective of what is affordable than the
style, since there is only one style—and little attention

182
is given to the spatial distribution of furniture; in some
homes sofas and easy chairs literally line the living room
walls (personal observation).
The typical living room has an entertainment stand,
varying in elaboration and expense, on which the television,
VCR, and stereo sit. The reader should note that, in the
asthma study, as was presented in Chapter Two, the number of
households with at least one television was greater than the
number of households with a refrigerator. Lace curtains are
very popular and adorn every window, as well as each doorway
in the house, even if a door is present. In keeping with
the prevalent ornamental horticulture around the house,
householders enjoy a number of indoor plants (personal
observation).
In contrast to the front room, bedrooms are quite
simple as a rule, usually just big enough for a double bed
and perhaps a dresser. Closets are not common and many
residents hang their clothes on nails driven along the
bedroom walls, or store them in suitcases or cardboard boxes
in the corners of bedrooms. Almost all bedrooms observed in
the asthma study had a small rug next to the bed, though
very few had carpeting (personal observation).
Installation of indoor utilities
Potter concludes that the low percentage of land
ownership is significant in limiting the degree of housing
upgrading among the masses in Barbados in regard to plumbing

183
and sewerage provisions (1986,1988,1989). Certainly an
aspect of home improvement that has been admittedly slow in
evolving—considering the economic development of Barbados
compared to other West Indian countries—is the conversion
from pit latrines and community water pipes to indoor
plumbing. This factor is directly attributable to the fact
that, if a tenant does not own the house spot, he/she cannot
legally add permanent (concrete) structures to the home. In
1980, just over half (58.9%) of all Barbadian homes had
piped water inside the home and less than half (47.8%) had
indoor toilets (Potter 1986). Twenty-one percent of the
households had a standpipe in their own yard and close to
10% had to rely on a public standpipe (1980/1981 Population
Census 1985) . In a 10-year period, the annual number of new
water connections increased from 614 (1979) to 1,453 (1989)
(Ministry of Housing and Lands 1990). Since Barbadians are
charged for water based on the number of taps, when a family
can finally afford indoor water, the household typically
installs a kitchen sink and may continue to use an outdoor
privy and shower until additional taps—and the construction
of a bathroom—can be afforded.
Indoor plumbing and electricity was initiated on a
large scale in the 1940s and 1950s, due to the availability
of the technology and the large number of emigrants sending
back remittances for home improvement. M. Hurley at the
Valuation Department explains:

184
In the 1950s, there was a lot of migration to England
and Canada. A lot. The Barbadians there would send
"expatriate funds" to their families, and people
started to improve their houses. They would improve
the house, and remove the shed. Or most common, they
would build a wall bathroom-toilet, and just keep
adding concrete. We use to have outdoor kitchens; they
moved the kitchens indoors in the 1940s and 1950s.
Running water was introduced in the 1950s...Then you
could get an installment plan, where they put a tap in
your house. You just paid for having that water into
the house. That is something that people are angry
about—now you have to pay for water based on the
number of taps in the house, and rates have gone way
up.
This step-by-step upgrading of the Bajan home is
evident in the 1990s as well. When a Barbadian wants to
improve his/her home, the first addition is an indoor
kitchen. Once the kitchen is moved indoors, piped water for
the kitchen sink is installed. The addition of an indoor
toilet requires the construction of a new room, usually a
small concrete room added to the rear of the house and a
toilet is installed. If the family has the means, they will
add a second concrete slot (at the same time or at a later
date) next to the toilet slot, for a shower. It is not
unusual for households to continue using an outdoor privy
after the addition of an indoor toilet and shower, as a sort
of "second" bathroom (personal observation).
Similarly to plumbing, the last 10 years have seen a
dramatic increase in the number of electrical inspections
for new dwellings; inspections increased from 1,213 in 1979
to 2,365 in 1989 (Ministry of Housing and Lands 1990). In
1985 the National Census Bureau reported 55,738 homes with

185
electricity, or 83% of all households (1980/1981 Population
Census 1985). Electricity sales soared from 100 million
kwhs in 1968 to 285 million kwhs in 1980; domestic sales
accounted for 21% of that increase (Town & Country
Development Planning Office 1988). Bottled gas is the
predominant form of cooking fuel, although increasingly
natural gas is being connected in a number of villages. In
1980, close to 30% of the households were relying on
wood/charcoal, kerosene, or some form of cooking fuel other
than gas or electricity (1980/1981 Population Census 1985).
The Role of the Family System
The impact of costs and tenure
The adaptable characteristic of the Bajan house form is
due in part to the extended family. The economic advantages
of the extended family are varied. Due to the economic
constraints in Barbados, a young adult cannot easily afford
to secure his/her own apartment or house, nor afford the
items necessary for a new home (e.g., appliances).
Typically, after completing compulsory education, a young
person may choose to go on to college and/or university, or
go immediately into the work force. By staying at home the
young adult can save his/her money until enough capital is
available for a home. Because of the extended family, if a
young woman becomes pregnant, childcare provisions are
available if she is working. A proportion of the young

186
adult's income is pooled into the family income, thus
allowing the family to live in a higher quality home with
many of the household amenities that they might not be able
to afford individually.33
Marital (legal) and nonmarital (nonlegal) unions play a
role in initiating a new household.34 "Ian" and "Mary"
recently had their first child. Mary has a 10-year-old son
from a previous nonmarital union. She is 28 years old and
Ian is 29 years. Just before the baby arrived, they moved
into a new chattel that Ian built himself. They live in
Cotton Vale, where Ian grew up, and Mary's family lives in
the neighboring village. Ian explains:
When does a young person decide to get they own house?
Well, ya see different ways. Young people may live at
home after school, while they work, and save they
money. But if you are a Christian, if you a Christian
follower, then I would say around 22 to 25 ya decide to
get married. It's the thing to do. After ya get
married, you live with the family or you rent...until
you could afford to build a house. But if you not a
Christian, then you in relationships for pleasure, see,
no responsibility. They put off the responsibility, so
they can move around and don't have to be at one
place...
The fact is, however, that a legal marriage in Barbados is
unrelated to religious affiliation (Dann 1984) and as was
discussed in Chapter Two, the likelihood of engaging in
legal marriage increases with age. Nevertheless, "Ian's"
narration regarding a young couple's move to set up their
home is applicable to common law unions as well.

187
Trends in household density
Household density has traditionally been used as an
index for socioeconomic status. Lowenthal noted from the
1946 census that, despite the extreme population density,
household density was lower there than the other British
West Indies, at 1.55 persons per room (1957). He did find,
however, that within Barbados, room density was inversely
proportional to regional population density; the very rural
parishes of St. John, St. Joseph, St. Lucy and St. Andrew,
with densities of 1.92, 1.71, 1.69, and 1.86 persons per
room, respectively, were considerably higher than a density
of 1.36 in Bridgetown.
Using preliminary figures from the 1990 Population
Census, a trend is observed in population density per
household by parish (total number of persons per parish
divided by the total number of households in that parish)
(note; figures were not available to calculate density per
room for 1990) (unpublished data). Table 3-10 illustrates
the gradual but very steady decline in household density for
each parish from 1970, 1980 and 1990. When a comparison is
made to Lowenthal's report from 1946, it is apparent that
significant changes over a 24- to 44-year period were only
made in a few of the parishes and those were the very rural
parishes in which a great deal of urban migration has
occurred.

188
An important development, however, is not so much the
shift in household density in general, but the increasing
number of rooms in contemporary homes, which is probably
reducing the overall household density, when calculated by
total number of persons divided by the total number of
rooms. Historically, the average Bajan home was a two-room
structure; Lowenthal, relying on statistics from 1946,
concluded that, in the most rural and distressed parishes
along the windward coast, more than half of the households
had a density of greater than two to a room, and the most
common arrangement for the entire island was four persons
living in a two-room house (1957). From the 1980 census, it
is apparent that more than 78% of the population lives in a
dwelling with four rooms or more (1980/1981 Population
Census 1985, see Table 3-11), thus illustrating a
significant change in household spatial distribution
patterns and suggesting an increase in the number of
bathrooms and bedrooms per household. Similarly, just over
half of the households (56.6%) had four or more persons
living in one dwelling (1980/1981 Population Census 1985),
rather than the majority as Lowenthal reported.
Housing Trends and Health Implications
Moisture
Excessive moisture levels develop within the home in a
number of different ways. Two well-known means of moisture
build-up in homes of temperate climes are not factors in

Table 3-10. Number of persons per
1980, and 1990.
household
by parish, for
the years 1946,
1970,
Parish
1946a
1970b
1980b
19901
St. Michael
2
3.8
3.4
3.4
Christ Church
4
3.9
3.6
2.8
St. George
4
4.4
4.0
3.8
St. Philip
4
4.3
3.8
3.1
St. John
7
4.6
4.2
3.8
St. James
4
3.8
3.5
3.0
St. Thomas
4
4.3
3.9
3.7
St. Joseph
6
4.6
4.1
3.7
St. Andrew
5
4.6
4.2
3.9
St. Peter
4
4.2
3.8
3.3
St. Lucy
6
4.1
3.9
3.4
Source: aLowenthal, D. 1957,p.473. (Note:
b1990 Population Census, unpublished data.
figures denote
"mode")
00

190
tropical, developing countries—those are winter
xnoisturecondensation on windows and moisture that is
deliberately added via humidifiers. Means of achieving high
levels of moisture in the home that do apply to an
environment such as Barbados are moisture build-up via
normal living activities, household density, and ground
moisture (absorbed through crawl space floors or foundation
walls via wicking from the wet soil). This is, of course,
in addition to the persistently high relative humidity that
is part of the macroenvironment.
Hansen (1984) estimates that a family of four produces
an average of seven to twelve liters of water per day by
means of daily living activities such as clothes
drying,bathing, and cleaning the floor (Table 3-12). Even
bodily functions (e.g., exhaling) contribute ca. 0.18 liters
of moisture per hour, per person, to the environment (Hansen
1984) .

Table 3-11. Percent of households calculated for the number of persons by the number of
rooms.
Number of Rooms
Number
of
Persons
1
2
3
4
5
6
7 &
over
Not
stated
Percent of
households
Percent of
Total
Households
1
4.6
18.1
19.4
32.9
13.3
2.5
1.1
8.1
100.0
22.0
2
1.4
7.2
14.4
40.1
22.9
5.1
2.7
6.2
100.0
19.5
3
0.8
5.2
11.1
37.6
29.3
6.7
3.4
5.9
100.0
15.1
4
0.4
4.2
9.1
34.4
32.8
8.5
4.6
6.0
100.0
13.5
5
0.4
3.9
9.0
32.5
34.4
8.9
5.1
5.8
100.0
10.0
6
0.4
3.7
8.0
30.2
37.4
9.6
5.1
5.6
100.0
7.1
7
0.4
4.1
8.3
30.9
36.8
10.9
3.6
5.0
100.0
4.7
8
0.3
2.9
7.6
27.1
39.6
13.2
4.3
5.0
100.0
3.1
9
0.3
2.6
6.9
24.9
38.7
16.5
4.1
6.0
100.0
2.0
10
0.1
2.1
7.8
23.3
41.1
14.6
5.9
5.1
100.0
1.2
11
0
1.6
7.5
23.1
36.7
19.0
7.6
4.5
100.0
0.8
12
0
2.6
6.1
19.1
35.8
22.0
7.9
6.5
100.0
0.5
13+
0.4
2.3
3.5
19.2
38.0
21.8
9.3
5.5
100.0
0.6
Total
1.5
7.8
12.4
34.2
27.2
7.1
3.4
6.4
N/A
100.0
Source: 1980/1981 Population Census. 1985, p.238.
191

192
Table 3-12. Sources of moisture in the home. Figures
are based on a family of four living in a one-story
bungalow with a full basement and ground floor area of
111m2 (1200 square feet).
Sources of Moisture
Quantity in Liters
Clothes drying* (unvented)
Cooking*, gas (unvented)
Clothes washing* (unvented)
Floor mopping (7.4 m2)
Cooking*, electric (unvented)
Dish washing*
Bathing, shower
Human contribution (per hr.)
Bathing, tub
House plants (per hr.)
11.97
2.16
1.96
1.09
0.92
0.45
0.23
0.18
0.05
0.02
♦Figures for a family of four.
Source: Hansen, A.T. 1984,pp.231-1.
Although activities of daily living are significant
sources of moisture in the home, the biggest culprit in
moisture build-up is the structure itself. Exposed earth
and rock under the house produces up to 45 liters of water
per day when the soil is wet (Hansen 1984), and in temperate
climates, crawl spaces are reportedly the single most
important factor in moisture build-up in the house (Moffatt
1992). Admittedly, the build-up of moisture is reduced in
the event that a polyethylene sheet is laid before pouring
the concrete foundation. But as described, not everyone in
Barbados utilizes a moisture barrier. A significant amount
of moisture is added to concrete and plaster during
construction, and during the first year much of this
moisture may be released inside the home (Hansen 1984).

193
Even when polyethylene moisture barriers are used on the
foundation slab, there is remarkable moisture that is wicked
via concrete foundation walls (Moffatt 1992). Of the four
major moisture transport mechanisms in buildings, including
(1) liquid flow as a result of gravity and air pressure
difference, (2) capillary suction, (3) air movement and (4)
vapor diffusion, the first two, liquid flow and capillary
suction, are most important moisture mechanisms whereby rain
and ground water are the primary sources (Christian et al.
1992).
Another moisture-related problem that applies to almost
all Barbadian homes is the minimal use of gutters in housing
(personal observation). Considering the large amounts of
rainfall in a short period of time and persistent rainfall
during the rainy season, the tradition of allowing water to
drip off the edge of the roof and onto the ground
surrounding the house no doubt contributes tremendously to
moisture build-up, affecting all types of foundations (e.g.,
soil, coral rock, and even concrete). Regarding water run¬
off from houses, J.C. May found the following:
Splash from overflowing gutters is the most common
cause for moisture and pest decay of foundation sills
at masonry landings and at wood decks abutting the
foundation of a house. Improper dispersal of roof
water at downspouts is the main cause of wet basements
and subsequent mildew. (1992,p.49).
Certainly "overflowing gutters" are less of a problem than
the lack of gutters altogether, as in Barbados.

194
Concrete structures are erected in Barbados regardless
of the season, rainy or dry. Christian et al. note that,
although building assemblies may start out wet due to
construction under wet conditions, as long as the rate of
moisture entry does not exceed the rate of moisture removal
(e.g., a drying period), then "acceptable performance" can
still be achieved in that the materials do not deteriorate
due to persistently adverse (wet) conditions (1992). While
the building contractors interviewed argued that moisture
build-up in new concrete structures was not a problem, even
when constructed in the rainy season, the combination of
constant rain and ground water flow plus minimal air
movement during the months of August to November cannot be
overlooked as real impediments to the drying process.
The materials used for new homes—primarily concrete—
are probably less a factor in contributing to moisture
build-up in the home than is the method of construction.
Quite simply, availability of credit for home building is
limited, and the system works against the lower income
groups, who are forced to build in piece-meal. Such
building practices often negate the methodical use of
moisture barriers in concrete foundations and the treatment
against termites (personal observation).
Certain moisture-related sources inside the home are
also a factor in indoor humidity levels. Again, quoting the
work of J.C. May, a discovery made in a home inspection in

195
Massachusetts certainly applies to any locale, including
Barbados:
An asthmatic was interested in eliminating sources of
asthma triggers in her house. We uncovered one foul
source after another, but the refrigerator drip pan was
the most egregious. I noted in my own kitchen that I
started coughing every time the refrigerator compressor
started. Curious, I removed the grille (that always
needs a few good kicks of encouragement to replace) and
pulled out the drip pan. In the middle was what once
must have been an onion, now about twice its size and
covered with mold. Every time the compressor turned
on, air from the blower sent spores from the blob into
the room. When was the last time you cleaned out the
drip pan of your refrigerator? (1992, p.55).
Leaky faucets under sinks (where many Barbadians store empty
drink bottles and cooking utensils) no doubt contribute to
moisture build-up in the kitchen area. Traditional
"moisture problem" sites inside the home include mildew
build-up under furniture, inside closets, and on wall
surfaces (Sherman 1992). Leaky potted plants and improper
carpet cleaning have been implicated in abundant mold growth
(Brunekreef et al. 1989).
The deleterious effect of moisture in housing on health
has received particular attention in regard to respiratory
disease. A study in London revealed that children sleeping
in bedrooms with relative humidities greater than 75% for a
full week exhibited higher prevalence rates of respiratory
illness than children sleeping in rooms of lesser humidities
(Melia et al. 1982). In a similar study, Murray and Zuk
(1979) reported a significant increase in hypersensitivity

196
to house dust mites for children in living in damp homes as
compared to children living in dry homes. Platt et al.
(1989) found that both adults and children living in damp
homes had a greater prevalence of respiratory symptoms than
adults and children living in dry homes.
The relationship between a damp indoor environment and
respiratory disease is primarily due to the presence of
molds (Burr et al. 1985; Brunekreef et al. 1989; Platt et
al. 1989; Dales et al. 1991), fungi (May et al. 1986) and
house dust mites (Bronswijk, J. 1973; Murray & Zuk 1979).
In several studies, respiratory disease as a result of the
presence of these various agents was not dependent on
already-existing disease states such as asthma (Brunekreef
et al. 1989; Dales et al. 1991). The severity of
respiratory disease associated with molds has been found to
be dose-dependent (Platt et al. 1989).
It is important to note that in the majority of the
studies on dampness and respiratory disease, the research
was conducted in temperate regions, primarily focusing on a
dampness range of 40% to 60% (Spengler et al. 1992).
Furthermore, in most of the studies described above,
independent variables such as smoking, socioeconomic status,
age and sex were considered, but in none of the studies did
the researchers consider the role of the house structure.
Molds exhibit a critical relative humidity level of
just under 80% to greater than 90% (Gravesen 1979). While

197
house dust mites depend on human skin scales for nourishment
and exhibit a preferred temperature range of 17-32° C, the
most critical constraining factor for their survival is a
relative humidity level of above 55% (Korsgaard & Iversen
1991) (see Chapter Five for a thorough discussion on house
dust mites). Certainly the tropical climate of Barbados
provides an ideal environment for both of these disease-
causing agents.
Ventilation
Fraser and Hughes (1986) identified a number of
characteristics in the traditional chattel and great houses
that allowed for optimal ventilation, including the wide
verandas, demerara and jalousied windows, high gables and
tray ceilings. But, as explained, many of these features
are disappearing in the construction of new Barbadian homes.
The new "fad" is the closed-board ceiling, or a finished
ceiling. A closed ceiling reduces air flow within the
house, lowers the ceiling, conceals the rafters and the
underside of the roof and increases the temperature inside
the house. Also, whereas in the past, consideration was
given to prevailing winds when situating a structure and
constructing the windows, one building contractor lamented
that "now people want to face the sunset", or select window
openings for other aesthetic purposes (Nicholls & Edghill
Construction, Ltd.,35 personal communication).
Furthermore, as tenantries—especially those in the urban

198
sector—become more and more crowded, houses are erected and
additions made in whatever space is available; space
typically precludes strategic positioning in terms of air
flow.
The characteristic of adding concrete structures behind
the main unit of the house has been discussed, and the fact
that these concrete structures are used to house indoor
toilets and showers was presented. For the purpose of
privacy, windows in these small rooms are typically placed
quite high and, being relative to the size of the room, are
small. Because the concrete structure is added onto the
main unit, a window opening is usually only on 1 wall.
These 3 features of the "added-on toilet/shower" should,
theoretically, result in creating a space of very limited
airflow.
Air conditioning is rarely used in Barbados,
particularly in housing (personal observation). When asked,
most Barbadians, including building contractors, will
contend that it is not necessary, that the air temperature
cools down significantly at night and electric fans are
sufficient for circulating air in the home. When fans are
used, they are placed where residents spend most of their
time, either the living room or in the bedrooms, but not in
small space areas such as the bathroom. Ceiling fans are a
luxury and are not commonly found in the average Barbadian
home (personal observation).

199
Similarly to moisture in the home, a number of studies
have implicated poor indoor ventilation with respiratory
disease (tuberculosis. Riley et al. 1959; Legionnaires1
disease. Fraser et al. 1977). Admittedly, most of these
studies have focused on buildings in temperate climes where
decreased ventilation has been a deliberate action so as to
conserve energy (e.g., heating, air-conditioning), whereas
in a case such as Barbados, decrease ventilatory practices
have been quite accidental.
Relative humidity in the dwelling is not due entirely
to a change in structure—it is largely dependent on reduced
ventilation. As Arundel et al. noted, in a discussion of
the indirect health effects of the construction of sealed,
energy efficient buildings, a compromise has been made in
that "...the high fresh air ventilation rates found in older
leaky buildings may dilute the concentration of pathogens,
allergens and noxious chemicals in the indoor air and thus
offset some of the health problems associated with relative
humidity" (1986, p.359). Certainly, a similar picture
emerges from the Barbados scene.
Summary
In summary, land distribution patterns were established
early in Barbados, dictated by the planter elite and, more
importantly, sugar monoculture. Early land distribution
patterns played a major role in stratifying the population,

200
by creating a majority landless proletariat, that persisted
well into the twentieth century.
National steps toward reform of land distribution have
put into place policies that allow for the purchase of land
by all Barbadians, although the transition has been
sluggish, particularly in the densely urban sector. An
outgrowth of reforms and overpopulation in the urban sector
has been the birth of suburbs.
Although the use of concrete in construction of the
domestic dwelling is preferable for a number of reasons
(e.g., weather-proof, termite-proof, less maintenance), the
author contends that the predominant influence in the use of
construction has been the social stigma attached to a
concrete home—concrete in the house is synonymous with land
ownership. Therefore, the construction of concrete houses
and the amenities associated with them (e.g., indoor
showers, toilets, finished ceilings) are the aspiration of
Barbadians as a whole. As demonstrated, these factors
associated with the modern home are contributory to
increased indoor relative humidity and decreased indoor
ventilation—elements associated with the proliferation of
house dust mites and possibly a host of other household
pests.

201
Notes
1. The civil war in England contributed as many as 8,000
laborers between 1645 and 1650 (Beckles 1981), and by 1655
at least 12,000 prisoners of war had been sent (Chandler
1986). Cromwell's capture of the town of Drogheda in 1649
resulted in the shipment of a large number of Irish soldiers
to Barbados, and in 1651, 800 Scot prisoners from the Battle
of Worcester were sent (Roach 1984). Between 1654 and 1675,
2,000 servants came to Barbados from Bristol (Beckles 1980).
Sometimes children were confiscated from orphanages,
although those under the age of eight did not usually
survive the voyage (Roach 1984).
2. Certainly at least as significant a factor in the
preference for white servants was the low cost of servants
compared to African slaves in the early sugar years.
Middling and small planters—70% of all planters—found
white servants to be cheaper overall than African slaves,
because of the cost of buying, training, and disciplining
slaves, and the high mortality of the Africans (Beckles
1981). In 1652 there were approximately 13,000 indentured
servants and freemen employed on sugar plantations, nearly
balanced with about 15,000 African slaves (Beckles 1981).
3.By the end of the 1650s, the price for indentured
servants was increasing dramatically, as was their demand,
in contrast to the beginning of the fall in slave prices.
For example, in 1637, servants sold for seven pounds, but by
the mid-1650s, a servant cost as much as 14 pounds; this was
in contrast to a decrease in slave prices from 40.88 pounds
in 1638 to 20.98 pounds in 1645 (Beckles 1990). Indentured
servants were becoming more expensive in regard to
transport, food, and wages, and the supply was inadequate
for a sugar economy. During the 1660s, increasing
punishment in England for the kidnapping of persons for
servitude deterred would-be smugglers and diminished supply
(Watson 1970; Beckles 1990).
4.The white indentured servants of the seventeenth century
earned a number of derisive nicknames, to which they are
referred even in modern Barbados. These nicknames,
however, serve to demonstrate the class consciousness of the
white plantocracy and the black population (enslaved and
freed), both of whom despised the indentured servants. They
were most commonly referred to as "Red Legs," a term which
supposedly depicts the newly-arrived Scots who, wearing
their kilts, developed sunburns on their legs after working

202
in the hot tropical sun (Watson 1970). Watson (1970)
contends that, although the supposed etiology of this
nickname denotes a Scottish origin for the Redlegs, family
names among contemporary poor whites suggest a largely
English origin (e.g., "Cheeseman," "Gooding," "Goddard,"
"Kinch"). "Poor Bakros" is another derogatory name, created
either from the fact that white servants were forced to sit
in the "back rows" during Church service, or as a derivation
of an "African dialect word," "Bakra," meaning "white man"
(Roach 1984).
5. As the plantation slaves increasingly acquired technical
skills for which working-class whites were once hired, and
as freed blacks moved into various trades, the poor whites
were further marginalized into utter poverty, and left
Barbados with a higher number of unemployed whites than in
any of the other colonies (Handler 1974).
6. Contemporary "Redlegs" are distinguished from other poor
whites on the island by virtue of the fact that their
poverty extends back to more than a few generations;
according to Watson,
"...they have been poor since their arrival in the
island some three hundred years ago and have been
trapped in that poverty, consigned to the lowest rung
of the social ladder in an island where possession of a
white skin almost automatically puts one in the upper
or upper middle class. They are a strange breed of
people and are regarded as such—blue eyed hewers and
toilers in a land where manual labour is regarded
distastefully by white Creoles and all others who
aspire to high social status... (1970, p.2).
7. Compared to the African slave system of the older
Spanish colonies, slavery in the English and French colonies
was particularly cruel. Williams notes the "appalling
mortality" evident in Barbadian statistics; he explains
that, after eight years of slave importations, 35,397 slaves
had come into Barbados, while 31,897 disappeared (1970). It
appears that after 1760, mortality among Barbadian slaves
declined and the population was reproducing itself.
According to Hoyos (1978), it was not until the abolition of
the slave trade in 1807 that planters turned their attention
to increasing the life-expectancy of the slaves (e.g.,
improved prenatal and antenatal care).
8. Research on the Dutch slave trade between 1640-1670, and
trade by the Royal African Company between 1673-1700,
suggests that most Africans transported to Barbados during
the seventeenth century were from the following peoples:

203
the Adangme, Ibo, Ashanti, Dahomey, Ga, Edo, Ewe, Fanti, and
Yoruba (Beckles 1990).
9.This is not to infer a total loss of African culture in
Barbadian society. Legal suppression of such African
magico-religious practices as Obeah merely forced the belief
system underground, but did not eradicate it. Bush teas
were commonly used, and reliance on slave midwives and their
medical knowledge, along with the borrowing of medicinal
practices by the poor whites and subsequent diffusion
upwards through the classes, contributed to the
Africanization of Barbadian culture. Additional
manifestations of Africanisms include superstitions, folk
tales, and food preparation (Watson 1979).
10. J.C. Hudson, Chief Executive, Carib Agro-Industries
Ltd., Edghill, St. Thomas, Barbados.
11. It should be noted, however, that acquiring a loan for
land and a house has and continues to be a particularly
difficult process in Barbados, in that the mortgagor is
responsible for all charges and costs, including legal fees
involved in the application process, regardless of if he/she
receives the loan or not (Nurse 1983). Loan agencies
sometimes demand an insurance policy equivalent to the loan
value, or the difference between the total equity value
price and the loan (Nurse 1983). Consequently, building a
home on a sub-division has evolved into a two-staged
process, in which the lot is financed first, typically over
a five-year period, so that a mortgage can be secured for
the construction of a house (Nurse 1983).
12. The 1970 Census estimated a 9.4% unemployment level,
which rose significantly to 15-17% in 1976-1977 (Nurse
1983). The figure remained unchanged at 16.9% in 1983,
rose sharply to 22.9% in 1987, and dropped to 18.6% in 1987
(PAHO 1990), although currently, the unofficial unemployment
figure is close to 20% (Hudson, personal communication).
13. Schofield (1991) identified five factors associated
with the decline in labor, concluded from interviews with
church rectors, and included: The link with slavery;
political factors, such as Barrow's speech; less power to
estates, by means of legislated tenant rights and financial
pressure to sell estates to the emerging black middle class;
free education to all, thus raising employment expectations
and opportunity above manual labor; and "other
opportunities," such as improved transportation in and out
of the metropolitan region, and increasing job opportunities
in the non-agricultural sector.

204
14. ••Bajan” is a colloquial reference to anyone who is
Barbadian-born or anything that is of Barbados, e.g., "Bajan
cuisine," "Bajan ways," and particularly the "Bajan
dialect." "Bajan" denotes a creolization process of the
African and English culture, and is uniquely Barbadian.
15. It is difficult to determine exactly how many
Barbadians are employed by tourism, as many benefit
indirectly from the industry, and an unknown proportion
classified as "underemployed" probably contribute as well
(e.g., snack food vendors, beach peddlers). Noel Drakes of
the Ministry of Tourism and Sports reports that tourism
employs roughly 20,000 Barbadians—10,000 directly and
10,000 indirectly (personal communication). If the number
of visitors to the island is an indication of its status,
Barbadian tourism is in good standing, as the number of
visitors to the island rose from 471,357 in 1985 to 794,903
in 1990 (Drakes, personal communication).
16. "Leeward" literally refers to the side to which the
wind is blowing. In the eastern Caribbean, or Windward
Islands, of which Barbados is a part, the leeward side of
the island faces the Caribbean sea, while the windward side
faces the Atlantic. As the tropical breezes blow from the
Atlantic into the Caribbean Basin, or, from the northeast,
the leeward coast is considerably calmer than the windward,
as it is protected by the land mass, or island.
Consequently, primate cities and harbors were established on
the leeward coast, where ships could enter safely, and
damage due to hurricanes could be expectedly less than that
on the windward coast. Barbados has long endured scrutiny
regarding its legitimate placement in the Caribbean; some
argue that, geographically, Barbados sits outside of the
Caribbean Basin, and in the Atlantic. For example,
Vincentians and Grenadians alike refer to their windward
coast as the Atlantic, and Barbados lies approximately 100
miles west of those islands. Cognitively, however, Bajans
have created a mental map in which the Caribbean sea lies on
the leeward coast, and the Atlantic on the windward.
17. There is an apparent relationship between the decline
of the sugar industry and the increasing sub-division of
previously agricultural land into residential lots, although
the cause-and-effeet is debatable. J.C. Hudson argues that
the initial effect of the Tenantries Act was positive for
the sugar industry, as home and land ownership served to
reduce the stigma associated with plantation work, and a
field laborer was no longer synonymous with "landless
proletariat" (personal communication). Nurse (1983)
contends that sub-division is a result of. rather than the
cause of. the declining industry. In analyzing the period

205
between 1965 to 1977, he observed a 25% decline of cane land
(13,200 acres), and of that, only 4,000 acres of active
farmland were converted to residential lots (Nurse 1983).
The number of rab (idle land) acres converted to residential
lots jumped from 6,000 to 17,000 acres, suggesting that, had
that idle rab land not been transformed into residential
land, it would remain in disuse (Nurse 1983).
18. M. Hurley, Valuation Department, Department of
Taxation, Bridgetown, Barbados.
19. M. Broome, Chief Licensing Officer, Ministry of
Transport & Works (MTW), St. Michael, Barbados. Mr. Broome
provided unpublished information on the number of motor
vehicles in Barbados as of February, 1991.
20. P.Y. Barrow, Permanent Secretary, Ministry of Housing
and Lands, Marine House, Hastings, Christ Church, Barbados.
Ms. Barrow provided unpublished data and statistics based on
the 1980 Census regarding housing in Barbados.
21. Prior to 1968, the Barbados government practiced a
taxation method based on the English system, in which only
the land was taxed ("site value"), rather than the total
value of the land plus the structure situated on the land
("improved value"). The theory behind this original
taxation method was that, if the land was going to be taxed
regardless of the development on that site, then development
by the owner might actually be stimulated. The law was
changed because it was felt that, if an owner had the
capital to maximize his/her lot, then he/she should be taxed
according to the wealth of the lot. This philosophy evolved
into the current taxation system, in which every three years
parcel values are assessed by the Commissioner of Land Tax,
and the resident is charged a "site value" tax (0.6% up to
$100,000 BDS and 1% thereafter) and an "improved value"
(0.35% up to $300,000 BDS and 0.95% thereafter). Foreign-
owned land is charged a 3% "site value" and a 2% "improved
value" (Hurley, Valuation Department, personal
communication).
22. The "demerara window" is derived from Guyana, and
sometimes referred to as a "cooler window" (Fraser 1990).
It is a full-sized window with a single shutter, which
hinges at the top and "pushes out." Once opened, it is
supported by a long stick or rod that is stuck against the
sill to keep it in place. Bajans refer to this window-type
as a "push-out" window, and admit that it allows for maximum
ventilation. The term "cooler window" refers to the
tradition of keeping a large clay water jug, or "monkey,"

filled with water, on the window ledge, a device which,
situated in the path of a breeze, would deep the water cool.
23. "Georgian" refers to an architectural style prevalent
during the reign of the Georges of England, during the
eighteenth and nineteenth centuries. In the West Indies,
the English style of architecture had a greater influence on
design than did any other European country, regardless of
the European sovereignty for a particular island, with some
exception in those colonies under Spanish rule. The style
itself was actually popularized by four architects,
including Christopher Wren of Virginia, who combined the
interpretations by Inigo Jones (1573-1652) of the Late
Renaissance architect, Andrea Palladio (1508-1580), as well
as the increasingly popular Dutch Palladianism style, to
develop a country house model that would be constructed
throughout England and her colonies. The West Indians,
however, did not follow the model as closely as the North
American colonists, for a variety of reasons, including
societal and labor influences, climate and resources, and
subsequently evolved what is termed as "Caribbean Georgian"
(see Gosner 1982 for a full description).
24. A long-standing tradition in Barbados is large-scale
home improvement during the Christmas holiday season. This
is the time when most workers receive a holiday bonus, and
use the extra cash to up-grade the home. A local department
store reported that Christmas time was their busiest time,
not so much in gifts, but in the sales of appliances and
furniture, when "people want something new. They want to
show off their house...". According to another informant,
holiday home improvement begins around the first of
December, and continues "right up to Christmas Eve,
sometimes Christmas Day...'cause ya never know if someone
might be stopping by for the holiday, and they want their
house to look just so."
25. R. Hughes, historian and researcher. Mr. Hughes has
conducted research at the University of the West Indies
(Cave Hill campus) regarding Sugar Plantation Ownership and
Development in Barbados.
26. In 1663 a group of Barbadian planters received a grant
from the King of England to establish a settlement in what
is now Charleston, South Carolina. The venture was
primarily in response to the early scarcity and escalating
price of land in Barbados. Although the first colony of
1664-1667 failed, a permanent settlement was established in
1670. A number of Barbadian contributions left a lasting
influence on Charleston, including place names, cane
economy, and most notably, architecture. Of particular
interest is the 'single house' of Charleston, a long,

207
narrow, single-room wide house, with a single gable roof,
and a long veranda on one side of the exterior. There is
contention the African-derived Gullah dialect of the
Carolina coast and islands resembles Bajan dialect, although
a definitive relationship has not been established, and
credence must be given to the fact that North American and
West Indian slaves all shared a common West African
ancestry. (See Alleyne & Fraser 1988 and Fraser et al.
1990).
27. G. Dann, Senior Lecturer in Sociology, University of
the West Indies (Cave Hill), Barbados.
28. W. J. Babb, National Housing Corporation, Country Road,
St. Michael, Ministry of Housing and Lands, Barbados.
29. D. Daisley, General Manager, National Housing
Corporation, Country Road, St. Michael, Barbados.
30. Edghill Associates, Ltd., General Contractors, Wildey,
St. Michael, Barbados.
31. Oran Ltd., Harbour Industrial Park, Bridgetown,
Barbados, W.I.
32. Courts Department Store, Oistins, Christ Church,
Barbados.
33. Economic constraints, national health care, and greater
access to birth control have no doubt had an affect on the
fertility rate in Barbados. In the asthma study, women were
asked what they believed to be the "ideal" number of
children, and the mean number reported was 3.97 (note the
difference in the median of 2, and mode of 2). The average
number of children that the informants actually had was 2.9
(median=3, mode=2), demonstrating relative consistency
between the median and mode; but oddly, the actual is less
than the "ideal" mean number. This difference was
statistically significant (r=0.17, p=0.03). When asked if
they believed women were having fewer children "these days",
105 (61.0%) answered in the affirmative, and when asked why
(open-ended question), the most common response was that
children are "too expensive nowadays" (N=50, 29.1%) followed
by the availability of birth control (N=27, 15.7%) (note;
63, or 36.6%, would not respond). The official fertility
rate in Barbados has actually decreased significantly, from
4.7 in 1950-1955, to 2.0 in 1985-1990 (PAHO 1990); this
figure is, for reasons poorly understood, lower than the
fertility rate of the sample.

208
34. In Barbados, as elsewhere in the Caribbean, union
status is typically divided into the following: 1) legally
married; 2) common law union, recognized as the same as
marriage, but the union has not been formalized according to
East Indian custom, or by law; 3) visiting, in which the
couple does not share a single dwelling; and 4) single.
35. Nicholls & Edghill Construction, Ltd., Frere Pilgrim,
Christ Church, Barbados, W.I.

CHAPTER 4
THE ASTHMA STUDY: AN ANALYSIS OF CONTEMPORARY
LAND TENURE PATTERNS, HOUSING, AND ASPIRATIONS
In the previous chapter, a detailed historical review
of the evolution of land tenure and house forms in Barbados
was presented, as well as the effects of the political,
economic, and social forces that shaped contemporary
housing. In the proceeding paragraphs, the suggestions
presented in Chapter Three will be analyzed in terms of a
contemporary, sample population. A review of contemporary
trends in land tenure and distribution, combined with
verbalized aspirations for the ideal home, will elucidate
the direction of Bajan housing from the world view of a
sample of Barbadians. For the purpose of this study, it
will allow for the assessment and selection of housing
variables that are representative of the modernization
process and the identification of associations between
sociodemographic and architectural variables that may or may
not affect asthmatics, by providing ideal habitats for
allergenic household pests.
Spatial Distribution of Land and Sociodemoaraphics
Although a great deal of attention has been focused on
the development of suburbia in Barbados, the island is,
209

210
nevertheless, primarily dichotomized into urban and rural
districts (Figure 3-2, Chapter Three). Furthermore, there
is little difference between rural tenantries and rural
heights and terraces regarding the "clustering" effect,
other than the fact that homes in heights and terraces are
situated on relatively larger lots. The overt difference
between the two residential areas is the building material
and quality of the homes—new suburban homes are built
almost entirely of concrete and homes in tenantries vary,
but have traditionally been of wood and are increasingly
built of mixed materials.
Households in the asthma study were delineated as
either "urban" or "rural," although a breakdown by "type" of
residential region was considered when appropriate (e.g.,
rural tenantry, suburban height/terrace). This decision was
based in part on the focus of house-type as an important
independent variable in the study and the fact that
"tenantry" status does not exclude the possibility of living
in a "modern," concrete house.
Although 141 informants (79.7%) stated that they owned
their homes either outright, through mortgage, or by
government grant, only 92 (52.0%) owned the land on which
the house was situated. Land ownership was positively
correlated to rural residency (X2=10.83; 1 df, p=0.001), to
demographic site (f=21.55; df=l, 175; p<0.001), and to
parish (f=9.25; df=l, 175; p=0.003). Thirty-nine (42.4%) of

211
the urban residents owned their house-spot compared to 53
(57.6%) of the rural residents. Table 4-1 illustrates the
breakdown of land ownership by demographic region; the
highest percentage of landowners was for residents in the
peri-urban district (81.8%), suburban heights and terraces
(of the five suburban residents in the study, four owned
their own land), and the rural tenantry residents (68.0%).
Only 25% of residents in the most densely populated regions
owned their land. These data correspond with studies
heretofore outlined.
Table 4-1. Land ownership patterns according to
demographic region (N=177).
Region
Frequency
of land
ownership
Percent
of land
ownership
Densely populated (within
2 miles of Bridgetown)
11
25.0
Semi-urban
16
41.0
Peri-urban (in urban district,
visible agriculture)
9
81.8
Suburban height/terrace
4
80.0
Rural tenantry
51
68.0
Government housing, rural
0
0
Mixed rural (tenantries &
suburban heights/terraces)
1
50.0
TOTAL
92
N/A
Table 4-2 shows the distribution of landowners by
parish, illustrating that the parishes most important in
tourism, manufacturing and government—St. Peter, St. James,
and St. Michael—have the least number of landowners, and
the parishes which are fast becoming the "suburban"

212
parishes, such as Christ Church, St. Philip, St. Thomas, and
to a lesser degree, St. George, are relatively high in land
ownership. Keeping with tradition, the very rural parishes
of St. John, St. Joseph, St. Lucy, and especially St. Andrew
also showed a high degree of land ownership.
Land ownership was not correlated to sex, age, marital
status, educational level, or occupational status, although
it was very strongly correlated to wealth as measured by
•'amenities" (t=4.12; df=166.1, unequal variance, p<0.001).
Persons living on larger plots were more likely to own the
land (f=20.43; df=l, 174; pcO.OOl), and the fewer the number
of dwellings on a single plot, the more likely the household
was to own the land (t=4.77; df=100.4, unequal variance,
p<0.001) .
Ownership was positively correlated to length of time
on the plot of land (t=3.02; df=165.6, unequal variance,
p=0.003), possibly indicating a number of lots belonging to
family and having been passed on to heirs. Of the 107
informants who stated that the home was built by their
household or family, 59 (55%) said that the land belonged to
or had been purchased by their parents or grandparents.
Regarding inheritance, 67 of the landowners (62.6%) stated
that all children and/or family members would inherit the
plot; four (3.7%) specified one individual to inherit the
land, and 36 (33.6%) were not sure who would inherit the
land, or could not answer the question.

213
Only 30 informants (or 17%) lived on a lot larger than
one quarter acre, while 142 (80.7%) lived on lots of one
quarter acre or smaller (four informants were not sure of
the size). Seventy-six of those homes (42.9%) shared the
lot with at least one other dwelling, indicating a fair
degree of external crowding. The distance from the nearest
neighbor (in yards) was related to owning the land (t=2.28;
df=101.7, unequal variance, p=0.02). Table 4-3 shows that
the same regions in which there was a high degree of land
ownership are also the regions in which there is the
greatest distance between neighbors—the peri-urban suburban
heights and terraces and rural tenantries. However,
distance from the nearest neighbor was not related to parish
or urban/rural residency and not to socioeconomic status,
thus reiterating the crowded nature of Barbadian housing in
general.

Table 4-2. Frequency and percentage of households owning their residential lot, by
parish.
Parish
Frequency
by parish
Landowners
Percent of
ownership
for
individual
parish
Percent
of
ownership
for all
parishes
Non-
Frequency
by parish
-Landowners
Percent of
ownership
for
individual
parish
Percent
of
ownership
for all
parishes
Christ Church
6
54.5
3.4
5
45.5
2.8
St.
Philip
9
75.0
5.1
3
25.0
1.7
St.
John
15
79.0
8.5
4
21.0
2.3
St.
George
4
50.0
2.3
4
50.0
2.3
St.
Joseph
2
66.7
1.1
1
33.3
0.6
St.
Andrew
4
100.0
2.3
0
0
0
St.
Lucy
7
63.6
4.0
4
36.4
2.3
St.
Peter
8
40.0
4.5
12
60.0
6.7
St.
James
7
38.9
4.0
11
61.1
6.2
St.
Michael
24
38.1
13.6
39
61.9
22.0
St.
Thomas
6
75.0
3.4
2
25.0
1.1
Total
92
N/A
52.0
85
N/A
48.0

Table 4-3. Distance from the nearest
region (N=177).
neighbor (in
yards) according
to demographic
Number of
Mean
Median
Region
Informants
distance
distance
Densely populated (within
2 miles of Bridgetown)
44
6.3
5
Semi-urban
39
9.1
5
Peri-urban (in urban district,
visible agriculture)
11
20.5
15
Suburban height/terrace
5
21.8
15
Rural tenantry
75
18.2
5
Government housing, rural
1
0
0
Mixed rural (tenantries &
suburban heights/terraces)
2
11
11
TOTAL
177
13.3
5
215

216
The "Ideal" Place of Residency
An important factor in developmental trends in housing
is the degree of satisfaction with the location of one's
home. In his "Quality of Life" study, Dann (1984) found
that, contrary to other sociological studies, "district," or
residential region, placed low on the list of priorities for
Barbadians. Yet Dann noted that he could not be sure if
this result was "because of satisfaction" and a "taken-for-
granted attitude", or because of another unknown phenomenon
(1984, p.81). Potter (1983a) observed that, when informants
were asked which parish they would prefer to live, the
majority cited the parish in which they currently residéd.
His sample, however, did not include members from all 11
parishes; rather, respondents were from Bridgetown, Oistins,
Six Cross Roads, Speightstown, and Belleplaine. He did note
that the most preferred areas overall were the most affluent
parishes of Christ Church, St. James, St. Philip, and St.
Thomas, respectively, and that the more rural and
"traditional" parishes were generally less preferred (Potter
1983a).
Respondents in the asthma study were asked the
following: If they could live anywhere, where would they
prefer to live? Table 4-4 illustrates the results from this
question, referred to as the "ideal place of residence," and
depicts an overwhelming preference for one's home parish
(note: Only 166 informants responded to the question). The

217
parish with the highest degree of preference for one's own
parish was St. Philip; 100% of the informants from St.
Philip stated that it was the "ideal" place to live.
Reasons for high satisfaction with St. Philip are probably
related to the fact that its residents enjoy some of the
most sought after beaches, commuting is relatively easy in
and out of Bridgetown, and the parish is technically part of
the urban belt, without the congestion of the urban center.
Interestingly, residents who were least satisfied with their
home parish were those from St. James (35.3%) and St. George
(40%). This is perhaps because residents of greater
affluence have more pronounced material aspirations (Dann
1984) and St. James and St. George are typically suburban
parishes. Informants living in Christ Church, St. Peter,
and St. Thomas were highly satisfied, as were the rural
residents of St. Andrew and St. John.
Residents living in St. James and St. Michael were most
diverse in their responses; many preferred parishes
surrounding their home parish. This reflects the shift of
residency from the highly urban districts to the suburban
regions (of these two parishes, only two informants
preferred to live in a traditionally rural parish; the
remainder of respondents chose the semi-urban parishes).
Two residents in St. Michael stated that they would like to
live "someplace in the country." One person in St. George,
the centermost parish, stated that she wished she lived by

218
the sea, and one informant in St. Michael wanted to live
"someplace airy."
When the parishes are ranked in order of overall
preference (as opposed to preference according to
residency), discretion is noted between what the total
population prefers and where the total population actually
resides (Table 4-5). For example, St. Michael ranked as the
most preferred parish to live (19.9%), but nearly twice as
many informants actually lived in St. Michael (36.8%) than
the number who cited the parish as the "ideal place to
live," indicating that a number of St. Michael residents
would prefer to live elsewhere. Conversely, nearly twice as
many people would prefer to live in St. Philip and Christ
Church than actually do and, similarly, there was disparity
for the suburban parishes of St. George and St. Thomas. In
short, the asthma study results concur with Potter's study,
which indicates an overall preference for what is perceived
as "affluent suburbia."

Table 4-4. Analysis of residential preference by parish among households. The proportion
of informants in each parish citing the "most preferred parish" for residence (N=166).
"Ideal"
Parish
Christ
Church
St. St.
Philip John
St.
George
St.
Joseph
St.
Andrew
St.
Lucy
St.
Peter
St.
James
St.
Michael
St.
Thomas
Home Parish®
70.0
100.0
72.2
40.0
50.0
75.0
40.0
68.4
35.3
50.8
75.0
Christ Ch.
N/A
0
5.6
40.0
0
0
20.0
5.3
5.9
13.1
12.5
St.
Philip
0
N/A
5.6
0
0
0
10.0
10.5
11.7
13.1
0
St.
John
0
0
N/A
0
0
0
0
0
0
0
0
St.
George
20.0
0
0
N/A
0
0
0
0
5.9
4.9
0
St.
Joseph
0
0
5.6
0
N/A
25.0
0
0
0
3.3
0
St.
Andrew
0
0
0
0
0
N/A
0
0
0
0
0
St.
Lucy
0
0
0
0
0
0
N/A
0
0
0
0
St.
Peter
10.0
0
0
0
0
0
10.0
N/A
11.8
0
0
St.
James
0
0
5.6
0
50.0
0
20.0
15.8
N/A
3.3
0
St.
Michael
0
0
0
0
0
0
0
0
17.7
N/A
0
St.
Thomas
0
0
0
0
0
0
0
0
11.7
4.9
N/A
Otherb
0
0
5.4
20.0
0
0
0
0
0
6.6
12.5
aPercent naming the parish in which they resided as the most preferred parish; "N/A" is
entered in the row representing that parish.
‘’Responses other than a specific parish, including "a place in the country," "seaside,"
"someplace airy," and "anywhere."
219

220
Table 4-5. Overall rank of
parishes
as "the
ideal
place to live"
according to
the total
informant
population (N=
166) .
No. of
Percent
of
Percent of
informants
informants
informants
preferring
preferring
living in
Parish
parish
parish
parish
St. Michael
33
19.9
36.8
St. Philip
24
14.5
7.2
Christ Church
22
13.3
6.0
St. Peter
17
10.2
11.5
St. James
15
9.0
10.2
St. John
13
7.8
10.8
St. George
8
4.8
3.1
St. Joseph
4
2.4
1.2
St. Lucy
4
2.4
6.0
St. Andrew
3
1.8
2.4
St. Thomas
10
6.0
4.8
Other
13
7.9
0
Total
166
100
100
Implications for Trends in Housing
The asthma study statistics support what has already
been discussed by governmental planners and developers,
geographers, and sociologists in Barbados: There is
continued growth and settlement in the urban belt,
especially the semi-urban sector, with disproportionate land
ownership in regard to urban/rural residency and
socioeconomic status. Increasingly there is out-migration
from the rural sector, often by those residents who can best
afford to migrate, thus potentially diminishing the impetus
to improve development and services to the rural sector.
This process has left the Town and Country Development
Planning Office wondering "to what extent declining

221
tenantries are viable as future residential areas given
their poor accessibility to services and employment" (1988,
p.44). Subsequently, the population shift contributes to
the increasing overcrowded status of the urban sector, and
widening the socioeconomic disparity between the two
regions. Improvement of housing in the urban sector is then
hampered by impossible demands secondary to the population
density and a low rate of land ownership and subsequent
limitations on upgrading utility services and the structure
of the home.
Land ownership is enjoyed most by the rural peasant
farmers who can barely afford home improvement anyway, and
the wealthy suburbanites who set up residence out of the
capital center, but still within the urban belt. As has
been noted, despite the relatively larger plots of land in
the heights and terraces, even the suburban sector is
characterized by overcrowding. Land ownership is least
prevalent in the heavy urban sector where residents are
subjected to health threats and psychological stress due to
overcrowding.
The implications of the current land distribution
patterns regarding the asthma study are as follows: Rural
residents, who own the land (probably largely out of
inheritance) do not have the capital to upgrade their homes
and are probably exposed to pests unique to that environment
and to poor quality homes. On the other hand, residents in

222
the densely urban sector experience a low rate of ownership,
thus dissuading them from upgrading their homes and, due to
poor sanitary provisions and high population density, are
likely to be subjected to their own set of household pests.
Lastly, residents who are "mainstream” in regards to semi-
urban or suburban residency—the stated ideal by the sample
population and the overall trend according to statistics—
are in fact landowners who are upgrading their homes, or
"modernizing" them in such a way that probably includes the
high moisture and poor ventilatory elements previously
described in this thesis. They too probably have their own
set of household pests, some of which, according to the
guiding hypothesis in this study, are particularly
allergenic and a threat to the asthmatic. The following
section will address the specific features related to land
ownership, home ownership, and modernization of the house,
that are changing the microenvironment of the Bajan home.
Housing Patterns Among the Asthma Study Population
Ownership of Dwellings
Housing patterns among asthma study informants reflect
the overall trend in Barbados. The mean length of time that
a family had lived on a given lot was 19 years (median=12).
The mean age of the house was 21 years, but a median of
eight years indicates a tremendous range, and suggests that
a number of homes had been relocated. In fact, 21 (12%) of
the residents stated that their house had been moved in the

223
past. The greatest proportion of homes that had been
relocated were for families living in St. James (N=5) and
St. Michael (N=4), at 23.8% and 19.1%, respectively.
Sixty-six informants living in the urban sector (68.8%)
owned their own home, while 75 informants in the rural
sector (92.6%) owned theirs, and this difference was highly
significant (X2=15.4; 1 df, pcO.OOl) (Table 4-6). Sixteen
of the informants were renting homes from the National
Housing Corporation (NHC); when the data were corrected for
these cases, there was still a significant difference
between the urban and rural sector regarding ownership.
There was also a significant difference of home ownership by
residential region (f=5.61; df=6, 170; p<0.001) and by
parish (f=2.43; df=10, 166; p=0.01). Specifically, the
lowest percentage of home ownership was in the densely
populated region (59.0%) and 100% of the peri-urban
residents owned their home. Strangely, Table 4-6 indicates
that only three out of the five suburban height/terrace
residents owned their home; one explanation for this
unexpected ratio is that informants did not consider "owned
but under mortgage" as a possible response. Again, when the
data were corrected for NHC renters, the same trend in
regional location was observed.

224
Table 4-6. Home ownership patterns according to
demographic region (N=177).
Region
Frequency
Percent
Densely populated (within
2 miles of Bridgetown)
26
59.0
Semi-urban
29
74.4
Peri-urban (in urban district,
visible agriculture)
11
100.0
Suburban height/terrace
3
60.0
Rural tenantry
70
93.3
Government housing, rural
0
0
Mixed rural (tenantries &
suburban heights/terraces)
2
100.0
TOTAL
141
N/A
The parishes with the highest proportion of home
ownership were similar to the parishes with the highest
proportion of land ownership and included the very rural
parishes of St. Joseph, St. Andrew, St. Lucy, and St. John,
the suburban parishes of St. Thomas, St. Philip, St. George,
and to a lesser degree, Christ Church. Table 4-7 provides a
breakdown of home ownership by parish, demonstrating that
St. Michael and St. James had the lowest percent of home
ownership.
There were no statistically significant differences in
home ownership among the informants according to age, sex,
marital status, occupational status, or educational level.
However, wealth (according to the amenities score) was
positively related to home ownership (t=2.75; df=175.0,
equal variance, p<0.001).

225
Construction of Dwellings
Seventy-two of the informants (40.7%) lived in all-wood
dwellings, compared to 105 informants (59.3%) who lived in
concrete or mixed wood and concrete homes. Having a
concrete or mixed wood and concrete home was correlated to
land ownership (Xz=5.2; 1 df, p=0.02), but not correlated to
home ownership. When correcting for the 16 NHC renters
(because all NHC dwellings are concrete), there was still no
significant difference between home ownership and concrete
or mixed concrete construction. This peculiarity can be
explained in that some informants were renting homes,
probably in which concrete was already part of the building
and also because there are more homeowners than landowners
in general. Living in a concrete or mixed structure was
highly correlated to socioeconomic status according to the
amenities score (t=5.72; df=173.9, unequal variance,
p<0.001). Also, a concrete/mixed home was correlated to a
higher occupational status of the informant (f=9.54; df=l,
175; p=0.002) and to legal marriage (f=4.49; df=l, 175;
p=0.04), but not related to age, sex, or educational level
of the informant. It was not related to type of
neighborhood (e.g., suburban, urban), demonstrating that a
number of persons living in both the urban and rural
sectors, when they have the capital, are adding concrete
structures to their homes. Similary, having a concrete or

Table 4-7. Frequency and
percentage of
informants owning
their dwelling,
by parish.
Parish
Homeowners
Percent of
ownership
for
Frequency individual
by parish parish
Non-Homeowners
Percent of
ownership
for
Frequency individual
by parish parish
Christ Church
9
81.8
2
18.2
St.
Philip
11
91.7
1
8.3
St.
John
18
94.7
1
5.3
St.
George
8
100.0
0
0
St.
Joseph
3
100.0
0
0
St.
Andrew
4
100.0
0
0
St.
Lucy
11
100.0
0
0
St.
Peter
16
80.0
4
20.0
St.
James
12
66.7
6
33.3
St.
Michael
41
65.1
22
34.9
St.
Thomas
8
100.0
0
0
Total
141
N/A
36
N/A

227
mixed home was unrelated to parish and urban/rural
residency, even though concrete in the home is related to
land ownership. It can be concluded that, based on the
asthma study, the upgrading of homes is, on the whole,
irrelevant to locale in Barbados. One explanation for this
conclusion is that the sample size was too small to
determine a significant difference between the urban and
rural sector. However, another plausible explanation, based
on empirical, ethnographic observations is that a number of
residents are upgrading their homes prior to purchasing the
land, possibly with the intent to purchase, or the security
of knowing they have the option to buy the land rather than
be evicted. Table 4-8 illustrates that, of the three
variables—wealth, home ownership, and land ownership—the
"amenities" score is most associated with concrete in the
dwelling, followed by land ownership.
Table 4-8. Comparison of housing quality (concrete or
mixed structure) by wealth score, home ownership, and
land ownership.
Variables
Concrete Walls
Correlation
Coefficient df
p-value
Amenities
t=5.72
173.9
p=<0.001
Land ownership
X2=5.17
1
p=0.02
Home ownership
X2=l. 92
1
p=0.17
Having a concrete or mixed wood and concrete dwelling
was predictive for a number of structural variables. It was
correlated to the presence of an indoor shower (X2=97.2; 1

228
df, p<0.001) , an indoor toilet (X2=88.0; 1 df, p<0.001), and
the total number of water taps inside the house (t=8.92;
df=174.0, unequal variance, pcO.OOl). Concrete in the home
was associated with a greater number of windows (t=3.71;
df=174.9, unequal variance, pcO.OOl), having a finished
ceiling (f=12.24; df=l, 175; p<0.001), the likelihood of
having a concrete foundation (X2=104.8; 5 df, p<0.001), and
having a crawl space beneath the house (X2=12.4; 1 df,
pcO.OOl). Also correlated to concrete were the number of
bedrooms in the house (t=2.19; df=124.2, unequal variance,
p=0.03) and the total number of rooms in the house (t=7.97;
df=172.7, unequal variance, pcO.OOl). Informants with
concrete and mixed dwellings did not have carpeting in their
home more frequently than did those informants in wood
dwellings, but they did have more rooms with carpeting
(t=3.17; df=173.7, unequal variance, p=0.002). Table 4-9
illustrates the frequency and percentage by material of the
dwelling for some of these features.
In summary, the data illustrate a definite trend in the
development of Barbadian housing. It is evident that, in
the event a family owns the land—either by purchase or
inheritance—and sufficient capital is available, concrete
is added to an existing dwelling, or a new concrete dwelling
is built instead. Ownership of the house is not directly
associated with the upgrading of the home, probably because
a number of informants who own their home do not own the

229
land; ownership of land is legally required in the event
that concrete is used, since a permanent fixture is created
with the use of concrete. There is evidence that some
homeowners are adding concrete to the home prior to
purchasing the land, possibly with the intent to buy the
land in the near future.
The importance of building homes with concrete is both
directly and indirectly significant in regards to allergies
to household pests. As described in Chapter Three, a number
of microenvironmental factors contribute to the development
of excessive indoor moisture and decreased indoor
ventilation, including water-producing elements (e.g.,
showers, kitchen activities such as dishwashing and cooking,
and indirect contact with the ground via foundations and
crawl spaces) and climate control. In the asthma study,
data indicate that, with the addition of concrete, there is
a greater likelihood of having more indoor water taps, a
concrete foundation and a crawl space, all of which are
moisture-related factors, and there is a greater likelihood
of having a finished ceiling, which may result in decreased
ventilation, particularly in the absence of climate control
(e.g., dehumidifiers, air conditioning). Moreover, the
concrete home is larger with more rooms, and provides a
larger microhabitat for pests. In summary, the implications
for the increasing integration of concrete in Barbadian
homes are an increase in indoor moisture and decreased

230
indoor ventilation, which in turn provide an ideal
environment for molds, fungi, and house dust mites, and
possibly other types of pests unbeknown at this point.
Structural Features and Demographics
The fact that each individual contributes a significant
proportion of moisture to the indoor environment—both
physiologically and in activities of daily living—
implicates the importance of household density on indoor
moisture levels. In the asthma study, household density was
not correlated to home ownership. However, it was weakly
and inversely related to the degree of wealth (r=0.19,
p=0.02), inversely related to occupational status (f=2.04;
df=7, 169; p=0.05), and inversely related to the age of the
informant (r=0.15, p=0.04), suggesting that the younger
informants lived in extended family environments. Household
density was not related to gender, union status or
educational level of the informant, nor was it related to
the region or parish of residence for the household.
Household density was related to certain structural
variables of the dwelling. The relationship between high
density and wood homes was statistically significant
(t=2.47; df=122.4, unequal variance, p=0.02), and higher
density homes were less likely to have indoor showers
(t=2.09; df=104.9, unequal variance, p=0.04), indoor toilets
(t=2.69; df=101.3, unequal variance, p=0.008), and fewer
water taps indoors (r=0.28, p<0.001). High density homes

231
had fewer windows (r=0.25, p<0.001), and had more unfinished
ceilings (or rather, a greater percentage of exposed
rafters) (f=2.62; df=7, 169; p=0.01). These findings
suggest that a high household density level is not a
characteristic of adding concrete to the home, a factor that
might indirectly reduce the moisture level in concrete and
mixed concrete homes; upgrading the home appears to result
in lower household densities.
Aspirations of the Study Population; The "Ideal” House
Informants were asked to answer questions about what
they believed to be the "ideal" house, or their "dream
house", so as to determine aspirations—and the presumed
direction—in modernization of the house (note; 10 persons
did not answer this category of questions; N=167).
Questions were asked in open-ended style, thus avoiding any
suggestion of expected answers. The majority of persons
(78.4%) believed that concrete was the best building
material for a house; 26 persons (15.6%) preferred wood,
five (3.0%) preferred brick or limestone, and five (3.0%)
would build a mixed (concrete and wood) house. Preference
for concrete in the "ideal" house was not related to the
presence of concrete in the respondent1s current house

Table 4-9. Structural features of the dwelling by the type of material the dwelling is
constructed, and for the total number of dwellings, for the asthma study households.
Structural
All-Wood
Dwellina
Concrete
& Mixed
Total
variable
Frequency
Percent
Frequency
Percent
Frequency
Percent
Dwelling ownership
61
84.7
80
76.2
141
79.7
Land ownership
30
41.7
62
59.0
92
52.0
Age of the home
average (years)
21.7
N/A
20.3
N/A
20.9
N/A
range (years)
2-70
N/A
1-81
N/A
1-81
N/A
Type of foundation
soil
1
1.4
0
0
1
0.6
coral rock/mix rock
66
91.7
44
41.9
110
62.1
1imestone/concrete
5
6.9
61
58.1
66
37.3
Presence of an
indoor shower
14
19.4
97
92.4
111
62.7
Presence of an
indoor toilet
16
22.2
96
91.4
112
63.3
Number of bedrooms
average
2.7
N/A
3.1
N/A
2.9
N/A
range
0-7
N/A
1-6
N/A
0-7
N/A
Total number of rooms
average
7.1
N/A
11.4
N/A
9.6
N/A
range
1-228
N/A
4-27
N/A
3-27
N/A
232

Table 4-9 continued.
Structural
All-Wood
Dwellinq
Concrete & Mixed
Total
variable
Frequency
Percent
Frequency Percent
Frequency
Percent
Household density
(# occupants per
# bedrooms)
average
range
Indoor carpeting
2.3
1 - 8b
37
N/A
N/A
51.4
1.9 N/A
0.8-4.7 N/A
66 62.9
2.1
0.8 - 8
103
N/A
N/A
58.2
aDenotes an unusual case in which an informant and her offspring were living in 2 combined
wood houses, situated side-by-side, sharing all facilities and rooms, thus counted as 1
household.
bAccounts for one home consisting of one room shared by two people, without a designated
bedroom.
233

234
(f=1.05; df=l, 165; p=0. 3) , nor wealth, land ownership, home
ownership, or urban/rural residency.
The majority of the respondents (76.5%, N=127) thought
that having a pitched roof was best, mostly because a
pitched roof is "attractive" (46.4%), followed by the fact
that its "hurricane-proof" (22.9%). Choosing the shape of
the roof for ventilatory purposes was the third-most common
response, at 18.7%, followed by the response that "water
runs off more efficiently" (6.0%). The remaining responses
were ten individual responses each worth 0.6% of the total
response rate.
Seventeen different window types were cited, indicating
the wide variety of windows in Barbadian housing. More than
half of the respondents (56.7%) preferred the "aluminum sash
windows." Very few cited the traditional wood jalousies or
demerara windows. The second-most preferred type of window
was the three- or four-pane glass awning type ("Oran"), at
17.1%.
Regarding the foundation, 80.2% of the respondents
preferred concrete. Only 20.4% would carpet their floor;
the majority preferred "rubber tile" (linoleum) as a
covering (44.9%). Twenty-two (13.2%) would have carpet in
some of the rooms and another covering (e.g., linoleum,
wood) in other rooms, raising the percentage of respondents
who would have some carpet in their home to 33.5%.

235
The average number of bedrooms cited as the "ideal"
number was 3.7 (median=4, mode=4). The preferred number of
bedrooms was correlated to the actual number of bedrooms
(r=0.16, p=0.04); people who already had a lot of bedrooms
would prefer to have a lot of bedrooms in their dream house.
But the preferred number of bedrooms was not related to
household density, implying a sense of satisfaction even in
crowded households.
It is apparent from the sample population that the
majority of householders believe that the ideal house is a
concrete house. Aesthetics appear to play a greater role in
architectural preference than ventilatory principles (e.g.,
the reason for choosing a certain roof-type or window-type).
The implication here is that personal aspirations are
concurrent with the apparent direction of Barbadian housing.
Discussion and Summary
Figures 4-1 and 4-2 are a presentation of the inter¬
relationships between the various structural and demographic
variables. Because the independent variables were
categorical, ordinal and interval, which necessitated
various bivariate analyses (Chi-square, Pearson correlation,
t-test, and ANOVA), the first (Figure 4-1) correlation
matrix presents the p-values, and Figure 4-2 presents the
Chi-square/Pearson's r/T-/F-values (correlation
coefficient). At a glance, the matrices indicate that, in
regards to intercorrelation, wealth is the strongest

236
variable, followed by concrete/mixed walls, foundation
quality, the percent of a finished ceiling, the number of
indoor water taps, the presence of an indoor shower and
toilet, and the number of rooms.
Interestingly, urban/rural residency plays a very
marginal role in determining the quality and upgrading of
homes, even though regional variables were important in
determining land and home ownership. A very significant
finding in this study is the percentage of concrete/mixed
dwellings despite the absence of home and particularly land
ownership. Possible explanations for this phenomenon have
been discussed.
The matrices and several of the "aspiration" responses
indicate a solid trend in the upgrading of the home, that
involves the addition of water sources following the
construction of concrete, an increase in the number of
rooms, and a subsequent decrease in household density. As
described under "Health Implications" in Chapter Three,
household density affects the humidity level in the home.
However, homes with lower densities expectedly compromise
their "lower moisture factor" advantage by virtue of the
fact that they have indoor sources of water that poorer,
high density homes do not have (e.g., shower, toilet,
kitchen sink), and are more likely to afford other water-
producing amenities such as a washer or dryer. In contrast,
the higher density, poorer wood homes have their own sources

237
of moisture; in addition to moisture produced from human
activities of daily living, wood has been implicated as a
source of moisture build-up, and wood homes are more likely
to have soil crawl spaces, a site of moisture production.
But traditional wood homes are notoriously the better-
ventilated homes (e.g., traditional windows, unfinished
ceilings with exposed rafters) and, according to Hansen's
work (1984), cooking, dishwashing, and bathing/showering
produce more moisture than the human contribution, thus
minimizing the importance of household density as a
moisture-related factor.
Regarding ventilation, there are advantages and
disadvantages in the trend of Barbadian housing. On the one
hand, the number of windows in the home increase with the
addition of concrete, but so do the number of rooms. As has
been described, the areas of the home requiring the most
ventilation in order to minimize humidity levels (toilet and
shower area) are those where Barbadians use the smallest
windows and those situated in areas of lowest air flow in
the home. From reported aspirations among the asthma study
informants, it would appear that the "old fashioned" windows
that offered maximum ventilation are clearly out of fashion.
Another trend is a finished ceiling; a finished ceiling
decreases ventilation by the creation of a dead airspace
between the ceiling and rafters (attic), in addition to the
fact that any spaces previously between the roof and wall

238
are sealed off when creating the ceiling, further minimizing
airflow (K. Pope,1 personal communication).
In summary, a number of moisture-related and decreased
ventilation-related factors are increasingly being
integrated into the Barbadian home (Figure 4-3). Having
thoroughly outlined the basis for this evolution of housing,
the next logical step in this thesis is to identify the
household pests present in Bajan homes, and to sort out
relationships between the presence of those pests and
modernization factors of the home.
Notes
1. K. Pope, A.I.A., Baskerville & Son Architects and
Engineers, Richmond, Virginia. Mr. Pope graciously provided
the blueprints and sketches (figures 3-3a-c & 3-4a-c) based
on ethnographic data from the author, and site visits by Mr.
Pope in 1991. Mr. Pope also provided architectural insights
regarding ventilation and the lowering of the chattel house
ceiling.

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urban residency
X
land ownership
<0.001
X
home ownership
<0.001
<0.001
X
age of home
0.93
0.52
0.25
X
wealth
0.11
<0.001
0.007
0.04
X
household density
0.54
0.27
0.20
0.45
<0.001
X
concrete walls
0.21
0.02
0.17
0.57
<0.001
0.02
X
foundation quality
0.02
0.04
0.02
0.11
<0.001
0.13
<0.001
X
cellar
0.001
0.88
0.003
0.003
0.04
0.56
<0.001
<0.001
X
% of finished ceiling
0.54
0.05
0.09
0.14
<0.001
<0.001
<0.001
0.008
0.81
X
H indoor water taps
0.06
0.35
0.11
0.78
<0.001 <0.001
<0.001
<0.001 <0.00
<0.001 X
Indoor shower
0.81
0.180
0.58
0.62
<0.001
0.04
<0.001
<0.001
0.008
<0.001 <0.001
X
Indoor toilet
0.48
0.240
0.64
0.93
<0.001
0.008
<0.001
<0.001
0.004
<0.001 <0.001 <0.001
X
tt rooms
0.64
<0.001
0.08
0.12
<0.001 <0.001
<0.001
<0.001
0.01
<0.001 <0.001 <0.001 <0.001
X
tf bedrooms
<0.001
<0.001 <0.001
0.22
<0.001 <0.001
0.03
<.001
0.41
<0.001 <0.001 <0.001 <0.001 <0.001
X
It windows
0.32
0.003
0.14
0.77
<0.001
0.009
<0.001
0.002
0.29 <0.001 <0.001 <0.001 <0.001 <0.001
<0.001
tt rooms with carpet
0.04
0.65
0.83
0.54
<0.001
0.16
0.002
0.004
0.004
0.13 0.010
0.01
0.003 <0.001
0.010
X
0.006
*
X
Figure 4-1. Correlation matrix (p-values) for structural and demographic variables
in the asthma study households. All values are p-values calculated from bivariate
analyses (Pearson's r, Chi-sguare, t-test, & .ANOVA). Values of less than 0.10 are
highlighted (bold-faced).
fO
GJ
VO

urban residency
land ownership
home ownership
age of home
wealth
household density
concrete walls
foundation quality
cellar
1
1
*
#
ft Indoor water taps
1
00
1
indoor toilet
tf rooms
urban residency
X
land ownership
-10.8a
X
home ownership
-15.4a
39.0a
X
age of home
0.09b
0.64b
1.15b
X
wealth
1.59b
4.12b
2.75b
-0.16
X
household density
0.62b
1.10b
1.31b
0.06
-0.19
X
concrete walls
1.54a
5.17a
1.91a
0.56b
5.72b
-2.47b
X
foundation quality
5.78c
4.15c
5.70c
1.94c 12.17c
1.71c 116.9c
X
cellar
11.41a
0.02
8.7a
2.99b
2.11b
0.58b
12.4a
-37.8c
X
% of finished celling
0.61b
1.98b
1.73b
0.12
0.44
-0.29
3.SOb
2.81c
0.24b
X
# Indoor water taps
l.OOb
0.94b
1.61b
0.02
0.55
-0.28
8.92b 15.33c
4.66b
0.34
X
Indoor shower
.062a
1.79a
0.30a
0.49b
5.89b
-2.09b
97.2a 63.87c
6.9a
4.56b
12.36b
X
Indoor toilet
0.50a
1.40a
0.22a
0.09b
5.80b
-2.69b
88.0a 73.31c
8.3a
4.78b 13.22b
148.0a
X
H rooms
0.47b
4.80b
1.78b
0.12
0.66
•0.35
7.97b 14.42c
2.55b
0.41
0.34 11.39b
12.73b
X
ft bedrooms
-3.43b
3.43b
4.79b
0.10
0.30
-0.30
2.19b
5.96c
0.82b
0.28
0.37
4.08b
4.96b
0.63
X
ff windows
l.OOb
3.04b
1.48b
0.02
0.40
-0.25
3.71b
4.03c
1.05b
0.29
0.52
4.12b
4.16b
0.62
0.54
tf rooms with carpet
2.10b
0.45b
0.21b
0.05
0.28
0.11
3.17b
3.64c
3.01b
0.11
0.19
2.58b
2.97b
0.25
0.19
o
•o
X
0.20
X
Figure 4-2. Correlation matrix for structural and demographic variables in the
asthma study households. All values are Pearson's r-values, except when indicated by
the letter "a," which represents a Chi-square value, "b," which represents a t-test
value, or "c," which represents an f-value.
to
.t»
O

UPHOLSTERED FURNITURE
Figure 4-3.
The Allergy Disease Model in the Architectural Perspective.

CHAPTER 5
NEW HOMES AND UNINVITED GUESTS:
HOUSEHOLD PEST INFESTATIONS
Introduction
An important dependent factor in developing allergies
to specific household pests is of course the presence or
absence of those pests in the domestic environment. From
the entomological survey a household pest taxonomy was
created, and asthmatic children were tested for allergies to
the most commonly-occurring pests. The objective of this
chapter is to present a household pest taxonomy specific to
Barbados, in order to identify the potential indoor
arboallergens and other pest allergens to which the
asthmatic is subjected. Variations in distribution of pests
will be discussed at the spatial (macroenvironment and
microenvironment) and temporal level and analyzed in terms
of the sociodemographic and architectural variables
associated with modernization of the domestic environment.
How residents view pests—how they are categorized and
classified (e.g., beneficial, dangerous)—and what they do
about infestations, will be discussed as well. This is
important in planning for control and/or eradication of
pests that pose serious health threats to asthmatics.
242

243
Determining the presence of household pests is not an
easy task. Expectedly, there are seasonal variations in
pest infestations and monthly variations as well. Recent
changes in the structure of the home may enhance or preclude
a particular species living in that home at the time of
analysis. A recent change in household behavior (e.g., food
storage regimen), use of chemical controls (e.g., switching
to a different insecticide), or a change in household
density (which might lead to changes in moisture production,
quantity of garbage produced, and cleanliness practices) are
but a few examples of sociodemographic influences on pest
populations.
Given the anticipated difficulties, and given the time
constraint of one year in which to complete all aspects of
the study, it was decided to qualify rather than quantify
household pest infestations (with the exception of two
species of house dust mites), indicating heavy infestations
when possible, as well as architectural features influencing
infestations, but concentrating on creating a household pest
taxonomy first and foremost, so as to identify in general
what Barbadians are exposed to in the domestic setting.
A significant problem in testing asthmatics to
household pests was deciding a priori exactly what qualifies
as a household pest in Barbados. While a sophisticated
Ministry of Agriculture with a separate division of
Entomology has functioned for some time in Barbados, limited

244
financial resources have mandated an agricultural focus.
Household pest research and management has been left mainly
in the hands of the private pest control companies, with the
exception of specific pests that are notoriously a health
problem (e.g., mosquitoes, rodents), for which a separate
civil vector control program and an international control
program (Pan American Health Organization) have been
responsible.
In summary, the household pest taxonomy created from
this study is based on limited taxonomic data, biseasonal
trapping, information from the Entomology Section of the
Ministry of Agriculture, advice from personnel at the Pan
American Health Organization vector control division (the
Eastern Caribbean PAHO branch is situated in Barbados),
members of the Rodent Control Service at the Ministry of
Health, and lastly—and certainly not least important—the
residents themselves.
Infamous Household Pests in Barbados
Pests Related to Disease
Barbadians have, historically, enjoyed overall good
health, largely due to the availability of a good, clean
water supply and the geophysical absence of stagnant bodies
of water (with the exception of Graeme Hall Swamp) that
could enhance the growth and development of many tropical
disease vectors. The accessibility of standing water pipes

245
near most homes has, in general, negated the need for
holding tanks outside of the home, thereby limiting
available habitats proximal to the house for pest species
such as mosquitoes. Compared to other Caribbean islands,
garbage collection is relatively reliable in Barbados;
indeed, much of the accumulation of trash one sees in
Barbados is due to negligent littering at the individual
level rather than from poor garbage management at the
national level. Sewerage disposal is available to the
majority of Barbadians.
Mosquitoes
Despite the overall low incidence of vector-borne
disease, some of the traditional tropical diseases have
plagued Barbados as elsewhere in the Caribbean. The two
vectors most responsible for these diseases are the mosquito
and the rat. Three genera of mosquitoes have been and
continue to be present in Barbados, which are potential
vectors for four diseases that have inflicted largescale
morbidity throughout the tropical regions: Anopheles
(malaria1), Culex (filariasis), and Aedes (yellow fever and
dengue).
The first dengue control program began in the 1950s,
and no major outbreaks were recorded until 1977, when 50
persons were infected with the Type-I serovirus (Dann 1984).
The incidence of dengue in Barbados has been relatively
stable over the past five years (Brown,2 personal

246
communication). The year-end total of "confirmed" cases
dropped from 25 in 1989 to 18 in 1990 (an outbreak was
reported in December, 19893) (Brown, personal
communication). Dr. Michael Brown, a general practitioner
who specializes in dengue diagnosis and treatment, laments
that, regarding preventive measures against dengue, a
mosquito-oriented campaign—rather than a dengue-oriented
campaign—tends to break down at the execution point. He
states that mosguito fogging is "completely reactionary,"
and is directed toward the area from which cases are
reported rather than spraying the entire island.
A PAHO/WHO-sponsored workshop "On Community Action for
Integrated Vector and Rodent Control" held in April, 1990,
in Barbados, drew the following response from the Ministry
of Health:
The aedes aegypti and rodent control programmes must be
seen as key elements in our overall health programmes.
Perhaps we have erred in the past by treating them as
vertical programmes. The Ministry of Health in
Barbados has sought to heighten the awareness of the
community to the part it can play in disease prevention
and health promotion. Greater emphasis has been placed
on education via T.V. programmes, community groups, and
by relevant health personnel in an effort to encourage
fuller participation by all sectors of the community.
Our major objective has been to change attitudes to
environmental health and to show that any major changes
can only occur with full participation by the
individual. We are very conscious that total
dependence of insecticides as a means of control cannot
be successful (Yard 1990, p.2).

247
Other díptera
Other díptera have been implicated in disease in
Barbados. Six species of the bloodsucking ceratopogonids—
or sand flies (biting midges)—are known to inhabit Barbados
(Greiner et al. 1990). While these díptera can be involved
in the transmission of a number of pathogenic protozoa,
viruses, and nematodes in both animals and humans, their
disease infliction has been limited to Bluetongue virus in
Barbadian sheep. Sand fly (family Psychodidae) bites are a
common complaint in Barbados; however, there is no history
of sand fly-related, human disease on the island (Nathan,4
personal communication).
Lowenthal noted that dysentery was especially prevalent
when cane fields were being fertilized, between July and
October, during what was termed "fly season" (1957). Since
Lowenthal's publication there apparently has been little or
no mention of flies as a serious health problem in Barbados,
although preliminary ethnographic research indicated that
they are perceived as a constant health hazard in the
domestic environment. There is no systematic control of
flies in Barbados, with the exception of commercial control
at poultry and dairy farms (Haslett,5 personal
communication).
Cockroaches
Pest control companies report that most of their calls
from the private sector are for treatment of cockroaches and

248
rodents, the majority of their clients being of the middle-
and upper-socioeconomic strata. According to the general
manager of Rentokil (Barbados) Limited, the German cockroach
(Blattella germánica) population is increasing in Barbados,
but is still confined primarily to the commercial sector,
whereas the predominant domestic problem is with the
Periplaneta spp. (American and Australian) (Haslett,
personal communication). Haslett confirmed that the general
public was aware of the relationship between cockroach
infestations and salmonella and other types of food
poisoning (personal communication).
Millipedes
The diplopods—or millipedes—are perceived by the
layperson as a potential danger because of the hydrogen
cyanide that they exude as a defense mechanism, colloquially
called a "poison." Millipede burns are a well-known
phenomena, and are most commonly presented in the head and
neck region, whereupon the victim—usually a child—has
brushed the arthropod from the body during sleep (Harwood &
James 1979). Although they prefer damp, dark habitats and
feed on decomposing vegetation, they are frequently found in
Barbadian homes, entering the dwelling through windows,
doorways, or voids between the roof and wall. Three
different types of millipedes have been recognized in
Barbados, although they have not been identified by
taxonomists. The smallest is referred to as the "Christmas

249
Worm," followed by a "medium-sized" species, and also a very
large red-brown species, apparently common in gullies
(Fraser et al. 1990).
Centipedes
Of greater concern to Barbadians—perhaps because of
their speed—are the Chilopods, or centipedes. Two types of
centipedes have been recognized in Barbados by the Caribbean
Agricultural Research and Development Institute (CARDI)
(both of the genus Scolopendra), but only one has been
identified to species (£L-_ subspinipes Leach) (CARDI 1985) .
Centipedes, unlike millipedes, have poisonous claws, or
"maxillipeds," used to sting and paralyze their prey;
however, the supposed neurotoxin injected by the centipede
has never reportedly killed a human, and the immediate pain
from the sting typically disappears in a short period
(Harwood & James 1979).
House dust mites
As previously discussed, Pearson and Cunnington (1973)
found house dust to be a important allergen to asthmatics,
and numerous house dust mite species were identified as a
major component of the dust samples. They found a total of
23 species of mites, the most predominant of which was
Dermatophagoides pteronvssinus. Dust was collected from
bedrooms and mattresses, and skin tests were conducted using
extracts from seven of the mite species; they found that a
relationship existed between the density of D^_ pteronvssinus

250
mattress infestations and the incidence of allergy to that
species (Pearson & Cunnington 1973). The scientists
concluded the following:
Barbadian houses are most commonly small single-storey
wooden structures containing two to four rooms and are
supported on either coral or concrete blocks about a
foot above the ground. These provide a damp
course,...[and] The conditions are, therefore,
especially suitable for the growth of many mite
species, particularly El. pter.. (Pearson & Cunnington
1973, p.304-305).
After the Pearson and Cunnington study, there was a
void in follow-up research on allergy to house dust mites in
Barbados, as well as efforts to control populations. As of
1991, pest control companies never mention acaricides as a
form of household pest control, and none of the informants
in either phase of the asthma study discussed control of the
house dust mite per se; only rarely did parents of
asthmatics mention controlling "dust" in the house as a
routine practice to minimize their child's asthmatic
attacks. Reflective of its microscopic size, the house dust
«
mite is apparently invisible in the minds of most Barbadians
as a real household pest. Nevertheless, their deleterious
effect on health was vividly depicted in the Pearson and
Cunnington study.

251
Rodents
Like any other seaport in the world, a common pest in
Barbados is the rat. Institutionalized control of the rat
can be traced to at least since 1745, when an act was passed
in which each parish church warden was required to pay a
twopence bounty for every rat head delivered to him;
possibly due to oversupply, the bounty was reduced to one
penny in 1867 (Dann 1984). It is estimated that 654,459
rats were destroyed between 1874 and 1879 (Dann 1984).
The three rodent species in Barbados are Rattus rattus.
R. norveaicus. and Mus musculus. In Barbados, rodents are
both disease carriers and agricultural pests. Rodents are
responsible for serious decreases in tonnage of cane because
they destroy the inner nodes of young cane when it starts
producing sugar (Williams,6 personal communication). In
1974, losses due to rats cost an estimated US $2.25 million
to the sugar industry (Williams 1984).
Rodents in Barbados have been implicated in
gastroenteritis, salmonella, and leptospirosis.
Leptospirosis is a particularly serious disease in Barbados
and the other Caribbean islands.7 Humans acquire the
Leptospira spirochete via infected rats, either directly by
rat bites, or, more commonly, by contact with infected rat
urine. The leptospires pathogenic to humans and animals
generally fall under the species name of L^_ interrogans. and
are divided into at least five different serotypes and

252
various serovars, and a number of them are present in
Barbados.8 The organisms are localized in the kidneys of
wild rodents—rarely fatal to the vector—and are excreted
in the urine. It is estimated that as many as 10-30% of the
rat population is infected with pathogenic leptospires, and
as many as one million leptospires per milliliter may be
excreted by an infected animal (Boyd & Hoerl 1981).
Leptospirosis was first reported in Barbados in 1939
(Yard 1990). Between November 1979 and December 1982 there
was an annual average of 43.6 cases; however, this figure
was unusually high, as the typical average is 17.6 per year
(Everard et al. 1984). The crude incidence rate is 15-23
per 100,000, and from 1979 to 1982 the overall fatality rate
was 18.8%, with an average of 8.2 deaths annually (Everard
et al. 1984). In a subsequent study, the mortality rate was
much lower, at 5.7% (Edwards et al. 1990). Because
acquiring the disease is an occupational hazard for cane
laborers and workers in small animal husbandry (because
these workers are more likely to be exposed to rats and
their urine), the rate is typically higher among males, and
the incidence of disease increases for both sexes with an
increase in age, up to 60 years9 (Everard et al. 1984).
In 1978, a veterinary public unit was established at
the Ministry of Health to better control and coordinate
activities related to food borne and zoonotic diseases. As
part of this project, a rodent control unit was founded

253
(Browne,10 personal communication). Similarly, a
leptospirosis research project was implemented during 1979-
1989, and the Leptospira Laboratory has continued research
in Barbados and elsewhere in the Caribbean, funded by the
Medical Research Council of Barbados and the Royal Tropical
Institute of Amsterdam.
Pests Not Related to Disease
During the preliminary phase of the study, several
pests were repeatedly mentioned, although they were not
associated with any disease. Perhaps one of the most-
frequently listed pests not related to illness is the
termite, colloquially referred to as "flying ants," or "rain
flies." CARDI recognizes seven different species of
termites in Barbados (1985), but apparently the most common
species is Nasutitermes costalis. which is primarily a tree
and canefield dweller rather than a domestic species, and
Coototermes havilandi. the main destroyer of wood homes
(Fraser et al. 1990). Seasonal relocation missions by the
secondary reproductives of a colony are realized by massive
swarms in search of a new home; the swarms are attracted to
artificial light in the evening and invade homes en masse,
forcing residents to turn off all lights immediately and
wait for the swarm to pass on to another home. The
colloquial name for the termite is attributed to the season
in which these flights occur; Barbadians associate the

254
passing of a swarm with eminent rain, and refer to the
insects as "rain flies" (Fraser et al. 1990). However, the
author experienced swarms of "rain flies" in her own
dwelling throughout the year and not during specific
seasons.
In the late 1800s the East Indian mongoose (Herpestes
auropunctatus) was introduced to the British West Indies as
a control measure against rats destroying the cane.
Erroneously, many assume that the mongoose was imported to
rid the island of the snake population; this is true only
for St. Lucia, where the project failed to eliminate the
deadly "Fer de Lance" cane snake (Fraser et al. 1990).11
The mongoose has, nevertheless, probably inadvertently
affected the snake population in Barbados, no doubt
disrupting a link in the ecosystem. The mongoose includes
in its diet small animals such as chicks and eggs and is a
nuisance to residents who own livestock.
Another Old World importation that is viewed as more of
a nuisance than a benefit is the African Green Monkey
(Cercopithecus aethiops sabaeus), brought from West Africa
during the slave trade. Currently the monkey population is
between 5,000 to 10,000 (Baulu et al. 1987). Having no
natural predators or means of population control, the monkey
has, in the past, been a target of bounty control. The
opening of the Barbados Wildlife Preserve by Canadian
primatologist Jean Baulu has re-directed the economic

255
interest of monkeys in the areas of tourism and medical
research; many of the animals are exported for research,
particularly the development of vaccines. Only a portion of
the monkeys live within the domains of the Reserve, and the
remaining free-roaming monkeys are a constant threat to
kitchen gardens, fruit trees, and other cultivated foods,
particularly in the rural regions of the island, and are
considered to be a pest.
At least six species of bats are known to occur in
Barbados. Their greatest health threat is the accumulation
of guano in rafters and attics, which in turn attract
cockroaches as a food source (Ebeling 1975). As in so many
other cultures, bats evoke a collage of myths and stories
and are often feared by the layperson. One myth is that the
nocturnal attributes of bats can be passed on to watch dogs
if the dogs are fed "dried powdered bat" mixed in their food
(Fraser et al. 1990). A colloquial term for bats—and more
frequently used than the word "bat"—is "moth." Conversely,
the lepidoptera-type moth is referred to as "bat."
The Pest Collection: An Inventory of Household Pests
Materials and Methods
As described in Chapter Two, entomological samples were
collected bi-annually, during the dry and rainy seasons.
Traps were set for a period of five days at each time period
and checked and replaced every 24 hours. The villages in
which the testing took place were Oistins (Christ Church),

256
Cotton Vale (St. Philip), Chalky Mount (St. Andrew), Rose
Hill (St. Peter), and Chapman Street Village, Bridgetown
(St. Michael).
The following paragraphs describe the trapping methods
that were employed. All pest specimens were removed from
the trap and mounted, preserved in alcohol, or frozen for
later identification. Specimens recorded by sight were
listed at the time of the sighting. Trapped rats were
etherized and blood was collected for use by the Leptospira
Laboratory. In the event that any other animal was caught
in the live trap, it was identified, the information
recorded, and the animal was freed.
Liqht/CO: trap
A light/C02 trap was used for collecting mosquitoes and
other diptera outside of the home. The traps were set
proximal to the most frequented entrance of the house. The
trap design included an upper container for dry ice (the C02
source) and a light source above the collection tube. The
trap was run by a 24-volt battery that operated for a
maximum of 72 hours. Due to the prohibitive cost and
limited accessibility of dry ice, the trap was only run for
a 24-hour period with dry ice and the light source, followed
by a 24-hour period with the light source only.

257
Flea trap
The Happy Jack12 brand flea trap was used over a five-
day period. The trap was placed in the living room, on a
carpeted area when available; otherwise the trap was placed
closest to a piece of upholstered furniture or a rug. The
trap consisted of a collecting pan, which was filled with
water and topped with vegetable oil, and an upper pan under
which a light source was suspended. Electricity was
available in all of the homes selected, although presence or
absence of electricity was not a criteria for selection.
Flv strips
Yellow, adhesive strips13 were used for the collection
of flies and other diptera in the kitchen and dining area.
Four strips were hung in each home and changed as needed,
for a five-day period. The strips were hung next to the
kitchen entrance, near a food-handling area in the kitchen,
and over the dining table.
Cockroach traps
Two types of cockroach traps were used. The first trap
was a newly patented trap designed by Dr. Jeffrey Jones at
the Ministry of Agriculture (Flick traps,14 Flick
Laboratories 1991), specifically for the Periplaneta spp..
The trap consists of a disc with four flap-door entrances,
which cannot be opened from the inside. A well inside the
trap is filled with toxic bait. The top of the trap is a

258
child-proof, twist-on top. The other trap used was the
sticky, tent-style trap. While this trap is designed
specifically for cockroaches, it catches any crawling insect
or pest (e.g., mice, small reptiles). Both types were set
in the kitchen (refrigerator and garbage collection),
bathroom (indoor or outdoor, depending on the home), and
near an entrance. Traps were replaced daily as needed and
employed over a five-day period.
Live trap
Three live-catch rat traps15 were used at each home.
The traps were set outside of the house, close to the
kitchen door, under the house, and in/around vegetation
proximal to the house. Bait consisting of peanut butter on
a cracker was placed inside each trap, as suggested by Dr.
C. Everard of the Leptospira Laboratory.
Mite sampling
Dust collections. A hand-held vacuum cleaner with an
built-in collection chamber was used for the purpose of
collecting dust samples. The chamber was inserted between
the hose and nozzle and consisted of a circular screen which
supported a coffee filter (8-cup size) (Mr. Coffee Inc.16)
for the purpose of trapping the dust. Dust samples were
collected from four sites in each home: A bedroom mattress;
the bedroom corner (preferably on a rug); the most-
freguently used piece of upholstered furniture in the living

259
area; and a corner in the living area (preferably on a rug
or carpeted corner). The dusting lasted for five minutes at
each site and included approximately 1 m2 of surface area at
each site. A separate filter was used for each site, and
each filter was placed in a zip-lock bag, labeled, and
frozen. Sites were vacuumed once in both the dry and rainy
season. Unfortunately, it was not possible to repeat
vacuuming in six of the homes during the rainy season, due
to noncompliance (refusal to continue participation by five
informants, and an unknown, change of address for another
informant).
Assay of the mite allergen and mite counts. House dust
was kindly analyzed by Dr. E. Caldas-Fernandez and Mr. W.
Trudeau (University of South Florida, Tampa, FL), for two
species of house dust mites, Dermatophaqoides pteronvssinus
and D_j_ farinae, using the ELISA protocol for quantification
of the major dust mite antigens for Dermatophaqoides spp.,
Per p I and Per f I. For each sample, a polystyrene
microtiter plate (Dynatech Immunlon II) was coated with 1
um/well of either 5H8 (Per p I assay) or 6A8 (Per f I assay)
in 0.1M bicarbonate buffer (pH=9.6) and left overnight at
4°C. Afterwards, the plates were washed twice with
PBS/0.05% Tween 20 (pH=7.4) (phosphate buffered saline,
containing 0.05% Tween 20), then incubated at room
temperature for 30 minutes with 0.1 ml 1% BSA PBS-T, then
washed twice with PBS-T and dried.

260
Next 0.1 ml of the diluted allergen sample (dust) was
added and incubated for one hour. Double dilutions of a
reference D^. Pteronvssinus and D^. farinae extract were used
to make a control curve, which contained from 250-0.5 ng/ml
Per p I and Per f I.17
The plates were washed five times with PBS-T, then
incubated for one hour with 0.1 ml 1/1000 dilution of
biotinylated 4C1. This monoclonal recognizes a cross¬
reacting epitope on both allergens and is used as a second
antibody for both Per p I and Per f I assays. Next the
plates were washed five times and incubated with 0.1 ml
1/1000 dilution of Streptavidin-Peroxidase (Sigma S5512) for
30 minutes. The plates were washed again five times and
assays were developed by adding 0.1 ml ImM ABTS in 70mM
citrate phosphate buffer (pH=4.2). The reaction was stopped
after five minutes by adding 0.1 ml 2mM sodium azide.
Absorbance was read at 414nm in an ELISA microplate
reader. Absorbance readings were directly proportional to
the quantity of either Per p I or Per f I bound and values
were extrapolated from the respective control curves.
Results: Collective Taxonomy of Barbadian Household Pests
The completed household pest inventory is presented
below. Pests were identified to species when possible or
the closest level thereafter. With the exception of the
live-trap animals, reptiles, amphibians, and cockroaches
(identified by the author), pest identification was

261
graciously completed by L. Davis (USDA/ARS, Gainesville,
FL), entomologists from the State of Florida Division of
Plant Industry,18 Dr. T. Walker (University of Florida,
Gainesville, FL), and E. Fernandez-Caldas and W. Trudeau
(University of South Florida, Tampa, FL). As stated, only
the house dust mites were quantified; the remaining pests
were simply identified to the closest taxonomic level
possible, and spatial and temporal distributive
characteristics were noted as appropriate.
Each of the 20 homes was considered for the pest
survey, except in the case of the house dust mite analysis;
as will be presented, three of the homes were deleted for
that aspect of the study. Of the twenty homes, twelve
(60.0%) were urban and eight (40.0%) were rural. The
average amenities score for the sample was slightly below
that of phase II, at 17.0 (median=15). The mean household
density was 1.7 (range= 0.5-4), which is consistent with
national figures. Eight homes (40.0%) were all wood, nine
(45.0%) were mixed concrete and wood, and three (15.0%) were
entirely concrete.
Rodents and other mammals
Rats were trapped on only three of the twenty homes,
although all residents reported seeing rats in the
neighborhood sometime in the past. Rattus norveaicus was
trapped most frequently; two Rattus rattus were trapped
throughout the study. During the dry season, a rat was

262
caught everyday from one of the highest-quality homes—a
concrete home in Oistins. The family raised chickens
directly behind the kitchen, on the patio/balcony, and
commented that rats were a constant problem to the coops.
In none of the homes did residents report using rat poison
or other means of rodent control. Rats were trapped in only
two of the five villages—the highly urban villages of
Chapman Street (Bridgetown) and Oistins.
Mice (Mus musculus) were caught in four of the homes.
In each case they were trapped on the "tent"-like sticky
trap, either in the kitchen or in the bathroom. For those
homes in which mice were trapped, there was poor containment
of garbage at the trap site. Similarly to rats, mice were
trapped in urban homes only (Chapman Street, Oistins, and
Rose Hill).
The East Indian mongoose (Herpestes auropunctatus) was
caught in the live trap in five different homes, in all of
the villages except for the most urban village of Chapman
Street. In one of the homes in Rose Hill, a mongoose was
trapped nearly everyday of the survey; the household raised
ducks and complained of the mongoose attacking the eggs on a
regular basis. The mongoose was observed in every village,
including Chapman Street.
The African Green Monkey (Cercopithecus aethiops
sabaeus) was sighted frequently in the very rural village of
Chalky Mount. It was most commonly seen in the early

263
morning hours, feeding off of the fruit in the trees. A
number of villagers in Chalky Mount complained that they
could no longer maintain a kitchen garden in Chalky Mount,
because the monkey destroyed the garden before its yields
could be harvested for human consumption. The animal was
not sighted in any of the other villages.
Orthoptera
Cockroaches (Periplaneta spp.) were the most
consistently-found pest in the study, except for the house
dust mite. They were recovered in 15 of the 20 homes,
primarily on the sticky trap;19 americana was found in
fourteen of the homes, and australasiae was found in
eight of the homes. In one home (Cotton Vale, St. Philip),
the Surinam cockroach (Pvcnoscelus surinamensis), a feral
species, was found in the kitchen trap. Periplaneta spp.
were found in all of the Oistins homes and in three of the
Chapman Street (Bridgetown) homes. They were found in
smaller numbers in three of the Cotton Vale homes, in three
of the Rose Hill homes, but found in only one of the very
rural Chalky Mount homes. This finding illustrates their
affinity for the urban district, where food sources and
preferable habitats are abundant.
German cockroaches (Blattella germánica) were found
only in two homes—one home in Chapman Street village and
one in Oistins. In both homes, the insects were trapped in
the concrete sections of the home (both homes were mixed

264
concrete and wood), near poorly contained garbage. The
German cockroach was found in large numbers in the Chapman
Street home; it is important to note that Chapman Street
Village lies in the center of commercial Bridgetown, near
grocery stores and other businesses where the insect could
easily be imported*via boxes and cargo.
Also found were two species of crickets, one of which
had not been identified previously in Barbados, Grvllodes
sioillatus; the other was Acheta assimilis. A Grass Mantid
(family Mantidae) was trapped, but could not be identified
to species.
Coleóptera
A few beetles were found in the homes. Of
significance, the bruchid Callosobuchus maculatus was
identified; this is a stored food pest, that typically feeds
on cowpeas, pigeon peas, and other legumes, a staple in the
Bajan diet.
Amphibians/reptiles
Geckos are common in Bajan homes, and were trapped in
four of the homes, in Oistins, Rose Hill, and Chapman
Street. Hemidactvlus mabouia is typically seen after
sunset, because it clings to walls and feeds on insects
attracted to artificial lights; probably for this reason the
animal was never spot-sighted. The common green lizard
(Anolis extremus) was trapped in seven homes; a specimen was
recovered in all of the villages except for Chapman Street.

265
It is believed that these animals were accidentally caught
in their effort to catch an already-trapped insect on the
sticky traps.
It was not uncommon to find a Bufo marinus. the only
species of toads in Barbados, inside one of the live traps
outside of the house. The toad was found in three of the
four Oistins homes, and recovered in three villages:
Oistins, Cotton Vale, and Rose Hill.
Díptera
House flies (Musca domestica) were observed in every
home in each village, although they were sighted with much
greater frequency in homes with fowl and stock (N=12) around
the house than in those without fowl and stock. From the
CO2/light traps, the following families of díptera were
found: Sciaridae, Psychodidae (moth flies and sand flies),
Tipulidae, Chloropidae (Drosophila spp., a vinegar fly),
Muscidae, and Culicidae, including Culex spp. of mosquitoes
and Forcipomvia spp., a biting midge.20 Díptera collected
from other traps included Acalyptrata spp., Phoridae
(Meqaselia spp.), Ceratopogonidae (Atrichoqogon spp.), and
Eolichopodidae. Most of the Psychodidae were of the
Psvchoda spp.; these species are not bloodsuckers, but can
be a considerable annoyance around washbasins in bathrooms
(Harwood & James 1979). Most of the Muscidae were Musca
domestica L. and Hvdrotaea spp. (a blood-feeder). The
greatest number of díptera were retrieved in the urban and
semi-urban villages of Chapman Street and Oistins.

266
Hvmenoptera
The evaniid wasp, Evania appendiqaster. was trapped in
six of the homes, in three villages (Oistins, Cotton Vale,
and Chapman Street) . E^. appendiqaster is harmless to
humans, incapable of stinging, yet parasitizes cockroach
eggs; the insect was found in six of the homes in which
Periplaneta spp. were found. It is important to note that
E. appendiqaster does not parasitize German cockroaches
(Brenner, personal communication).
Ants (family Formicidae) were very common and seen in
and around all of the homes. They were trapped most-
frequently in outhouses and also around garbage collection
areas. Species found included Odontomacus spp.,
Paraturchina spp., and Camponotus spp..
Isoptera
Termites were trapped in eight of the homes, in three
villages (Oistins, Cotton Vale, Chapman Street). They were
found in every home in Cotton Vale, in all house-types
(wood, mixed wood and concrete, all-concrete). The only
species trapped was Coptotermes havilandi Holmgren (Family
Rhinotermitidae, Subfamily Coptotermitinae), a species that
was probably introduced into Barbados from Southeast Asia
before 1930.21
Lepidoptera
A number of moths were trapped from most of the homes;
moths were found in each of the five villages. The most
common moth was the Clothes Moth (family Tineidae). Most of

267
the larvae of this family of moths are scavengers that feed
on fungi or fabrics (Borror & White 1970). Also recovered
was the Pyralid Moth (family Pyralidae), of which there are
numerous species, some of which feed on stored grain or meal
during the larval stage (Borror & White 1970). In addition,
the Gelechiid Moth (family Gelechiidae) was recovered (some
of which are known to be grain pests), the Blastobasid Moth
(family Blastobasidae), and possibly the Cosmopterygid Moth
(family Cosmopterygidae) (questionable identification).
Isopods
Sowbugs were found in outhouses in two of the homes, in
two different villages (Chalky Mount and Cotton Vale). They
were not found inside homes and were recovered in both the
dry and rainy season. Cubearis murinae and Metaponorithus
pruinosus were the two species identified, found
specifically in Oistins and Chalky Mount.21
House dust mites
Two of the most important allergenic components in
house dust mites that have been recognized in the
immunological community are Per p 1 and Per f 1 (Group I)
(Schou & Lind 1991). In the Barbados study, two species of
house dust mites—P^_ pteronvssinus and P^_ farinae—were
identified in the dust samples from 17 and 14 homes,
respectively, using monoclonal antibodies to these Group I
allergens. Three homes were deleted from the house dust
mite assessment due to overall insufficient data. Total

268
densities, the density range, and the number of homes
present were calculated for four regions in the home
(mattress, bedroom floor, living room floor, and living room
furniture) and for the home in general (totals were
calculated for each home from the total density of the four
regions in that home). Table 5-1 presents the data for the
two species of house dust mites.
Of the 17 homes in the house dust mite sample, ten
(58.8%) were urban and seven (41.2%) were rural. The
average amenities score for the house dust mite sample was
also slightly below that of phase II, at 16.9 (mean=15).
The mean household density was 1.5 (range= 0.5-3.0), which
is consistent with national figures. Eight homes (47.0%)
were all wood, seven (41.2%) were mixed concrete and wood,
and two (11.8%) were entirely concrete.
D. pteronvssinus densities did not change significantly
from the dry season to the rainy season; although the mean
density was 60.66 micrograms/gram in the dry season and
78.66 um/g in the rainy season, the range in each home was
considerable. After conducting a GLM on ranks (SAS Inst.
1988) of density (Conover & Iman 1981) with means for season
separated by Tukeys test, it was determined that there was
no significant difference between any of the densities (four
locations in the home plus the total density) according to
season. Densities of D¿_ pteronvssinus in the 17 households
did not vary according to urban/rural residency, geophysical

269
location of the home, or village, and crowding of homes at
the macroenvironmental level (measured by distance from the
nearest neighbor) was not important. The degree of wealth
of the household did not affect density levels.
Two- and three-way interactions (season, location in
the home, and the presence of concrete) were not
significant; consequently, a main effects ANOVA was
conducted on the D^_ pteronvssinus data. Subsequently,
densities did vary according to location within the home
(f=3.04; p=0.03). An investigation of the least-square
means (LSM, GLM ranked procedure) found a significant
difference between furniture (the location with the highest
mean densities) and the three other locations; the pair-wise
t-test showed significant differences between the bedroom
(p=0.009), living room floor (p=0.01), and the mattress
(p=0.07).
Concrete homes had higher densities of D^_ pteronvssinus
than wood or mixed (wood and concrete) according to the
pair-wise T-test (f=9.55; p<0.001). However, this
association should be considered with caution, because there
were only two homes that were built completely of concrete,
and while there was a significant difference between the
wood and concrete homes (p=<0.001) and the mixed and
concrete homes (p=<0.001), there was not a significant
difference between the wood and mixed homes (p=.18).

270
Counts in the mattress increased with the age of the
home in both the dry (r=0.69, p=0.003) and rainy season
(r=0.62, p=0.02). Several other independent variables were
associated with densities, but for the dry season only, and
included the following: Homes with more bedrooms had higher
counts overall (r=0.52, p=0.05); densities in the bedroom
increased with the number of beds in a bedroom (r=0.61,
p=0.009); and densities were correlated to the age of the
living room furniture (r=0.53, p=0.03). Interestingly,
mattress densities were not related to the age of the
mattress.
Other household moisture factors did not affect the
overall density of D^_ pteronvssinus. including the number of
indoor water taps, an indoor shower or toilet, or the type
of foundation. Carpet in the home was not an important
factor in the degree of density. D¿_ pteronvssinus overall
was significantly correlated to household density, but only
during the rainy season (r=0.60, p=0.03); there was no
relationship between D^. pteronvssinus and household density
during the dry season.
Similarly to IX pteronvssinus. mean densities of D.
farinae in the 17 homes did not vary according to season.
It is important to note that overall densities of D^_ farinae
were 1/1000 that of pteronvssinus. and were measured in
nanocrrams per gram of dust rather than micrograms per gram
of dust. Also, Dj. farinae were found less frequently in the

271
sample of homes; specimens were collected from only nine of
the seventeen homes in the survey for both seasons.
Furthermore, no specimens were recovered from homes in the
densely urban sector (Bridgetown) for either season.
Densities were not related to macroenvironmental crowding
(distance from the nearest neighbor).
Two-way interactions ANOVA indicated a borderline
relationship between densities of D¿. farinae and season and
the presence of concrete; analyses suggested that there were
significantly higher densities in the rainy season in
concrete homes; however, a main-effects ANOVA indicated that
mean densities were actually highest in the wood homes and
lowest in mixed (concrete and wood). It can be argued that
the extremely low counts of p_¡_ farinae. in addition to a
small sample size, suggest that any observable associations
may be spurious.
Discussion of the Pest Collection Results
Food and/or garbage pests
The common household pests, typically attracted to food
and/or garbage, were abundant in Barbadian homes, and
include the cockroaches, ants, flies, and rodents. The most
common cockroach in the 20 homes was the Periplaneta spp.,
although Blattella germánica was found as well.
The ant species found in the study were primarily those
attracted to sweets (Paraturchina spp., Camponotus spp.).
It is possible that contact with ant-related allergens is

272
predominantly ingestant rather than aerosolized; crawling
over foodstuffs and cooking utensils, ants, like
cockroaches, have been incriminated as mechanical vectors of
viable pathogens (Harwood & James 1979). In addition to
pathogens, they are possibly contaminating food and utensils
with frass, egg cases, and other particles which may
function as allergens.
Musca domestica was particularly common, especially in
those homes with fowl and/or stock around the house (12
homes). It is typical for Bajans to keep stock—especially
fowl—near the house, usually in the space under the house,
as a personal food source. According to the entomological
survey, the raising of fowl around the home is not related
to socioeconomic status; the two wealthiest households as
well as the poorest household had fowl around the house.
Having fowl around the home does appear to be a factor
related to urban/rural residency, because none of the
Bridgetown households kept fowl, and all of the Chalky Mount
households had fowl. The prevalence of this pest—due
mainly to human behavior (stock around the house)—implies
that it is a significant component of domestic
aeroallergens.
Pests dependent on human hosts
The two most common pests that are dependent upon
humans for survival, and found in the Barbados study, were
the two mosquitoes of the genera Aedes and Culex. and the

273
house dust mites (to be addressed below). All of the
residents complained of having mosquitoes at one time or
another; therefore, contact with these pests, both injectant
and possibly via aeroallergens, appears to be relatively
common.
All four of the households in Rose Hill (the village near
Speightstown) complained of sand flies, although these pests
were not trapped. It can be inferred, that, based on
taxonomic information, as well as ethnographic data, sand
flies are common in Barbados, and sand fly bites (an
injectant allergen) pose an additional threat to the atopic
who is hypersensitive to arboallergens.
Moisture-related pests
Moisture-related pests are those which usually feed on
fungi, and live in damp cracks, crevices, and wall voids,
where the habitat is favorable to their survival (Ebeling
1975). They typically include fungus beetles, gnats and
moths, springtails, psocids, and certain mites; these
arthropods are attracted to damp areas because of the mold
and fungus that grows there (Ebeling 1975). Other
arthropods, including sowbugs, centipedes and millipedes,
must live in damp places because they do not have a
protective lipid film to prevent a lethal rate of water
loss; their preferred habitat is not necessarily the house
itself, but the damp areas surrounding or beneath the

274
structure, and their entrance is usually accidental (Ebeling
1975).
The traps used in the study were not designed
specifically for collecting most of these moisture-related
pests, although some of these pests were, nevertheless,
recovered. Although not identified to species, several
families of moths found in the study are moisture-related
pests; they include species of the Pyralid Moth, such as the
Fungus Moth (Aglossa caprealis) and the Meal Moth fPrvalis
farinalis), and also a species of the family Tineidae
(Ebeling 1975). A number of sowbugs, millipedes, and
centipedes were trapped in the study. One of the ant
species (Camponotus spp.) identified in the study is also a
moisture-related species, in addition to its affinity for
sweet foodstuffs.
Stored food pests
Health risks associated with stored food pests include
contamination with a number of pathogens (Gorham 1991),
nutritional changes caused by damage (Scott 1991) , and the
consumption and/or exposure to arboallergens (Brenner 1991;
Wirtz 1991). Stored food pests range from the minute thrips
and mites to beetles, moths, ants, and parasitic wasps
(Munro 1966). Several stored food pests were found in the
Barbados sample, including various moths and bruchid
beetles. Because the focus of this study was not stored
food, it is likely that many more stored food pests exist in

275
Bajan homes; the traps used in the study were not
specifically directed toward stored food pests.
Mites infesting food typically belong to the
Tyroglyphidae, Glycyphagidae, and Carpoglyphidae families
(Wirtz 1991); however, as will be demonstrated, exposure to
one species of an arthropod often predisposes the atopic to
develop hypersensitivity to other species of that same
arthropod. Cross-reactivity also extends across different
families and orders of arthropods (Baldo & Panzani 1988).
The critical implication in regard to stored food pest
infestations in Barbados is the problem of multiple exposure
sites for highly allergenic arthropods (e.g., aerosolized,
ingestant).
House dust mites
The high densities of D^_ pteronvssinus in Barbadian
homes corresponds to findings of Pearson and Cunnington
(1973) two decades ago. The extreme low density of D.
farinae—and in some cases, absence of the species
altogether—is also consistent with the researchers'
conclusions. Similarly, in other studies, densities of D.
farinae are remarkably lower than those of D^_ pteronvssinus
when both species are found in the same locale (Charlet et
al. 1978; Chang & Hsieh 1989; Colloff et al. 1991) and D.
farinae is often absent (Colloff 1987a & 1987b, 1988a). A
curious finding in the Barbadian setting was the total
absence of D^. farinae in the densely urban sector.

276
Densities of both pteronvssinus and D¿_ farinae did
not change significantly from the dry to rainy season in the
asthma study, which is contrary to other studies, in which
the warmest and wettest months of the year with the highest
levels of relative humidity are the months in which
densities are typically the greatest (Wharton 1976; Charlet
et al. 1978). This probably is due to the relatively high
year-round humidity level. Densities of D^. pteronvssinus
were correlated to factors other than outdoor climate and
concrete in the home, but associations were strongest in the
dry season.
Interrelationships between the density of D.
pteronvssinus and numbers of different microhabitats (a high
number of bedrooms and more beds) were important for the dry
season only. Only the use of concrete in construction was
significant in both seasons. This relationship suggests
that the combination of very high relative humidity levels
in the rainy season and a concrete home may supersede the
importance of individual features.
The implications of the modernization process in
Barbadian homes and, subsequently, an undue increase in
indoor moisture and a decrease in ventilation, have
heretofore been discussed. Spatial distributions of D.
pteronvssinus in the current study confirm the hypothesis
that the construction of concrete is an important element in
the proliferation of certain house dust mite species,

Table 5-1. Density of house dust mite species D¿_ pteronvssinus and .Djl farinae in 17
Barbadian homes. (Note difference in units of measurement for the two species).
D. pter.
D. farinae
Location in the home
No. of
times
present
Mean density
of mites
(microgram/
gram of dust)
Range
No. of
times
present
Mean density
of mites
(nanogram/
gram of dust)
Range
Dry Season:
Mattress
16B
15.81
0.13-120
58
11.11
1.8-44.0
Bedroom floor
17
4.23
0.02-44.8
4
10.71
44.0-50.0
Living room floor
16
1.26
0.13-5.05
7
17.86
44.0-60.0
Living room furniture
Total mean density
17
40.37
0.02-284.2
5
19.34
42.8-148.0
for the home
17
60.66
0.17-287.07
9
53.21
86.8-240.0
Rainy Season:
Mattress
14°
3.68
0.21-23.16
7b
22.99
44.0-68.0
Bedroom floor
13b,c
0.85
0.14-2.74
4&.C
16.92
44.0-72.0
Living room floor
14b
10.03
0.024-125
4b
15.0
44.0-60.0
Living room furniture
Total mean density
14b
64.17
0.15-252
4b
11.06
1.8-60.0
for the home
14b
78.66
0.814-254.1
9b
64.76
88.0-240.0
aOne sample was insufficient to determine mite density.
bSamples could not be repeated in three homes during the rainy season.
cOne sample was insufficient to determine mite density.
tvj
vj

278
probably because of the overall accumulation of moisture
associated with concrete in housing (e.g., indoor water
sources, finished ceilings, and smaller and fewer windows
situated in the moisture-laden areas of the home, such as
the shower stall). Individual contributors of moisture
(e.g., indoor shower, number of water taps) did not bear
significance in the analysis; yet the author contends that
the small sample of homes (17) limited the number of
independent variables that could demonstrate a relationship
at a significant level. A relationship between higher
counts of Di. pteronvssinus and older homes, more beds in the
bedroom, more bedrooms, and older pieces of living room
furniture, suggests the importance of multiple microhabitats
within a single home. The significance of this is of course
the greater likelihood of exposure to house dust mite
allergens by the atopic; the more locales in the home
infested with house dust mites, the more frequently the
asthmatic will come into contact with the allergens.
There was no difference in densities of D.
pteronvssinus according to mattress-type. The lack of
association must be considered with caution, because only
two mattresses (11.8%) in the study were spring; the other
mattresses (88.2%) were foam, which is the most common type
of mattress in Barbados, primarily due to affordability.
However, foam mattresses wear faster and are replaced more
frequently than spring mattresses in Barbados; this may be

279
an important factor in predicting densities of house dust
mites and deserves further attention.22
House dust mites do not tolerate relative humidity
levels below 55% (Korsgaard & Iversen 1991). The relative
humidity requirement for D^_ pteronvssinus is higher than
that for Dj. farinae (Arlian 1975; Brandt & Arlian 1976;
Wharton 1976). Hallas summarizes the interrelationship
between temperature and relative humidity as follows: "Much
simplified, it can be said that it is mostly temperature
that decides how quickly mites can develop, whereas humidity
determines the number of house dust mites able to live in a
home" (1991, p.7). Relative humidity is important to mites
because it is their primary source of water; this is
achieved by passive and active absorption of water from
unsaturated air (Arlian 1975). House dust mites, like other
animals, also receive water by ingestion of their food and,
of lesser importance, mites obtain metabolic water via the
oxidation of fats and carbohydrates (Arlian 1977).
Although the house dust mite thrives anywhere in which
there is the presence of irregular surfaces that trap dust
and skin scales,23 the bedroom—particularly the mattress—
is thought to be the primary focus for breeding of the house
dust mite in most homes (Wharton 1976; Colloff 1989; Colloff
et al. 1991; Hallas 1991; Korsgaard & Iversen 1991). This
is because the bedroom mattress provides warmth, a constant
source of shed skin scales, and subsequently both food and

280
water. Because people spend approximately eight hours per
day on their mattress, the mite has a dependable source of
nutritional and metabolic provisions. An additional
moisture source available in mattresses is the nocturnal
sweating and body heat produced from sleeping humans; this
metabolic function can increase relative humidity and
temperatures to 95% and 35°C, respectively (Colloff 1989).
However, Barbados densities were higher in living room
furniture than in the mattress or bedroom. For reasons
unknown, it appears that EK. pteronvssinus. in the Barbadian
setting, prefers the microhabitat of living room furniture
over its more traditional habitat, the bedroom mattress.24
This factor deserves further study.
A temperature range of 20-25°C and a relative humidity
of 75-80% are optimal for the survival and growth of most
mite species (Colloff 1989), although optimal levels do vary
slightly according to species (Arlian 1975; Brandt & Arlian
1976). Temperature is important to mite survival primarily
in regard to its effect on humidity (a proportional
relationship), because, according to Korsgaard and Iversen
(1991), studies have shown that temperature by itself does
not affect mite counts. This is apparently true, however,
for low temperatures only, as maximum tolerance levels for
high temperatures have been demonstrated (Arlian 1975;
Brandt & Arlian 1976).

281
Researchers contend that, despite the overall
temperature and relative humidity, slight changes of these
two elements within the microhabitat can markedly affect
fecundity and migration patterns of mites seasonally,
monthly, and even daily (Colloff 1991). There is evidence
that this feature is magnified in the tropical setting where
the annual range of temperature and relative humidity is
fairly narrow (Charlet et al. 1978; Colloff 1991). In fact,
this lower tolerance in species to minor fluctuations has
been demonstrated in vitro for populations subjected to
long-term optimal conditions and then challenged with slight
variations in temperature and relative humidity, after which
the mortality rate was quite high (Colloff 1987c). Even in
temperate climes, changes in the microclimate within the
mattress causes mites to migrate to different regions of the
bed25 (Colloff 1988a & 1991) .
The small sample size of homes for dust sample
collections in the asthma study, and collection during two
time periods in the year only, may have resulted in data too
limited from which to make appropriate conclusions. Murray
& Zuk (1979) found that peaks in mite populations occurred
in different months over a two and-a-half year period,
suggesting that additional fluctuations may have been missed
in the Barbados study. However, the analyses do confirm the
presence of one of the most allergenic arthropods known—D_j_

282
pteronvssinus. and the data suggest that concrete provides a
more favorable microenvironment for that pest than wood.
The Ethnographic Survey: Categorization. Classification.
and Responses to Household Pests
One of the objectives in the interview schedule was to
assess the worldview of Barbadians regarding household
pests, by randomly selecting, from the total group of
informants, a sub-group to whom questions about their own
pest infestations, and household pests in general, could be
asked. The purpose of this assessment is multi-dimensional.
First, responses from the informants could support and
supplement findings from the entomological survey, both in
the household pest taxonomy, and in the investigation of
relationships between infestations of pests and
sociodemographic and structural variables. Second, to the
author's knowledge, an assessment of the mental mapping of
household pests—what constitutes a household pest, and how
it should be managed—has not been investigated in Barbados.
Such information can be extremely helpful in planning
control strategies at all levels: International, civil,
commercial, and private. Also, intensive campaigns have
been conducted against two common pests in Barbados—aedine
mosquitoes and rodents—to reduce the incidence of two
serious diseases, dengue and leptospirosis, respectively.
It is useful to assess the knowledge base of citizens
regarding these two pests, in comparison with other common

283
pests, to determine both the effectiveness of these
campaigns and, if the campaigns have been successful, to
possibly apply certain aspects of these campaigns in the
control of other potentially hazardous pests. Last, even
though the layperson might be familiar with the name of a
pest, will she/he recognize that pest in the event that
contact is made with it? This factor is vital in the
successful reporting of infestations to proper
authorities/control personnel and in the domestic control of
a hazardous pest.
Sixty-five informants were chosen randomly from the
group of 177 informants to answer the household pest-related
questions in the questionnaire. This section of the
interview was conducted in the home because of the
additional amount of time required for the questions and the
use of pile sorting as an interview technique. The pile
sort included a collection of 33 different arthropods and
four cards with a color photo of an animal on the card;
cards were used for monkey, mongoose, house dust mites, and
toad, because it was not possible to obtain actual
specimens. One of the arthropods—a scorpion—is not
present on Barbados and was included to determine validity
in recognition and recall. One of the cards—the house dust
mite—is not a pest with which most laypeople are familiar
and is microscopic. To parents of asthmatics, however, it

284
is a pest of which they have no doubt heard a great deal in
the media and from health care professionals.
The sample population for the pest-related questions
was composed of 64 females and one male. The average age of
the informant was 36 years (median=35). The mean
"amenities" score was 17.1 (median=15). Thirty-eight
informants (58.5%) lived in the urban sector and 27 (41.5%)
lived in the rural sector. This sub-population compares
favorably with the total population. Obviously, male
informants are seriously under-represented, but there were
only 12 (6.8%) male informants in the total sample. The
average age of the total sample was slightly lower, with a
mean of 35.6 years (median=34). The amenities score for
this population was slightly higher than that of the total
population (mean=16.6, median=15). The urban/rural
breakdown is also very similar; for the total population, 96
(54.2%) informants were urban and 81 (45.8%) were rural.
Forty-nine (75%) of the informants had a child with asthma
and 16 (25%) did not. In summary, the sub-population was
highly representative of the total population for the study.
The Ethnographic Taxonomy
The first step in the ethnographic assessment was to
determine which pests informants had most frequently in
their homes and to determine their recognition of 37
household pests. When clients were asked to list all the
pests that they had ever seen around their home, the average

285
number of pests recalled was 6.0. Only 3% (N=2) could list
more than 10 pests around their home. A total of 38
different pests were listed. Cockroaches (Periplaneta spp.)
were the most frequently listed pest (nearly 90% of the
population), followed by mice (70.8%) and mosquitoes
(70.8%), millipedes (60.0%), and flies (52.3%). Each of the
other pests listed were reported by less than 50% of the
population, and 10 of the pests were only listed by one
person each. Table 5-2 presents the 37 different household
pests listed and the frequency with which they were
reported.
After clients were asked to "free list" all the pests
that they could recall seeing around their home, they were
presented with the pile sort. Eight of the pests listed
were not part of the pile sort, but one of these was a
domestic cat (listed by one informant only), five other
arthropods were listed only once, and one was listed twice.
It was concluded that the most important pest species were
included in the pile sort, and the technique was believed to
be valid for the population. Clients were asked to name
each specimen in the pile sort, in order to determine their
recognition of a pest (Table 5-3). If they recalled seeing
an animal, but could not name it, the information was
recorded. If the informant misidentified the animal, the
answer was counted as "unable to name." Recognition was
recorded according to the common name used by the informant.

Table 5-2. Reported pests in Barbadian homes by
informants in the Asthma Study.
Pest
Frequency
Percent
Cockroach fPeriolaneta
SPPO
58
89.2
Mouse
46
70.8
Mosquito
46
70.8
Millipede
39
60.0
Fly
34
52.3
Centipede, large spp.
27
41.5
Rat
25
38.5
Ants
15
23.1
Sand fly
15
23.1
Lizard
12
18.5
Centipede, small spp.
9
13.8
Gecko
8
12.3
Grasshopper
5
7.7
Frog
5
7.7
Termite
5
7.7
Slug
5
7.7
"Giant" cockroach
(Blaberus spp.)
4
6.2
Moth
4
6.2
Beetle*
4
6.2
Bat
3
4.6
German cockroach
3
4.6
Mongoose
3
4.6
Cricket
2
3.1
Sowbug
2
3.1
Stink bug
2
3.1
Spider
2
3.1
Honey bee
2
3.1
Caterpillar*
2
3.1
Fruit fly*
1
1.5
Cat*
1
1.5
Gnat*
1
1.5
Butterfly*
1
1.5
Worm*
1
1.5
Snail*
1
1.5
Toad
1
1.5
Monkey
1
1.5
Praying mantis
1
1.5
Wasp
1
1.5
*Not included in the pile sort.

Table 5-3. Ethnographic taxonomy of 33 pests (frequency and percent of responses, N=65)
The scientific common name is underlined, and the Barbadian common name is listed under
the scientific common name.
Recognized,
but could Incorrectly
Specimen
Frequency
Percent
not name
named
Gecko
65
100.0
0
0
House lizard
23
35.4
-
-
Gecko
22
33.8
-
-
Poison lizard
9
13.8
-
-
White lizard
6
9.2
-
-
Night lizard
1
1.5
-
-
Ground lizard
1
1.5
-
-
Slav
1
1.5
-
-
Cold lizard
1
1.5
-
-
Lizard
1
1.5
-
-
Whistlinq froct
65
100.0
0
0
Frog
40
61.5
-
-
Tadpole
16
24.6
-
-
Toad
6
9.2
-
-
Crapo
2
3.1
-
-
Jumping frog
1
1.5
-
-
Large cockroach
(Periolaneta spd.)
65
100.0
0
0
Cockroach
64
98.5
-
-
Mahogany bird
1
1.5
-
-
Honey bee
65
100.0
0
0
Honey bee
65
100.0
-
-
Larue centipede
65
100.0
0
0
Large centipede
65
100.0
-
-
Lizard
65
100.0
0
0
Lizard
65
100.0
-
-
Flv
65
100.0
0
0
Fly
65
100.0
-
-
287

Table 5-3
continued
Specimen
Freguency
Percent
Mouse
64
98.5
Mouse
64
98.5
Millipede
64
98.5
Millipede
62
95.4
Hard-back Harry
2
3.1
Soider
62
95.4
Spider
62
95.4
Ant (small)
61
93.8
Ant
53
81.5
Sweet/sugar ant
3
4.6
Running ant
2
3.1
Biting ant
2
3.1
Crazy ant
1
1.5
Stink Bua
61
93.8
Pea chink
58
89.2
Green bug
1
1.5
Bush bug
1
1.5
Pea lice
1
1.5
Ant (larcre)
61
93.8
Ant
41
63.1
Big-head ant
12
18.5
Wood ant
4
6.2
Biting ant
2
3.1
Sugar ant
1
1.5
Smelling ant
1
1.5
Slua
60
95.2
Slug
60
95.2
Recognized,
but could
not name
1 (1.5)
0
1 (1.5)
0
2 (3.1)
0
Incorrectly
named
0
0
2 (3.n
2 (3.H
3 (4.6)
1 (1-5)
288

Table 5-3
continued
Specimen
Freguency
Percent
Bat
59
90.8
Bat
52
80.0
Mouse bat
3
4.6
Duppy bat
2
3.1
Night bat
2
3.1
Ladvbua/Ladvbird
58
89.2
Ladybug/Ladybird
58
89.2
Mosauito
58
89.2
Mosguito
58
89.2
"Giant" (Blaberus
sod.) cockroach
58
89.2
Giant
38
58.5
Knocker
11
16.9
Giant mahogany
bird
4
6.2
Cockle
3
4.6
Hard-back
cockroach
2
3.1
Small centioede
57
87.7
Centipede
56
86.2
Christmas worm
1
1.5
Termite
57
87.7
Rain fly/ant
21
32.3
Flying ant
14
21.5
Wood ant
11
16.9
Termite
10
15.4
Wood eater
1
1.5
Rat
56
86.2
Rat
56
86.2
Recognized,
but could
not name
Incorrectly
named
2 (3.1) 3 (4.6)
.
-
-
-
-
.1—LU51
5
(7.7)
-
-
0
2
L3 i l)
“
0
2
(3.1)
—
—
—
—
—
—
—
—
_
1 (1.5)
5
(7.7)
-
-
-
-
0
7
O
CO
—
—
-
-
-
-
-
-
-
—
1 lo
9
(13.8)
289

Table 5-3
continued
Specimen
Frequency
Percent
Grasshopper
54
83.1
Grasshopper
54
83.1
Cricket
54
83.1
Cricket/Money
cricket
54
83.1
Pravino Mantis
41
63.1
God horse
36
55.4
Praying mantis
4
6.2
Wood horse
1
1.5
German cockroach
39
60.0
German cockroach
28
43.1
Johnny Possel
8
12.3
Different species
of an American
cockroach
2
3.1
Jack Spaniard
1
1.5
Sand flv
33
50.8
Sand fly
28
43.1
Sour fly
2
3.1
Pepper fly
2
3.1
Pygmy fly
1
1.5
Mosauito larvae
26
40.0
Mosquito larvae
24
36.9
Baby mosquitoes
1
1.5
Ning-nings
1
1.5
Recognized,
but could Incorrectly
not name named
2{.3 • 1)
2 (3.1)
13 (20.0)
3 (4.6)
3(.4.,6)
7 (10.8)
7 (10.8)
8 (12.3^
4 (6.1)
10 (15.4^
3 (4.6^
290

Table 5-3
continued
Specimen
Frequency
Percent
Sowbucr
25
38.5
Hog lice
20
30.8
Sowbug
2
3.1
Pig lice
1
1.5
Grub
1
1.5
Mud lice
1
1.5
Scoroion
22
33.8
Scorpion
22
33.8
Moth
18
27.7
Moth
15
23.1
Bat
3
4.6
Fleas
18
27.7
Fleas
17
26.2
Chinks
1
1.5
Tick
16
24.6
Tick
16
24.6
Wasp
5
7.7
Wasp
5
7.7
Recognized,
but could Incorrectly
not name named
16 (24.6)
1-L1...5)
1-(1-5)
3 (4.6)
3 (4.6)
8 (12.3)
9 (13.8)
1 (1.5)
45 (69.2^
16 (24.6^
21 (32.3)
37 (56.9)

292
All of the informants were able to correctly identify
at least seven of the specimens, and for only seven of the
33 total specimens could less than 50% of the informants
correctly identify the animal. The less frequently
identified pests included mosquito larvae, for which 40% of
the informants could identify, a sowbug, recognized by 63.1%
of the informants, but correctly named by only 38.5%, a
scorpion, recognized by 33.8% (despite its absence on
Barbados), fleas, identified by 27.7%, and a tick,
identified by 24.6%. The wasp was called a number of
different insect names, but only "wasp" by 7.7%. The moth
specimen was identified by 27.7% of the informants, but it
should be noted that 69.2% (N=45) of the informants called
the specimen a butterfly, and this was counted as an
incorrect answer.
Ability to correctly name the specimens was not
correlated to age, sex, wealth, educational level, or
occupational status of the informant. Also, there was no
difference in ability to identify the specimens according to
residential location.
The harmless gecko was referred to by more colloquial
names than any of the other pests, but was correctly
identified by all informants, indicating its commonality.
It was called "gecko" by only a third of the informants; the
remaining names refer to a type of lizard, an understandable
assumption. Ants, both small and large, are typically

293
identified with a variety of adjectives as well, including
"sweet," "'running," "biting," "crazy," "smelling," and
"big-head." Cockroaches are given a surname (e.g., Johnny
Possel, Jack Spaniard), or humorous references (e.g., a
"knocker," "mahogany bird," "cockle"). Names for bats
connote superstitious beliefs, such as "duppy bat." Bats
are sometimes called "moths," and moths are sometimes called
"bats." Termites are usually referred to as a type of ant
(e.g., "rain," "flying," "wood"), although, upon inquiry,
informants note that they are actually a termite, or an
insect that damages wood. Only 10.8% of the informants
could not identify the termite correctly.
G.A. Forde (1988) has collected and published a number
of interesting folk beliefs about different household pests,
and almost all of these beliefs were mentioned during the
"household pest" section of the questionnaire. Not
surprisingly, the relatively benign, accidental household
pests possess rather ambivalent beliefs; one cricket, for
example, promises to bring money to the house and must not
be killed, although another cricket, "which is not as noisy
as the first," comes to a home to announce that a family
member is going to die (Forde 1988, p.13). Similarly, a
green grasshopper flying into the home is bad luck, and the
animal should be killed immediately, but a brown grasshopper
is good luck and should not be killed (Forde 1988).

294
Sentiments towards the mongoose in Barbados are
bittersweet; people recognize that it is a pest to
householders raising fowl, but the animal is considered
attractive, and very few of the total population interviewed
throughout the year-long study ever attempted to kill a
mongoose. One informant—an old man—sat day by day, at his
front window in the center of Bridgetown, looking across the
street at an old church that was undergoing renovation.
When he was asked the question, "what are some of the things
you watch for each day?", he replied:
I watch the mongoose come runnin' out from under de
building there. They usually two of 'em. They play
and such. I'd love to catch one of 'em...I'd like to
have one, an' keep it as a pet. I'd just like to have
it to admire it...
According to Forde (1988) , legend says that, if a mongoose
runs across the road in front of one, it is a sign of good
luck (the antithesis of a black cat running in front of a
person and bringing bad luck).
A fascinating colloquial name, and one for which none
of the informants could explain to the author its origin,
was the "godhorse." A godhorse is, according to Forde
(1988), a walking stick, although informants referred to the
praying mantis in the pile sort as a godhorse. Yet even
Forde recognizes that the two are often confused (1988).
Forde believes that the name "godhorse" is African in
origin, noting that in South Africa the praying mantis (not

295
the walking stick) is referred to as the "Hottentot god"; he
therefore speculates that "the name godhorse was originally
brought from Africa and given to the mantis, and because
many people confuse the two insects, the name was eventually
transferred to the stick insect" (Forde 1988, p.17).
Not surprisingly, beliefs regarding the centipede are
contemptuous; seeing a centipede crossing one's path
indicates that the individual has an enemy, and the
centipede should therefore be killed immediately (Forde
1988). The centipede is literally the most dangerous animal
on Barbados in regard to a painful bite—there are no
snakes, dangerous spiders or otherwise potentially lethal
animals—yet even the centipede bite is far from fatal.
Nevertheless, belief about the seriousness of a centipede
bite is represented in the aggressive folk belief about the
animal.
After naming each of the specimens, and teaching the
client the actual name of each specimen in the event that
she/he did not already know the name, the client was asked
to choose, from the collection, the pest with which she/he
had the biggest problem in her/his home. The first four
pests—and the only ones for which at least 10% or more of
the informants cited that pest as the "biggest problem"
pest—were the same pests, in almost the same order, as
those from the free listing: Periplaneta cockroach, mouse,
mosguito, and fly (Table 5-4). Interestingly, notoriously

296
harmless "pests" (lizard, gecko, and toad) were included in
the "biggest problem" list. One informant chose the house
dust mite card as her "biggest problem" pest, a choice that
no doubt reflects the fact that she was the parent of an
asthmatic child. Table 5-4 presents the frequencies and
percentages of the selected "biggest problem" pests.
Table 5-4. Frequency and percentage of responses to
the question: "which pest do you have the biggest
problem with?" (N=65).
Pest
Frequency
Percent
Cockroach
spp.)
(Periolaneta
14
21.5
Mouse
13
20.0
Mosquito
8
12.3
Fly
8
12.3
Sand fly
5
7.7
Millipede
5
7.7
Rat
4
6.2
Cockroach,
German
2
3.1
Lizard
2
3.1
Gecko
1
1.5
Ant
1
1.5
House dust
mite
1
1.5
Toad
1
1.5
Total
65
100.0
Reported Temporal Distributions
Clients were asked to select those specimens and cards
that they had ever seen around their home. They were asked
to place the specimen/card under one of five categories,
including the following: 1) usually/always see; 2) see once
a month; 3) see during the rainy season only; 4) rarely
see;and 5) never see. Table 5-5 illustrates the frequency

Table 5-5. Frequency and percent of specimen categorization regarding when informant
the animal around the house (N=65).
Pest
Usually/always
see around the
house
See once
a month
See during
the rainy
season only
Rarely
see
Never
see
Fly
54
(83.1)
5 (7.7)
4 (6.2)
2 (3.1)
0
Lizard
53
(81.5)
4 (6.2)
0
8 (12.3)
0
Ant, small
51
(78.5)
3 (4.6)
4 (6.2)
6 (9.2)
1 (1.5)
Cockroach
(Periolaneta)
49
(75.4)
9 (13.8)
5 (7.7)
2 (3.1)
0
Mosquito
46
(70.8)
2 (3.1)
11 (16.9)
5 (7.7)
1 (1.5)
Gecko
40
(62.5)
11(17.2)
-
9 (14.1)
4 (6.2)
Millipede
39
(60.0)
4 (6.2)
12 (18.5)
7 (10.8)
3 (4.6)
Sand fly
32
(50.8)
3 (4.8)
12 (19.0)
12 (18.5)
4 (6.3)
Mouse
31
(47.7)
6 (9.2)
-
26 (40.0)
2 (3.1)
Moth
29
(44.6)
11(16.9)
1 (1.5)
16 (24.6)
8 (12.3)
Honey bee
28
(43.1)
7 (10.8)
-
28 (43.1)
2 (3.1)
Spider
28
(43.1)
11(17.2)
1 (1.6)
22 (34.4)
2 (3.1)
Whistling frog
25
(38.5)
4 (6.2)
25 (38.5)
8 (12.3)
3 (4.6)
Ant, large
25
(38.5)
7 (10.8)
11 (16.9)
15 (23.1)
7 (10.8)
Mongoose
21
(32.3)
6 (9.2)
0
13 (20.0)
25 (38.5)
Toad
21
(32.3)
3 (4.6)
22 (33.8)
9 (13.8)
10 (15.4)
Giant cockroach
(Blaberus sdd.)
19
(29.2)
7 (10.8)
3 (4.6)
14 (21.5)
22 (33.8)
Cricket
16
(24.6)
10(15.4)
6 (9.2)
21 (32.3)
12 (18.5)
Grasshopper
14
(21.5)
12(18.5)
6 (9.2)
29 (44.6)
4 (6.2)
Rat
13
(20.3)
6 (9.4)
0
25 (39.1)
20 (31.3)
Slug
12
(18.5)
5 (7.7)
32 (49.2)
10 (15.4)
6 (9.2)
Bat
12
(18.5)
3 (4.6)
2 (3.1)
22 (33.8)
26 (40.0)
Ladybug/1adybird
11
(16.9)
13(20.0)
2 (3.1)
32 (49.2)
7 (10.8)
Centipede, small
11
(16.9)
3 (4.7)
6 (9.4)
31 (48.4)
13 (20.3)
German cockroach
10
(15.4)
5 (7.7)
-
14 (21.5)
36 (55.4)
Centipede, large
10
(15.4)
4 (6.2)
9 (13.8)
34 (52.3)
8 (12.3)
sees
297

Table 5-5 — continued.
Pest
Usually/always
see around the
house
See once
a month
See during
the rainy
season only
Rarely
see
Never
see
Stink bug
8
(12.3)
12
(18.5)
0
38
(58.5)
7
(10.8)
Flea
8
(12.3)
5
(7.7)
0
20
(30.8)
32
(49.2)
House dust mitea
7
(10.8)
5
(7.7)
1 (1.5)
5
(7.7)
47
(72.3)
Monkey
7
(10.8)
8
(12.3)
0
20
(30.8)
30
(46.2)
Termite
6
(9.2)
8
(12.3)
46 (70.8)
4
(6.2)
1
(1.5)
Sowbug
6
(9.2)
6
(9.2)
6 (9.2)
21
(32.3)
26
(40.0)
Wasp
4
(6.2)
9
(13.8)
1 (1.5)
22
(33.8)
29
(44.6)
Praying mantis
3
(4.6)
7
(10.8)
3 (4.6)
37
(56.9)
15
(23.1)
Tick
3
(4.6)
7
(10.8)
0
16
(24.6)
39
(60.0)
Mosquito larvae
3
(4.7)
4
(6.2)
15 (23.4)
19
(29.7)
23
(35.9)
Scorpion6
0
0
4 (6.2)
61
(93.8)
aHouse dust mites are microscopic and cannot be seen with the unaided eye.
^here are no species of scorpions inhabiting Barbados.
298

299
with which the specimens were reportedly seen around the
home.
All of the pests in the pile sort had been sighted by
at least one informant; the least-reported pest was the
scorpion, in which four persons stated that they saw the
scorpion "rarely." This is interesting given that no
species of scorpions exist on Barbados, but the fact that it
was the least reported pest suggests a high degree of
reliability of the pile sort tool.
Eight of the total 37 pests free-listed at the start of
the interview, and seven of the thirteen pests selected from
the pile sort as "the biggest problem" pests, were
"usually/always" seen around the home by more than 50% of
the informant population. Cockroaches (Periplaneta spp.)
headed the free-list and the "biggest problem" list and were
reported by more than 75% of the informants as
"usually/always seen" around the home, deeming cockroaches
as possibly the most common household pest in Barbados. A
list of the most common pests based on free listing,
choosing from the pile sort the "biggest problem" pest, and
those "usually/always" reported around the home by 47.7% or
more of the informants (in order to include "mouse"), is as
follows: 1) cockroach (Periplaneta spp.); 2) fly; 3) mouse;
4) mosquito; 5) millipede; 6) lizard; 7) gecko; and 8) ant.
Rats were not commonly seen around the home—70.4% of the
informants rarely or never saw them around their home—but

300
are a pest of great concern, free-listed by 38.5% and a
"biggest problem" pest to 6.2% in the study. Although moths
were only free-listed by four informants, and not chosen as
a "biggest problem" pest, they were usually/always seen
around 44.6% of the informants home, and are of great
allergenic concern. Sand flies and German cockroaches were
not an overall problem, but of great concern to some
informants, and also important allergenically. Termites
were free-listed, but were not considered a "biggest
problem" pest, and are important to 70.8% of the population
only during the rainy season. However, the characteristic
"swarm" flight patterns of termites as described in the
initial section of this chapter suggest that they too may be
of great allergenic importance; therefore, it was considered
prudent to include termites in an investigation of
sociodemographic and structural relationships. It should be
mentioned that geckos are of allergenic concern because of
their habit of leaving numerous fecal pellets stuck to
walls, counters, and ceilings—any place where the animal
has visited. These pellets, over time, become dried and
aerosolized, and are therefore potential aeroallergens.
The result is a list of 13 pests that are both common
and of great concern to the sample population and/or of
concern from an immunological point of view in regard to
their allergenicity and predominance.

301
Interrelationships with Sociodemographic and Structural
Variables
Upon correlating the frequency of sighting the 13 pests
of interest with specific sociodemographic and structural
variables, no statistical differences were found in
responses regarding classification of the informant
(parent/guardian of an asthmatic or non-asthmatic child),
age, sex and educational level of the informant. However, a
number of pest-specific correlations were found.
Rodents
A definite relationship between poor quality homes and
the presence of rodents was evident in the sample
population. Frequent sightings of rats were positively
correlated to living in a wood home (t=2.17; df=33.0, equal
variance, p=0.04), living in a home with a simple rock
foundation (f=4.21; df=4, 59; p=0.005), having less of a
finished ceiling (f=2.92; df=7, 56; p=0.01), and living in
the rural sector (t=1.96; df=62.0, equal variance, p=0.05).
Informants of lower status occupations or currently
unemployed reported seeing rats more frequently than their
higher status job counterparts (f=5.50; df=3, 60; p=0.002).
Frequent sightings of mice were not related to most of
the same variables as rats. Mice infestations were not
limited to the rural environment; there was no difference
between urban and rural residency and frequent sightings of
mice, nor was there a relationship between the construction
of the home and seeing mice. Frequent sightings of mice was

302
inversely related to the degree of wealth; sightings were
most often reported from the poorer informants (f=2.99;
df=3, 61; p=0.04) and persons in occupations of lower status
(f=3.41; df=3, 61; p=0.02).
The relationship between rats and poorer quality homes
probably is due to the openness of these domestic
environments, thus allowing easy access in and out of the
home during the animal's search for food. The relationship
between poverty and poor upkeep of surrounding environs—
thus additional food sources of garbage and water
collection—cannot be discounted. The findings suggest that
there is an inverse relationship between modernization of
the domestic environment and exposure to rodents, which
minimizes the likelihood of developing allergies to these
pests and is certainly favorable in overall health.
Cockroaches
The presence of Periolaneta spp. cockroaches around the
home was not correlated to any of the sociodemographic or
structural variables. This is perhaps because the presence
of this species in the home was so pervasive in the overall
sample. One possible explanation as to why there were no
observable relationships is the overall moisture level;
namely, water is the most important constraining factor in
cockroach survival, and it is likely that the relative
humidity level in the macroenvironment supersedes the
importance of the microenvironment. As a result,

303
Periplaneta spp. infestations are everyone's problem in
Barbados and are not limited to specific house types. The
presence of German cockroaches (Blattella germánica) was
correlated to several of the variables. German cockroaches
were significantly more of a problem in the urban sector
than in the rural sector (t=2.0; df=63.0, equal variance,
p=0.05), especially in the densely populated regions
(f=3.51; df=3, 61; p=0.02). "Wealth," according to
amenities, was not correlated to German cockroach sightings,
but having an occupation of low status or no occupation
(f=2.94; df=3, 61; p=0.04) and not owning one's house spot
(t=2.45; df=61.4, unequal variance, p=0.02) was correlated
to frequent German cockroach sightings. Also, living in a
home with fewer windows (f=2.61; df=3, 61; p=0.06) was
related to high numbers of German cockroaches.
In temperate climes, the German cockroach is typically
found in crowded living conditions, especially in the urban
sector. Its propensity for a similar environment in
Barbados is not surprising. Although German cockroaches are
believed to be more of a commercial than a domestic problem,
it is important to note that in the particularly dense urban
sector, shops and groceries are often nestled within urban
villages; thus, there is little distance for the cargo-
infesting German cockroach to travel when in search of a new
habitat. More sightings in homes with fewer windows may
represent the insect's preference for a microhabitat with

304
minimal ventilation and light. This difference in
distribution between Periplaneta spp. and the German
cockroach is probably due in part to ecological differences
between the two species. Periplaneta spp. are less
dependent on human-made, indoor environs than is Blattella
germánica.
Mosquitoes
"Usually/always" seeing mosquitoes was related to
several of the German cockroach correlations. Mosquitoes
were a greater problem for informants living in the urban
sector (t=3.64; df=35.7, unequal variance, pcO.OOl),
especially in the densely urban regions (f=5.24; df=4, 60;
p=0.001). While structural features of the home were not
correlated to mosquito sightings, not owning one's house
(t=2.80; df=47.7, unequal variance, p=0.007) or the house
spot (t=2.40; df=63.0, equal variance, p=0.02) were
significant factors. These correlations suggest a
relationship between available breeding sites and the
sociodemographic variables. The most densely urban sector
is one in which sewerage disposal is sometimes inefficient;
in downtown Bridgetown it is not uncommon to see waste water
drained outside the front of the house onto the street
gutters. Also, as has been presented, more of the densely
urban proportion of the population live on rented land,
thereby limiting the number of indoor water taps and
necessitating the storage of water in large buckets—a

305
possible breeding site for mosquitoes. Furthermore, urban
poverty is characterized by poor peridomestic upkeep and the
presence of discarded, human-made articles that serve as
potential breeding sites for mosquitoes (e.g., tires,
bottles, tin cans). Another explanation for the greater
frequency in the urban region is the geophysical situation
of the urban sector; the leeward side of the island has a
significantly lower wind velocity than the windward coast
(rural district), where flight of both mosquitoes and sand
flies is disrupted (personal observation).
Although the correlations indicate that seeing
mosquitoes frequently is more of a problem for urbanites in
rented housing, the overall frequency with which informants
included mosquitoes as a common pest, and their
pervasiveness throughout the island, suggests that they may
be a common source of allergy nonetheless.
Sand flies
Frequent sightings of sand flies—or more credibly,
frequent bites from sand flies, because they are difficult
to spot—were related to several sociodemographic and
structural variables. Informants in poorer quality homes
complained more about sand flies than did informants in
better quality homes. Frequent sightings of sand flies was
reported more by informants with lower amenities scores
(f=3.14; df=2, 62; p=0.05) and by those who rented the house
spot (X2=65.0; 2 df, p<0.001). Sightings were also

306
correlated to houses with fewer rooms (f=4.11; df=2, 62;
p=0.02). One explanation for the association of sand flies
and poorer homes is the relative openness of the poorer
homes, with greater access to the indoors, and subsequently
greater access to the human host. The same can be
postulated for the mosquito. While the better-built homes
in Barbados are, overall, largely open to the outdoors by
developed country standards, they may be more efficient than
the poorer homes in terms of effectiveness of household
insecticides (sprayed in a relatively confined environ),
which are relied upon heavily throughout the population.
Others
Frequent sightings of flies were not correlated to any
of the variables, illustrating the pervasiveness of flies
throughout the island. The same was found with moths, ants,
millipedes, and lizards, possibly for the same reason.
Similarly, sightings of termites were not correlated to any
of the variables. The fact that sightings of termites was
not associated with timber homes is not surprising, because
they are likely to be as serious a problem in mixed (wood
and concrete) dwellings as all-wood dwellings.
Frequent sightings of geckos was correlated to having
poorer foundations (f=4.01; df=3, 60; p=0.01) in the home,
but was not related to any of the other variables. It is
difficult to interpret the meaning of these associations, as
geckos are common in all homes; they feed on insects

307
attracted to artificial lights after sunset. Perhaps the
greater openness in the poorer homes allows for greater
numbers of flying insects and subsequently, the attraction
of a greater food supply for geckos.
Nearly three-quarters of the sample population (72.3%)
stated that they never "saw" house dust mites. This means
that over 25% of the informants cited the presence of a pest
in their home that can not be seen with the naked eye, and
one in which there has been virtually no quantification or
qualification in Barbados in general. much less at the
individual household level. More informants in the urban
sector believed they had house dust mites more frequently
than rural residents, at the 0.10 level (t=1.94; df=63.0,
unequal variance, p=0.06). There was no association between
stated house dust mite infestations and having a child with
asthma; in fact, slightly more parents without an asthmatic
child (31.3%) reported having house dust mites than did
parents with an asthmatic child (26.5%).
The pile sort was useful in distinguishing between the
emotional disdain for a pest, versus the belief that a pest
was a real problem in the home. For example, selecting the
Periplaneta cockroach as the biggest pest problem of all the
37 specimens was correlated to seeing the cockroach
frequently around the house (t=3.9; df=50.0, unequal
variance, p<0.001). Similar correlations were found with
the mouse (t=4.68; df=33.4, unequal variance, p<0.001) and

308
the rat (t=14.49; df=59.0, unequal variance, pcO.OOl).
Previous entomological surveys have found that visual aids
(e.g., specimens) are more effective in evaluating knowledge
and attitudes regarding household pests; respondents are
more likely to recognize an actual arthropod than the name
of an arthropod (Thoms 1985).
Classifying the Pests: What's Good and Bad?
Limited data are available that assess the perceptions
and attitudes of residents affected by household pests (Wood
et al. 1981; Byrne et al. 1984; Zungoli & Robinson 1984;
Robinson & Zungoli 1985; Thoms 1985; Thoms & Robinson 1986).
Of these, few have identified the impact of "knowledge" on
levels of household pest infestations. It may be inferred
that, if residents believe an arthropod is dangerous, they
will minimize the degree of contact, when possible. Byrne
et al. note that, when people have limited knowledge of
animals, they tend to be more aware of the ones that can
harm humans and notice them more often than favorable
animals (e.g., butterflies) (1984). Furthermore, certain
sociodemographic variables, such as income, may have more
influence over the level of infestation and thus obscure the
importance of knowledge as an influencing variable.
From the pile sort of 37 different household pests,
informants were asked several questions regarding the
classification of each pest. With the collection displayed
before the informant, she/he arranged the specimens into two

309
different piles, depending on the question. Informants were
asked these questions to determine how they viewed the
various species—as a real threat to humans, or not. The
rationale for assessing informant categorization and
classification of pests on this level was the following:
Does the perception of an animal as potentially harmful to
people and their families enhance awareness of that animal's
presence, and, are efforts at prevention or eradication of
that animal's presence heightened in the event that the
animal is perceived as harmful? The following paragraphs
present the results of the pile sorting.
Which of these are "disgusting"?
Recognizing that the word "disgusting” may connote
different meanings to different people, this question was
elaborated when presented to the informant. Informants were
asked to choose the pests that they did not like to see,
that repulsed them, or gave them a bad feeling. In no case
did there appear to be any hesitation by the informant to
qualify this term.
Table 5-6 illustrates the informants' selection of
disgusting pests. There was no difference in the total
number of pests classified as "disgusting" according to age,
sex, residential region, or wealth. Once again, the
Periplaneta cockroach, mouse, millipede, and fly head the
list. Although informants did not report seeing large
centipedes frequently, the arthropod evoked a sense of

310
repulsion by 60% of the sample, preceded only by the
Periolaneta cockroach, rat, and mouse. The same was true of
the Blaberus cockroach, which ranked seventeenth in
frequency of sightings, but was the sixth most disgusting
specimen (58.5% of the sample), and the slug, which ranked
21 on the frequency list, but was eighth on the "disgusting"
list (49.2%). Conversely, frequently seen pests such as the
gecko, and especially the moth and spider, were not
particularly disgusting animals according to the informants;
although moths were the tenth insect usually seen around the
house, they ranked thirty-second as the most disgusting
pest, and spiders, the twelfth most frequently seen pest,
ranked thirty-fourth as the most disgusting pest.
Which of these are "harmful"?
The two pests that are believed to be largely
responsible for leptospirosis headed the list of pests "most
harmful" to humans and were the rat (83.1%) and mouse (80%)
(see Table 5-7). In fact, leptospirosis was the most
frequently cited illness caused by any of the specimens.
Although leptospirosis actually affects a relatively small
proportion of the entire population (an average of 17.6
cases per year), response to this particular question
illustrates the exceptional success that national
campaigning has had on educating the public. It also
demonstrates that, despite a relatively low frequency of
rats in the home, and a relatively high frequency of mice in

311
the home, informants are acutely aware of exactly what
diseases are spread by rodents. Despite a void of
information regarding leptospirosis in mice, this animal is
classified almost the same as the rat in the Bajan
worldview.
Similar applications of disease were made for two of
the cockroaches; the Blaberus cockroach, a species that was
not particularly common in the home, was classified as
harmful in the same manner as the Periplaneta cockroach
(contamination, biting, eliciting fever and infection,
urinating on personal items, and causing "fright"). Oddly,
it ranked ahead of Periplaneta in degree of harmfulness
(72.3% versus 58.5%). This is surprising given Blaberus'
extreme rarity in comparison with Periplaneta. The German
cockroach was perceived as harmful by a smaller proportion
of the population (20%), but again, was regarded as harmful
in the same manner as the other two cockroaches.
In conclusion, there was not a significant relationship
between perceived degree of harmfulness and density and/or
frequency of pest populations. Rats, mice, Blaberus
cockroaches, and large centipedes, were regarded as
particularly dangerous animals, despite their low frequency
in the home, while flies, mosquitoes, and millipedes were
only believed to be harmful by 52.3%, 44.6%, and 37.0%,
respectively, and yet these pests were more frequently
sighted in the home than the former. Furthermore, the

312
second most-commonly sighted pest, the lizard, was not
reported to be harmful to humans by any of the informants.
This point suggests that the hypothesis proposed by Byrne et
al. (1984) may not be applicable to the Barbadian
population, in general. because residents did fairly well at
distinguishing between commonly-seen pests and harmful
pests.
The intense focus on the Blaberus cockroach, despite
its probable rarity in Barbadian homes, is reflective of
other studies regarding attitudes and fear toward certain
animals. Bennett-Levy and Marteau, in an analysis on the
"perceptual characteristics" of animals that are important
in determining their appraisal by humans (positive or
negative), found that "ugly, slimy, speedy or sudden-moving
animals" are more fear-provoking than animals that do not
share these qualities (1984, p.40). They suggested that
intensity of fear and apparent irrationality was not only
determined by perceived harmfulness of the animal, but also
by perceptual characteristics, to the degree that the animal
was physically different from humans, or the "mammalian
form" (Bennett-Levy & Marteau 1984). Cockroaches tend to
fair poorly when compared to other animals in public
preference studies (Kellert 1980), so it is no surprise that
a very large cockroach elicits such a degree of aversion as
the Blaberus did in the asthma study. A similar explanation
could be argued for responses to the large centipede,

313
because the smaller species are much more common in and
around homes that the large one. In short, larger animals
(e.g., Blaberus cockroaches, large centipedes, rats) appear
to evoke the greatest fear.
Which of these pests would you kill?
Table 5-8 illustrates the frequencies and proportion of
the sample population that would kill one of the pests if
they saw it. Note that all of the pests were listed by at
least 10% of the sample, indicating that even though a pest
is not perceived as harmful, an individual may want to
eliminate the pest anyway. Almost the same pests most
frequently listed as causing harm to humans were the most
frequently listed as those that informants would kill,
including rats, Periplaneta and Blaberus cockroaches, mice,
and the large centipede. Nevertheless, pests perceived as
harmless, including the spider and lizard, would be killed
by more than 25% of the population.
Oddly, the Barbados study indicated that general
dislike for an animal results in a greater likelihood of
wanting to kill it than does the perception of that animal
as harmful. More correlations were found between the degree
of disgust for an animal and wanting to kill it, than the
perception of an animal as harmful and wanting to kill it.
This suggests an irrational fear or overall negative
perception over many common household pests, a phenomenon
that is well-described in the literature (Levenson & Frankie

314
1983; Byrne et al. 1984; Thoms & Robinson 1986; Hahn &
Ascerno 1991). In a more general sense, those pests that
elicit a high degree of disgust are the pests that an
informant is likely to kill on sight; the inverse is true as
well, in that pests that do not elicit a response of disgust
are much less likely to be killed by that person. Table 5-9
illustrates the numerous correlations between disliking an
animal and wanting to kill it.
Which of these are "beneficial”?
Only 15 of the 37 pests were regarded as "beneficial"
by the sample population, and only four animals were
considered beneficial by more than 10% of the population;
the highest percent was only for 26.2% of the population
(gecko). Perceptions were very reflective of what is
scientifically true; perhaps two of the most beneficial
animals in the pile sort were most frequently recognized as
beneficial—the gecko and lizard. The honey bee was highly
appreciated also, despite the perception that it is harmful;
j- this reflects the fact that honey production is a
substantial business in Barbados. Two relatively favorable
pests were selected based on aesthetic merits—the moth and
ladybug. There were several oddities regarding "beneficial"
pests, which are not entomologically sound arguments, but
beliefs that were represented by one respondent each; one
person thought that slugs eat ants, another believed that
large ants could ward off termites, and one woman stated

315
that she raised mosquito larvae to feed to her tropical
fish. Despite their widespread distribution and daily
visibility in Barbados, bats and whistling frogs are under¬
reported both in frequency around the home and were not
mentioned at all as beneficial animals. Also, the wasp in
the collection was the a harmless species that parasitizes
cockroach eggs (Evania appendioaster) and is quite common in
Barbados; however, it was not considered beneficial to any
of the informants.26 Table 5-10 illustrates the
frequencies and proportions of responses.
The total number of pests recognized as "beneficial"
was not correlated to age, sex, or residential region, but
it was correlated to the degree of wealth; wealthier
informants classified more pests as beneficial than did the
poorer informants (r=0.31, p=0.01). In the United States,
researchers have found correlations between favorable
attitudes toward arthropods and educational level (certainly
an index of socioeconomic status in the U.S.) (Byrne et al.
1984; Hahn & Ascerno 1991). This may be explained by the
fact that better educated people are more likely to have
received information regarding the role of certain animals
in the ecosystem. Information supplied to people regarding
the beneficial role of an animal, despite the initial
perception of that animal, changes in a positive direction
once they are aware of it (Thoms 1985; Thoms & Robinson
1986) .

316
Are these pests indoor, outdoor, or accidental?
Periplaneta cockroaches were regarded as indoor (food
and garbage) pests more frequently than any of the other
specimens, by 84.6% of the informants. Nine people (13.8%),
however, believed that they were accidental pests. Flies
were the second most-common indoor pest, at 61.5%, followed
by the mouse and, strangely, the Blaberus cockroach
(actually a peridomestic or even a feral species), at 53.8%.
Despite their omnipresence throughout Barbadian homes,
geckos were classified as "accidental" pests by 98.5% of the
population. None of the informants classified house dust
mites as an indoor pest. In short, regardless of the
frequency with which a pest is found indoors, if it is not
perceived negatively, it appears to fall under the category
of "accidental" (e.g., the gecko).

317
Table 5-6. Responses (frequency distribution and
percentages) to the
question: "Which
of these pests
you consider to be
'disgusting'?"
Pest
Frequency
Percent
Cockroach,
fPeriolaneta sdd.)
49
75.4
Rat
46
70.8
Mouse
44
67.7
Centipede, large
43
66.2
Millipede
39
60.0
"Giant" cockroach,
(Blaberus sdd.)
38
58.5
Fly
37
56.9
Slug
32
49.2
Mosquito
30
46.2
Centipede, small
28
43.1
Sand fly
25
38.5
Bat
24
36.9
German cockroach
24
36.9
Gecko
23
35.4
Ant, small
21
32.3
Cricket
20
30.8
Lizard
20
30.8
Ant, large
20
30.8
Honey bee
18
27.7
Termite
18
27.7
Stink bug
18
27.7
Grasshopper
16
24.6
Praying mantis
16
24.6
Toad
16
24.6
Flea
15
23.1
Mongoose
15
23.1
Scorpion
14
21.5
Wasp
14
21.5
Tick
14
21.5
Mosquito larvae
13
20.0
Sowbug
13
20.0
Moth
13
20.0
House dust mites
13
20.0
Spider
17
26.2
Ladybug
11
16.9
Monkey
9
13.8

Table 5-7. Responses (frequency distribution and
percentages) to the question: "Which of these pests can
cause physical harm to people, and how?" (N=65).
318
Pest
Frequency
Percent
Rat
54
83.1
Leptospirosis
43
66.2
Contaminates food/
utensils/spreads germs
10
15.4
Poisons
1
1.5
Mouse
52
80.0
Leptospirosis
41
63.1
Contaminates food/
utensils/spreads germs
11
16.9
"Giant" Cockroach
(Blaberus sdd.)
47
72.3
Contaminates food/
utensils/spreads germs
11
16.9
Bite
3
4.6
Fever/infection
1
1.5
Urinates on clothing/
sick from smell
1
1.5
Fright
1
1.5
Can't specify
1
1.5
Cockroach (Periolaneta sdd.)
38
58.5
Contaminates food/
utensils/spreads germs
29
44.6
Bite
5
7.7
Fever/infection
1
1.5
Urinates on clothing/
sick from smell
1
1.5
Fright
Can't specify
Centioede. larae
1
1.5
37
56.9
Bite
13
20.0
Causes swelling/welt
8
12.3
Dangerous sting
7
10.8
Fever/infection
4
6.2
Poison
4
6.2
Can't specify
1
1.5
Fly
34
52.3
Contaminates food/
utensils/spreads germs
28
43.1
Dysentery/diarrhea
3
4.6
Fever/infection
2
3.1
Sneezing/wheezing
1
1.5

Table 5-7
continued.
Pest
Frequency
Percent
Mosquito
29
44.6
Dengue/malaria
21
32.3
Causes swelling/welt
2
3.1
Marks on skin from
scratching
2
3.1
Allergic reaction
1
1.5
Contaminates food/
utensils/spreads germs
1
1.5
Bite
1
1.5
Marks on skin from
Fever/infection
1
1.5
Millipede
28
37.0
Poison
14
21.5
Bite
6
9.2
Cause swelling/welt
4
6.2
Contaminates food/
utensils/spreads germs
4
6.2
Fever/infection
3
4.6
Dangerous sting
2
3.1
Exudes cyanide
1
1.5
Kills you by injecting
bad blood into you
1
1.5
Leaves a mark/scar
1
1.5
Can't specify
1
1.5
Honeybee
24
36.9
Dangerous sting
17
26.2
Allergic reaction
4
6.2
Causes swelling/welt
2
3.1
Fever/infection
1
1.5
Centioede. small
16
24.6
Causes swelling/welt
4
6.2
Bite
4
6.2
Fever/infection
4
6.2
Dangerous sting
3
4.6
Poison
1
1.5
German cockroach
13
20.0
Contaminates food/
utensils/spreads germs
7
10.8
Bite
3
4.6
Fever/infection
1
1.5
Urinates on clothing/
get sick from the smell
1
1.5
Can't specify
1
1.5

Table 5-7
continued
Pest
Frequency
Percent
Scorpion
11
16.9
Dangerous sting
4
6.2
Bite
4
6.2
Fever/infection
1
1.5
Poisons
1
1.5
Can't specify
1
1.5
Pravina mantis
10
15.4
Gets in your ear
10
15.4
Ant. larae
8
12.3
Contaminates food/
utensils/spreads germs
3
4.6
Bites
2
3.1
Dangerous sting
1
1.5
Causes swelling/welt
1
1.5
Poison
1
1.5
Bat
7
10.8
Leptospirosis
2
3.1
Rabies
2
3.1
Bite
1
1.5
Poke out your eye
1
1.5
Causes a heart attack
1
1.5
Ant. small
7
10.8
Contaminates food/
utensils/spreads germs
3
4.6
Dangerous sting
1
1.5
Causes swelling/welt
1
1.5
Bite
1
1.5
Fever/infection
1
1.5
Sluq
3
4.6
Can't specify
2
3.1
Allergic reaction
1
1.5
Flea
2
3.1
Dangerous sting
1
1.5
Bite
1
1.5
Wasp
2
3.1
Dangerous sting
2
3.1
Moth
2
3.1
Allergic reaction
1
1.5
Sneezing/wheezing
1
1.5
Monkey
2
3.1
Contaminates food/
utensils/spreads germs
2
3.1
Sand fly
2
3.1
Marks on skin from
scratching
1
1.5
Fever/infection
1
1.5

Table 5-7 — continued.
Pest
Frequency
Percent
Mosouito larvae
Contaminates food/
1
1.5
utensils/spreads germs
1
1.5
Termite
1
1.5
Smells
1
1.5
Gecko
1
1.5
Poisons
1
1.5
House dust mites
1
1.5
Asthma
1
1.5
Tick
Contaminates food/
1
1.5
utensils/spreads germs
1
1.5
Toad
Hits with a bone in
its back that is
1
1.5
poisonous
1
1.5
Note: The following pests were not listed as causing
illness: Ladybug, spider, stink bug, lizard, grasshopper
whistling frog, sowbug, mongoose, and cricket.

322
Table 5-8. Responses (frequency distribution and
percentages) to the question: "Which of these pests would
you kill if you saw it?" (N=65).
Pest
Frequency
Percent
Centipede, large
56
86.2
Periolaneta cockroach
55
84.6
Mouse
51
78.5
Millipede
42
64.6
Rat
40
61.5
Blaberus cockroach
38
58.5
Centipede, small
38
58.5
Fly
33
50.8
Slug
33
50.8
Mosquito
32
49.2
German cockroach
31
47.7
Honey bee
27
41.5
Scorpion
26
40.0
Fleas
22
33.8
Termite
21
32.3
Ant, large
21
32.3
Whistling frog
21
32.3
Ant, small
21
32.3
Cricket
20
30.8
Wasp
19
29.2
Tick
19
29.2
Sand fly
18
27.7
Praying mantis
18
27.7
Gecko
18
27.7
Stink bug
17
26.2
Lizard
17
26.2
Spider
17
26.2
Mosquito larvae
16
24.6
Bat
16
24.6
Grasshopper
15
23.1
Sowbug
15
23.1
House dust mites
15
23.1
Mongoose
13
20.0
Toad
13
20.0
Moth
12
18.5
Lady bug
10
15.4
Monkey
7
10.8

Table 5-9. Correlations between pests that were classified as "disgusting" and those that
the informant "would kill" (Chi-square). A p-value of 0.10 or less was accepted (N=65).
Pest
X2 value
degrees of
freedom
p-value
Blaberus cockroach
15.81
1
<0.001
Whistling frog
10.32
2
0.006
Lizard
8.51
1
0.004
Gecko
7.21
1
0.007
Mosquito
6.78
1
0.009
Millipede
6.46
1
0.01
Bat
5.96
1
0.02
Spider
5.21
1
0.02
Grasshopper
5.11
1
0.02
Fly
4.46
1
0.04
Moth
4.32
1
0.04
Honey bee
3.93
1
0.05
Slug
3.47
1
0.06
Termite
3.56
1
0.06
Centipede, small
3.41
1
0.07
German cockroach
3.34
1
0.07
Cricket
2.75
1
0.10
Praying mantis
2.73
1
0.10
323

324
Table 5-10. Responses (frequency distribution and
percentages) to the question: "Which of these pests are
beneficial, or good to have around?", and "Why?"
Pest
Frequency
Percent
Gecko
17
26.2
Eats other insects
12
18.5
Eats flies
6
9.2
Honey bee
14
21.5
Spreads pollen
8
12.3
Makes honey
6
9.2
Lizard
13
20.0
Eats other insects
9
13.8
Eats flies
6
9.2
Moth
8
12.3
Is attractive/pretty
4
6.2
Pollinates
4
6.2
Toad
4
6.2
Eats flies
3
4.6
Catches other insects
2
3.1
Lady bua
3
4.6
Good for the soil
1
1.5
Eats aphids
1
1.5
Pleasant, & pollinates
1
1.5
Spider
2
3.1
Eats other insects
2
3.1
Millipede
1
1.5
Eats centipedes
1
1.5
Centipede, larae
Eats root borers &
1
1.5
cockroaches
1
1.5
Slucr
1
1.5
Eats ants
1
1.5
Ant. larae
1
1.5
Keeps termites away
1
1.5
Ant. small
1
1.5
Fertilizes the ground
1
1.5
Cricket
1
1.5
Brings money/good luck
1
1.5
Monkey
1
1.5
Can be a pet
1
1.5
Mosauito larvae
1
1.5
Can use as fish food
1
1.5
Note that the German cockroach, bat, wasp, mouse, mosquito,
tick, praying mantis, rat, scorpion, fleas, stink bug,
Periplaneta cockroach, Blaberus cockroach, small centipede,
termite, fly, grasshopper, whistling frog, sowbug, house
dust mites, mongoose, and sand fly were not regarded as
beneficial.

325
Behavior Directed at Controlling Household Pests
In addition to understanding how people classify a
certain pest (e.g., harmful, accidental), it is important to
assess their behavior directed toward that pest, both
purposeful (control) and inadvertent (behavior that enhances
or dissuades infestations). Such an understanding will
assist in designing prevention and control strategies (e.g.,
minimizing house dust mites in the home), and will serve to
target households most at risk for exposure.
National Control
There is heavy reliance on chemicals for control of
household pests in Barbados, at all levels—governmental,
commercial, and private. A nationalized vector-control
program is in effect in Barbados for the control of the
aedine mosquitoes, and, in the past, to control for the
anopheline species (PAHO 1990). These consist largely—
although not exclusively—on ultra-low volume spraying. But
as one informant noted:
There's a real campaign here, especially in the
summertime, to contain the water around your house, and
not to leave containers that can serve as breeding
sites...Most people really try to comply, but in the
poor sections of Bridgetown—well, you just can't
imagine. People just dump their sewage water right out
the front door, sewage draining in the streets, garbage
all around the house—it's horrible. Sometimes in the
summer you see the trucks with the foggers—I don't
know how effective they really are.

326
Similarly to the building contractors in the private
sector, the National Housing Corporation has established a
building code that includes chemical treatment against
infestation of subterranean termites, of which the providing
pest control company must give a warranty for at least 10
years (Babb, personal communication). However, no other
pest control service is routinely provided to NHC tenants.
Barbados is fortunate among other Caribbean islands in
having a rodent control unit trained by consultants and
personnel of the Pan American Health Organization, which is
based on the island. Rodent control is managed almost
exclusively by the Rodent Control Unit, a division of the
Ministry of Health. The unit is comprised of 12 inspection
officers, who administer daily inspections in their
designated area. An emphasis is placed on public education
by the dispersal of literature and verbal explanations in
the home via the officers. The primary means of control is
poison bait (Active ingredient: 0.0375% coumatetralyl, 226
grams) (Browne, personal communication). In 1990, officers
delivered a total of 18,330 packages of bait, mostly in
metropolitan Bridgetown, and 24,481 packages were picked up
at the Unit by private individuals (Charlie Browne, Rodent
Control Unit, personal communication). Persons from the
private sector are invited to collect, free of charge, up to
two packages at the Unit.

327
Commercial Control
There are approximately 6 professional pest control
companies operating in Barbados (White,27 personal
communication). According to the general manager of
Rentokil (Barbados) Limited, contracting business in
Barbados is 60% domestic and 40% commercial (Haslett,
personal communication). He notes that, although contract
business has traditionally been requested by members of the
"middle class," people of the lower socioeconomic strata are
increasingly requesting commercial services. Haslett
remarked on the following:
Professional pest control is perceived as a status
symbol. In England, customers preferred unmarked cars
with PCO's [Pest Control Officers] coming to visit them
at their home, because professional pest control is
embarrassing. In Barbados, marked cars are preferred!
They're status symbols!
Professional pest control is comparable to U.S. prices,
but, nevertheless, expensive to members of the lower
socioeconomic strata. Haslett reports that a contract
including initial treatment, plus seven additional
treatments throughout the year, would cost an average of
$480.00; treatment typically is for cockroaches and/or
rodents and excludes flies and mosquitoes (personal
communication). Termite treatment is referred to as "job
work," or a one-time treatment, totalling 20% of Rentokil's
revenue, and 75% of total business (Haslett, Rentokil
(Barbados) Limited, personal communication).

328
Haslett noted that the most common complaints are
related to cockroach sightings at night, mostly Periplaneta
species, in addition to complaints about the German
cockroach in both the commercial sector and increasingly in
the private sector, and complaints are based on an awareness
of health threats due to cockroaches, such as Salmonella
(personal communication).
Only twenty-four (36.9%) of the study population had
ever used professional pest control, and seven (10.9%)
stated that they were currently using professional pest
control monthly. Most, however, had only received the
services one time (62%), and this probably indicates the
initial termite treatment on a foundation.
Control in the Private Sector
Perhaps the heaviest use of chemical control for pests
in Barbados rests in the hands of the layperson. J.C. Hudson
(Carib Agro-Industries Ltd.) laments the increasingly heavy
reliance of pesticides and herbicides in the agricultural
sector, reporting that as much as 800,000 kilograms of
pesticides are imported into Barbados each year (personal
communication). He also notes that overuse is not limited
to the large plantations, but occurs in backyard gardens as
well.
Specifically, over-the-counter insecticides make up a
large proportion of insecticide use. There are a number of
available brands, varying to some degree in chemical

329
composition and cost. Companies "sell” their product to
West Indians in general by a marketing strategy that
emphasizes use for both flying and crawling insects (White,
Bayer Caribbean Ltd., personal communication), although,
according to Haslett of Rentokil (Barbados) Limited, spray
insecticides are purchased mainly for the control of
mosquitoes (personal communication). It is difficult to
estimate how much is spent in the private sector on over-
the-counter insecticides; M. White of Bayer Caribbean Ltd.,
the maker of "Baygon," the most widely-sold insecticide in
the Caribbean, states that each year approximately U.S. $13
million worth of Baygon is sold throughout the Caribbean
(personal communication). For Barbados alone, in 1988,
wholesale Rentokil insecticide products totaled $1.2 million
(Haslett, personal communication). The average cost for a
400 ml can of insecticide ranges from $4.46-$10.14,
depending on the brand (personal observation).
The actual number of different pests for which
residents said they routinely used an insecticide was
relatively small (N=ll). However, they include pests for
which the sample reported with the greatest frequency,
including the Periplaneta cockroach, mosquitoes, flies, and
small ants, indicating frequent use of insecticides. When
informants were asked how often they bought a can of
insecticide, the most frequent answer was "weekly" (40.0%),
followed by every two weeks (24.6%). Only 35.4% stated that

330
they bought a can less than every two weeks. There was no
difference in frequency of purchase insecticides according
to wealth, the type of home (wood or concrete), or region of
residence (urban or rural). Table 5-11 indicates the pests
for which insecticides are used and the number of informants
who used them.
Table 5-11. Pests for which over-the-counter insecticides
are used, by frequency (percent) of
population (N=65).
the informant
Mosquito
49
(75.4)
Periolaneta cockroach
47
(72.3)
Fly
42
(64.6)
Blaberus cockroach
18
(27.8)
Ant, small
16
(24.6)
German cockroach
10
(15.4)
Stink bug
10
(15.4)
Centipede, small
9
(13.8)
Ant, large
9
(13.8)
Sand fly
8
(8.1)
Millipede
8
(8.1)
Based on ethnographic observations and informant
interviews, it can be concluded that the "closing up" of the
house (e.g., shutting windows and doors) at the end of the
day, or in the morning, after all of the family members have
left the home, and spraying an insecticide from room to
room, is as common a routine as taking the garbage out to
the dump. Informants in all types of homes reported this
activity. Ironically, participants in the asthma study were
averse to ULV mosquito spraying by the government, "because
it smells so bad," that they report shutting "all the
windows and doors when we hear the trucks cornin' 'round."

331
Other chemical controls are used that are not aerosols,
primarily poison baits for rats and mice (20.0% and 18.5%,
respectively), and Sevin powder for millipedes (4.6%),
Periplaneta cockroaches (6.2%), large ants (6.2%), small
ants (4.6%), and slugs (1.5%). "Slug-It" is another
chemical solution used against slugs (3.1%).
Non-chemical, commercial products are used, but
primarily against the rodents; sticky traps are used for
mice (20.0%) and Periplaneta cockroaches (1.5%), snap traps
are used for mice (15.4%) and rats (6.2%), and live traps
were reportedly used by one informant (1.5%).
Household products are used on occasion for pest
control. Hot water was used to kill millipedes (1.5%), and
salt was used to kill slugs (7.7%). Two informants (3.1%)
poured kerosene on standing water to kill mosquito larvae.
A "shoe" was reportedly used against a mouse, a millipede,
cockroaches, and ants. The Sunday Sun newspaper asked
people, "How do you feel about cockroaches, and how do you
kill them?" (Alleyne 1991). Typical responses included
striking the insect with a shoe or a broom; one informant
elaborated, '"til their insides ooze out" (Alleyne 1991,
p.6A).
Preventive measures for control of household pests were
rarely mentioned in the interviews. One informant stated
that the family cat was relied upon for controlling mice.
Only 1 informant mentioned "keeping things clean" as a form

332
of prevention of cockroaches; in fact, this was the only
case in 65 in which cleanliness was referred to prior to
direct questions about cleanliness. Although 18 informants
had indicated that they had house dust mites in their home,
dusting or cleaning was never mentioned for their control.
When asked directly, informants did admit to storing
foodstuff in containers so as to minimize contact with
pests. Only 18 informants (27.7%) did not describe a
special means for storing their food. Fifty-five percent
stored their food in plastic and/or metal containers. Other
storage means included the refrigerator, a barrel, or
suspending foods from the ceiling.
Structural barriers that were part of the house were
never mentioned as means of control. Ethnographic studies
and interviews indicate that Bajans are averse to the use of
screens in windows, because "they collect dust," or "ya
can't stick your head out the window." No association was
ever made between keeping fowl pens under or immediately
next to house and the frequency of pests such as flies and
rats. One of the informants from the entomological survey,
living in what was the best quality home in the study, kept
fowl pens immediately behind the kitchen, and the greatest
number of rats were trapped at that home. However, the
householders made no effort whatsoever to eradicate or
prevent the rodents.

333
The Effect of National Campaigns
Directed at Community Control
Despite the history of two separate campaigns against
two serious pests—the rat and the mosquito—knowledge and
behavior related to these two pests is markedly different.
Dengue is familiar to most Bajans, but knowledge and
appropriate preventative behavior is not. Only two
informants had never heard of dengue (3%), although just
over 75% were able to correctly identify the pest
responsible for dengue; three (5%) informants believed that
flies or rodents were involved, and 20% did not know. Most
people said that they knew about dengue from the radio
(23.1%), television (10.8%), or the multi-media in general
(15.4%) .
Informants were presented with 11 cards that described
actions promoted by health authorities for the control of
Aedes mosquitoes and therefore dengue. Informants were
asked to choose which cards they believed were important for
reducing mosquitoes. The maximum proportion of informants
who chose any one of the cards was 35.4%, and that was for
"placing covers over water containers." Few people believed
that emptying catchments, cutting down overgrown vegetation,
or disposing bottles, cans, or discarded tires, was
important.
Conversely, there is much awareness over the prevention
and danger of rats and the disease leptospirosis. All of
the informants had heard of leptospirosis, and 93.8% (N=61)

334
of the informants knew that rats were the main carrier of
leptospirosis. Other carriers cited were mice, mosquitoes,
frogs, dogs, cats, bats, monkeys, and cockroaches. A number
of different answers were given when asked where the
informant learned about leptospirosis. Thirty-five percent
first heard about leptospirosis from the media, and nearly
17% said they learned about the disease in school. Six of
the informants (9.2%) had an acquaintance with the disease.
A number of different responses were given when asked
how to control leptospirosis, all of which were applicable
to the disease. Most answers dealt with preventing the
presence of rodents (84.6%), and the remaining answers dealt
with proper sanitation and proper hand-washing.
Summary
Data indicate that the house dust mite, particularly D.
pteronvssinus. is a serious household pest in Barbados. The
intense allergenicity of house dust mites has been presented
throughout this thesis, and the implications are that most
Barbadian asthmatics probably are subjected to house dust
mite allergens. The data also confirm the contention that
the modernization process of the domestic environment is
resulting in a preferred habitat by the most common house
dust mite, and data from previous chapters indicate that
this process is a trend and is not likely to be reversed.
Specifically, the most important house dust mite species was
found in greater quantities in concrete homes and homes in

335
which moisture-producing features and decreased ventilatory
features were incorporated.
Other pests are common in Barbadian homes, although
associations between the infestation of these pests and
architectural features are less defined. What may be more
significant in regards to asthmatics, but was not addressed
in this study, is how the structure of the home affects the
accumulation and distribution of the allergens of those
pests, because their presence is rarely restricted to
certain house types and is equally common in different
homes.
Other than the use of over-the-counter insecticides on
mosquitoes, flies and cockroaches—the most common pests in
terms of real numbers—there is little in regard to control
of household pests. Certain types of human behavioral and
emotional response to infestations are dependent on income.
Behavioral responses are limited to economically feasible
means, which limits chemical control to over-the-counter
products, and precludes the hiring of professional pest
control services.
Another explanation for complacency is tolerance toward
the more common pests. Economic constraints and limited
resources for control may promote a feeling of hopelessness,
or resignation to living with the infestation. Several
studies have shown that the greater the infestation, the
higher the degree of tolerance,and the more skeptical

336
residents become about the ability to control the pest (Wood
et al. 1981; Zungoli & Robinson 1984).
The impact of level of knowledge on rates of allergenic
response also can be inferred; while knowledge in and of
itself with have no effect on the incidence of allergy
(biological reaction), behaviors associated with that
knowledge might (e.g., avoidance, minimizing infestations).
A person who is aware that she/he is susceptible to
cockroach or house dust mite allergens will probably take
greater care to avoid them than the person who is not aware
of personal hypersensitivity.
Unfortunately, for the sample of Barbadians, knowledge
of pests as potentially harmful did not appear to have much
effect on their behavior, with the one exception of the rat,
and to a lesser degree, the mosquito and cockroach. Even
informants who reported having house dust mites in their
homes did not acknowledge frequent dusting as a method of
control, or for that matter, any form of control against the
house dust mite. Regarding knowledge, it is apparent that
Barbadians do not recognize household pests as a threat to
the asthmatic; an allergic reaction was only cited a few
times and most commonly as an anaphylactic reaction as a
result of a sting.
In conclusión, while modernization of the domestic
environment was not associated with all of the common
household pests in Barbados, it is associated with the most

337
serious allergen-producing household pest, the house dust
mite. A number of pests are common to all householders; at
the least, this implies that modernization of the home does
not reduce infestations of pests, with the one exception of
rodents (found more frequently in poorer homes). The role
of modernization and accumulation of allergens other than
the house dust mite is not known and deserves further
attention. At this point, it is appropriate to analyze the
actual incidence of allergy to household pests and confirm
the relationship between modernization and infestations of
certain pests.
Notes
1. The most recent outbreak of malaria in Barbados
reportedly devastated the inhabitants of the Graeme Hall
swamp area, Christ Church, in the 1920*s (probably A.
aguasalis) (Nathan, PAHO, personal communication). Prior to
the infrastructural changes on the island in the present
century, malaria was a significant health problem to
Barbadians (Nathan, PAHO, personal communication).
2. M. Brown, M.D., General Practitioner, Brigade House
Medical Centre, Hastings, St. Michael, Barbados.
3. An established protocol is in place for Barbadian
physicians in the event that a suspicious case of dengue is
presented. A standard form is available from the Ministry
of Health, which includes a list of 44 "notifiable
diseases," of which dengue is one of them.
4. M. Nathan, Entomologist, Pan American Health
Organization, Bridgetown, Barbados, W.I.
5. R. Haslett, General Manager, Rentokil (Barbados) Ltd.,
Culloden Road, St. Michael, Barbados, W.I.
6. J. Williams, Rodent Control Advisor, Pan American Health
Organization, St. Michael, Barbados, W.I.

338
7.Leptospirosis is manifested by signs and symptoms
related to liver, kidney, meninges and lung infection,
including fever and chills, headache and muscular pain, and
sometimes subcutaneous hemorrhage. In about 50% of the
cases, jaundice develops, although in a 39-month clinical
study in Barbados, 95% of the patients presented with
jaundice (Edwards et al. 1990). The disease is sometimes
commonly referred to as "black jaundice" (Everard et al.
1984, p.600).
8. The following serogroups and serovars have been
identified in Barbados: serogroup Autumnalis. with eight
serovars in this group; Serogroup Icterohaemorrhagiae. with
two serovars; Serogroup Canicola, with one serovar
(canjeóla); Panama; Pvroaenes; Bataviae: and Ballum (Everard
et al. 1984; Edwards et al. 1990; Gale et al. 1990).
9. Of great concern, leptospirosis in Barbados is not
limited to the rodent vector, as pathogens have been
isolated in the whistling frog, Eleutherodactvlus iohnstonei
(Australis baian and Autumnalis bim) (Everard et al. 1990a),
the toad Bufo marinus (serovars bim and baian) (Everard et
al. 1988), stray dogs (Everard et al. 1987), and the African
green monkey (Cercopithecus aethiops sabaeus) (serogroups
Ballum. Icterohaemorrhaqiae. Autumnalis. Pvroaenes. Panama.
Pomona. Tarassovi and Canicola) (Baulu et al. 1987). The
monkeys, however, reportedly transmit the disease amongst
themselves and pose no threat to humans (Baulu et al. 1987).
10. C. Browne, Rodent Control Unit, Ministry of Health,
Jemmott Lane, St. Michael, Barbados.
11. There is some debate as to whether any of the two
species of snakes traditionally found in Barbados continue
to thrive or not. Leptotvphlops bilineata. the "blind
snake," was first identified in Barbados in 1963, near
Codrington College (St. John). It is an insect larvae and
termite feeder, and lives in leaf litter. Leimadophis
perfuscus feeds on frogs and lizards, and lives mainly in
the high rainfall regions. It is believed to be unique to
Barbados, and was thought to be extinct until recently.
Neither species is poisonous (Everard, personal
communication; Fraser et al. 1990).
12. Happy Jack Flea Trap, by Happy Jack Inc. 1988. Snow
Hill, NC.
13.Fly strips, Olson Products Inc., Medina, Ohio 44258.

14. Trap 'n Kill Roach Killer. Flick Laboratories
(Barbados) Ltd. Carmichael, St. George, Barbados, 1991.
15. Tomahawk Live Trap Co., Tomahawk, Wisconsin, USA
16. Mr. Coffee, Inc., Bedford Heights, OH, 44146.
17. Quantification of both assays is dependent on the use
of mite extracts with known Per p I or Per f I
concentrations. IL. pteronvssinus extracts can be sub¬
standardized against the WHO/IUIS EL. pteronvssinus reference
(NIBSC 82/518), which contains 12.5 um/ml Per p I. Although
no International Reference P^_ farinae extract is currently
available, an in house standard was prepared (UVA 86/01)
that contains 16.0 um/ml Per f I.
18. Entomologists include the following: Pr. J.B. Heppner,
Pr. J. Kingsolver, Pr. F.W. Mead, and Pr. W. Wirth.
19. It is not possible to comment on differences in numbers
of cockroaches by season, because six of the twenty homes
refused to participate in the rainy season.
20. Piptera identification was graciously provided by Pr.
W.W. Wirth, Pivision of Plant Industry, Gainesville, FL.
21. Isoptera were kindly identified by Pr. Rudi Scheffrahn,
Entomologist, Fort Lauderdale Research and Education Center,
Institute of Food and Agricultural Sciences, University of
Florida, Fort Lauderdale, FL. Pr. Scheffrahn provided
ecological information on the species as well.
22. Pillbugs were graciously identified by Mr. P. Prummond,
Entomologist, Santa Fe Community College, Gainesville, FL.
23. Abbott et al. (1982) found that spring mattresses
provided better harborages for house dust mites than did
foam mattresses, because of the numerous buttons, stitched
seams, and bound edges that predominated on the former.
24. The house dust mite's primary source of food is human
skin scales. One person produces an estimated 0.5-1.0 gram
of dander per day (Korsgaard & Iversen 1991). It has been
shown that the amount of dander is not critical to the
growth and proliferation of mites, as there is no increase
in density when mites are exposed to larger quantities of
scales; for example, Korsgaard & Iversen (1991) found that
there was no increase in populations in the habitat of a
person with psoriasis. Therefore, quantity of food appears
to be less of a constraint than humidity and temperature.
Relative humidity provides an added nutritional element to
mites by enhancing the growth of fungi, that attacks shedded

340
skin scales, and aids in the digestion of the scales by the
mites by either pre-digesting the scales or assisting
digestion of scales inside the mite's gastrointestinal
system (de Saint Georges-Gridelet 1987; Hallas 1991).
25. As de Boer (1990, p.131) notes, "at higher
temperatures, a higher [relative humidity] is required by
the mites, ... [and] raising the temperature results in a
drop in [relative humidity]." He tested the effect of
elevated temperatures on mattress-dwelling mites by covering
the mattress with an electric blanket for a prolonged period
of time; the majority of the mites were driven downward into
the mattress, away from their food sources, and eventually
disappeared (de Boer 1990). The implication of these
findings on the Barbados setting is the following; Higher
temperatures and relative humidity in Barbados during the
rainy season could result in elevated nocturnal body
temperature that result in a higher mattress temperature
and/or a lower relative humidity level than is desirable by
D. pteronvssinus. thereby causing a lower density than may
be typically seen in other settings.
26. Colloff (1988a) concluded that D_;_ pteronvssinus and
Tarsonemus spp. migrated away from the center of the bed
because of the dry heat generated by the individual, and
that many moved to the pillow region of the bed, near the
head of the individual. This of course has serious
implications for the asthmatic, as greater quantities of the
allergen are closer to the individual's face and the
allergen is readily inhaled (Colloff 1988a).
27. This is not a surprising finding, given that most wasps
are venomous, even though the evaniid is not. In a
household study among apartment dwellers in Virginia, Thoms
& Robinson (1986) found that the informants' initial
reaction to the idea of introducing the wasp into their home
was negative; however, once the informants were educated
about the wasp's beneficial role (parasitizes cockroach
eggs) and the fact that the wasp was incapable of stinging,
their attitude improved. Nevertheless, the evaniid is a
hovering-type wasp, frequently seen in Barbadian homes
(personal observation), and it was suspected by the author
that the combination of frequent encounters in the absence
of stings might subdue the negative attitude about the
evaniid wasp; this did not prove to be true.
28. M. White, Bayer Caribbean Ltd., Lowland, Christ Church,
Barbados. W.I.

CHAPTER 6
THE CLINICAL SETTING: THE EPIDEMIOLOGY OF ALLERGY
TO HOUSEHOLD PESTS AMONG BARBADIAN CHILDREN.
Biomedical Testing
The purpose of the skin test was to determine the
incidence of hypersensitivity among asthmatic children to
household pests. Subsequently, these results were examined
to assess the relationship between hypersensitivity and
independent variables associated with modernization of the
domestic environment.
Biomedical Materials
Subjects
One hundred and sixty-eight asthmatic children between
the ages of five and eighteen years were systematically
selected from five different polyclinics and one outstation,
the Accident and Emergency Department at Queen Elizabeth
Hospital, and an urban, private clinic, between the months
of June and December, 1991 (see Chapter Two for details on
selection of the sample population). Selection of
asthmatics was based on a positive history for asthma and
physical examination, and criteria included previous
attacks, diagnoses and treatment for asthma. Before the
biomedical testing commenced at a selected polyclinic, the
parent/guardian accompanying the child read and signed a
341

342
written informed consent. The parent confirmed that the
child had not received antihistamines, ephedrine, or asthma
medications 24 hours prior to the testing. In the event
that medications had to be administered, the appointment was
rescheduled.
The mean age of the population was 9.7 years, and there
were 78 girls (46.4%) and 90 boys (53.6%). There was no
statistical difference between age in the two groups. The
sample was almost equally divided according demographic
region (55.4% were urban and 44.6% rural).
Extracts
Extracts used for the skin test were standard,
commercially-prepared extracts purchased from Hollister
Stier (Hollister Stier Inc., Spokane, WA1) . Eleven aqueous
glycerinated solutions were used; extracts selected included
all household pest extracts available which were known to
occur in Barbadian homes based on previous taxonomies and
the entomological work described in Phase I. Antigens were
supplied in 1/10 weight/volume (w/v) dilutions. A
glycerinated diluent was used as control. The following
extracts were used;

343
- Control, negative
- Ant, red, red-black
- Cockroach, fBlattella germanica/Periplaneta
americana/Blatta orientalis)
- Cricket (Acheta spp./Grvllus spp.)
- House fly (Musca domestica)
- House dust mite (D^. farinae)
- House dust mite (D^ pteronvssinus)
- Mosquito (Aedes aeqypti/Culex pipiens)
- Miller moth (Heterocera spp.)
- Mouse (Mus musculus)
- Rat (Rattus spp.)
- Shellfish
(clam/crabmix/lobster/oyster/shrimp/scallops)
Biomedical Methods
The scratch test (epicutaneous) was applied to the
volar surface of the forearm after cleansing the skin with
isopropyl alcohol. One drop of each extract was placed on a
selected site, after which the skin was slightly abraded
with a standard scarifier. Each test was evaluated 15
minutes after application, using the scale recommended by
Krouse and Klaustermeyer (1980) (Figure 6-1).
Interpretations of the test were dichotomous (negative or
positive). If the test for a particular extract was
"negative," the allergen was administered again using the
intradermal test (intracutaneous), applied to the lateral
aspect of the upper arm (also cleansed with isopropyl
alcohol). A 26-gauge disposable needle and 1-cc syringe was
used to inject 0.02 ml of extract solution into the
superficial layers of the skin to produce an initial wheal
of 5mm in diameter. A negative control was also injected.

344
The test was evaluated 15 minutes after application, again
using the Krouse and Klaustermeyer scale.
Figure 6-1. Graded Skin Test Response (Krouse &
Klaustermeyer 1980).
Negative: 0 = control
1+ = erythema > control
2+ = wheal 0-4 mm > control
Positive: 3+ = wheal 5-10 mm > control
4+ = wheal 10 > control or
5-10 mm with pseudopod formation
Interviews
The questionnaire administered in the clinic included
sociodemographic information on the child's residence and
structural information about the dwelling, symptomatology
and preferred modes of therapy, and the informant's
perceptions and knowledge about asthma and etiological
factors in the child's disease. The questionnaire was both
written and oral; after the informant completed the form
independently, the questionnaire was reviewed orally and
discussed.
Skin Test Results
Individual Extracts
House dust mites
More children reacted positively to the house dust mite
allergens than to any of the other extracts; 130 children
(77.4%) tested positive to D¿_ pteronvssinus. and 125 (74.4%)
tested positive to farinae. More than 82% of the

345
children were allergic to at least one of the house dust
mite extracts (N=138). Similarly, a positive reaction to
house dust mite was correlated to more structural and
sociodemographic variables than any of the other extracts
tested. Allergy to both extracts was related to gender;
more asthmatic boys demonstrated hypersensitivity to house
dust mites than did asthmatic girls (D^. pteronyssinus.
Xz=3.924; 1 df, p=0.05; D^. farinae. Xz=6.221; 1 df, p=0.01;
at least one species, X2=6.014; 1 df, p=0.01).
Allergy to D^. pteronyssinus was correlated positively
to moisture-related factors in the home, including the
presence of concrete in the structure of the house
(X2=4.365; 1 df, p=0.04), an indoor shower (X2=4.366; 1 df,
p=0.04), and symptoms usually occurring during the rainy
season (X2=15.561; 1 df, p=0.007). Children who were
allergic to EK. pteronyssinus complained that house dust
elicited asthmatic symptoms (X2=8.23; 1 df, p=0.004).
Allergy was also weakly correlated to having a finished
ceiling (t=1.7; df=166.0, equal variance; p=0.09), a factor
suggesting reduced ventilation.
Allergy to D^. farinae was correlated positively to
concrete walls at the 0.10 level (X2=2.935; 1 df, p=0.09),
to symptoms occurring most frequently during the rainy
season (X2=8.856; 1 df, p=0.01), and to symptoms worsening
when exposed to house dust (X2=6.25; 1 df, p=0.01).
However, reactivity to the two species differed for several

346
of the independent variables. Allergy to D^. farinae—but
not to D_i_ pteronvssinus—was related to having carpet in the
home (t=1.83; df=166.0, unequal variance; p=0.07), while
allergy to D^_ pteronvssinus—not D^_ farinae—was related to
living in newer homes (t=2.37; df=155.0, unequal variance;
p=0.08), homes with finished ceilings, fewer windows, and
indoor showers. Table 6-1 illustrates the various
relationships between house dust mites in general (reactive
to at least one species) , EK. pteronvssinus. and farinae.
The likelihood of demonstrating hypersensitivity to at least
one of the species was slightly related to wealth (t=1.66;
df=166.0, equal variance; p=0.10), although wealth was not a
factor for the two species independently.
Crawling insects
Crawling insects included the order Hymenoptera (ants)
and Orthoptera (cockroaches and crickets). Of the 157
children tested for allergies to "ants" (Family:
Formicidae), 52.2% exhibited positive reactions to the
extract. A positive reaction to the ant extract was
correlated to only one of the structural and
sociodemographic variables—gender of the child; more boys
than girls were allergic to ants (X2=5.17; 1 df, p=0.02).
Also, more children whose symptoms worsened when exposed to
house dust were allergic to ants (X2=5.10; 1 df, p=0.02).
Sixty children (36.8%) tested positive to cockroach
extract. The only variable correlated to cockroach allergy

347
was the age of the child; older children were more likely to
test positive (t=1.84; df=161.0, equal variance; p=0.07).
Fifty children (30.5%) were allergic to the cricket
extract. Similarly to the cockroach, cricket allergy was
positively correlated to the age of the child; the older the
child, the greater the likelihood of cricket allergy,
(t=1.71; df=162.0, equal variance; p=0.09). More boys than
girls suffered from cricket allergy (X2=3.989; 1 df,
p=0.05).
Flying Insects
The "flying insects" included the orders Lepidoptera
(moth) and Diptera (flies and mosquitoes). Sixty-six
children (40.2%) reacted positively to the moth extract.
Allergy to moth (Heterocera spp.) was positively correlated
to symptoms worsening during the "rainy season" (Xz=7.257; 2
df, p=0.03), but not to any of the structural or
sociodemographic variables.
Sixty-five children (39.9%) were allergic to the house
fly (Musca domestica). Allergy to house fly was related to
completeness of a finished ceiling; children living in homes
with the least-developed ceiling, or no ceiling at all, were
more likely to be allergic to house flies (t=2.25; df=115.7,
unequal variance; p=0.03). Also, children from poorer
families were more likely to be allergic to flies than were
children from wealthier families at the 0.10 level (t=1.70;
df=157.8, unequal variance; p=0.09).

Table 6-1. Relationship between allergies to house dust mites, D¿ pteronvssinus. and D.
farinae. and structural and demographic variables (values are derived from a t-test unless
indicated by an asterisk, which indicates a X2 test).
Structural/
socio-
House dust mite
D. pteronvssinus
D.
farinae
demographic
variables
T-value/
X2*
df
P
value
T-value/
X2*
df
P
value
T-value/
X2*
df
P
value
Concrete walls
3.246*
1
0.07
4.365*
1
0.04
2.935*
1
0.09
Indoor shower
2.619*
1
0.10
4.366*
1
0.04
0.418*
1
0.52
Wealth
1.66
166.0
0.10
0.75
166.0
0.45
1.14
166.0
0.25
Gender
6.014*
1
0.01
3.924*
1
0.05
6.221*
1
0.01
Symptoms during
rainy season
14.553*
1
0.001
15.561*
1
<0.001
8.856*
1
0.01
Symptoms during
dusting &/or
cleaning the
house
11.69*
1
0.001
8.23*
1
0.004
6.25*
1
0.01
Age of home
1.64
29.2
0.11
1.80
39.8
0.08
0.99
50.7
0.25
% of finished
ceiling
1.87
166.0
0.06
1.72
166.0
0.09
0.80
166.0
0.43
# rooms with
carpet
1.47
166.0
0.14
1.22
166.0
0.22
2.09
95.3
0.07
OJ
•fc.
00

349
Fifty-one children (31.1%) were allergic to the
mosquito mix extract (Aedes aeqypti and Culex pipiens).
Allergy to mosquito was, similarly to flies, correlated to
not having a finished ceiling at the 0.10 level (t=1.76;
df=162.0, equal variance; p=0.08). Mosquito allergy was
inversely related to the number of rooms in the house
(t=2.18; df=145.9, unequal variance; p=0.03). More boys
than girls suffered from allergy to mosquitoes (X2=3.633; 1
df, p=0.06), and children whose symptoms worsened during
housecleaning and/or dusting were more likely to demonstrate
allergy to mosquito (X2=4.32; 1 df, p=0.04).
Shellfish
Shellfish were included in the battery of skin testing
because they are part of the phylum Arthropoda. More boys
than girls were allergic to shellfish (X2=6.373; 1 df,
p=0.01), and older children tested positive more often than
younger children (t=2.09; df=165.0, equal variance; p=0.04).
Allergy to shellfish was also correlated to symptoms being
worse during housecleaning and/or dusting (X2=4.93; df=l,
p=0.03).
Rodents
Rodents were the only mammal-related allergens tested
(extract was derived from the dander and urine). Mice (Mus
musculus) and rats (Rattus rattus and R_¡_ norvegicus) are
frequently-reported household pests in Barbados (see Chapter
Five). Yet rodents were the least-common allergies in the

350
study; only 17 children (10.5%) reacted positively to the
mouse extract and 15 (9.0%) reacted positively to the rat
extract.
Hypersensitivity to mouse was not related to any of the
structural variables except for the presence of carpeting;
children with allergy to mouse lived in homes with more
carpeted rooms than children without allergy to mouse
(t=2.25; df=160.0, equal variance; p=0.03). Older children
were more likely to suffer from mouse allergy than younger
children, at the 0.10 level (t=1.74; df=160.0, equal
variance; p=0.08).
Allergy to rat was inversely correlated to two
variables representing poor quality homes; children with
allergy to rat were more likely to live in homes with fewer
rooms (t=2.07; df=165.0, equal variance; p=0.04) and had
fewer indoor water taps (t=3.30; df=22.1, unequal variance;
p=0.003). However, there was also an association between an
indoor toilet and allergy to rat (X2=5.47; 1 df, p=0.02).
Allergy to rat was not correlated to wealth. Children whose
symptoms worsened during housecleaning and/or dusting were
more likely to be allergic to rats at the 0.10 level
(Xz=3.02; 1 df, p=0.08) .
Figures 6-2 and 6-3 illustrate the statistical
correlations between the 11 extracts and the various
sociodemographic and architectural variables. The combined

351
responses for "allergic to one or more house dust mite
species" is also presented.
Cross-Reactivitv
Table 6-2 summarizes the number of positive reactions
to all household pests tested. Only 15 of the asthmatics
tested did not respond positively to any of the extracts,
and the greatest number of responses was to five different
extracts (22 asthmatics) (illustrated in Table 6-3). More
than half (57.7%) of the sample population tested responded
to four or more different pests.
Figure 6-4 is a correlation matrix presenting the
interrelationships between the skin tests (Chi-square
analysis). All of the correlations except for those with
the two rodents yielded probabilities at the 0.05 level.
The highest Chi-square value was for the two house dust mite
species (X2=73.4).
Allergy to rat dander and urine did not increase the
likelihood of reacting positively to any of the arthropods
except for mosquito (X2=9.6; 1 df, p=0.002) and shellfish
(X2=12.7; 1 df, p«0.001) . Surprisingly, hypersensitivity
to rat was not associated with hypersensitivity to mouse.
Mouse allergy was associated with allergies to more of the
arthropods than rat; there was a significant relationship
between mouse and five arthropods, including D_s_ farinae. but
not D^_ pteronvssinus.

352
Correlations to shellfish yielded particularly high
Chi-square values, particularly for crickets (34.6),
mosquitoes (34.6), ants (34.2), moths (30.1), and
cockroaches (26.6). Associations with the house dust mites
species were, conversely, relatively weak when compared to
the other arthropods.
Table 6-2. Total number and proportions of responses
to specific extracts (note: Sample size ranged from
157-168, as indicated under frequency).
Extract
Frequency
Percent
House dust mite
(both spp.)
138/168
82.1
House dust mite
(D. Dteronvssinus)
130/168
77.4
House dust mite
(D. farinae)
125/168
74.4
Ant (mixed spp.)
82/157
52.2
Miller moth
66/164
40.2
House fly
(Musca domestica)
65/163
39.9
Cockroach (B. aermanica.
P. americana.
B. orientalis)
60/163
36.8
Shellfish (mix)
58/167
34.7
Moscruito (A. aeavoti &
Culex pipiens)
51/164
31.1
Cricket (Acheta sdd. &
Gryllus spp.)
50/164
30.5
Mouse (Mus musculus)
17/162
10.5
Rat (Rattus sdd.)
15/167
9.0

353
Table 6-3. Frequency distribution for total numbers of
different pests reacted to in the battery of skin
testing.
Asthmatics
responding positively
Total number of extracts
eliciting a response
Frequency
Percent
0
15
9.6
1
14
8.9
2
17
11.0
3
20
12.8
4
16
10.3
5
22
14.1
6
16
10.3
7
08
5.1
8
14
8.9
9
10
6.4
10
4
2.6
11
0
—

o
a
age of home
Q
u
o
u
a
Q,
Q
1.64
(0
3
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i
1
£
V
â– +->
a
Q
1.80
wealth
1.66
0.75
cocnrete walls*
3.25
4.37
% of finished ceiling
1.87
1.72
# indoor water taps
0.54
0.42
indoor shower*
2.62
4.37
indoor toilet*
0.88
1.96
# rooms
1.58
0.71
# rooms with carpet
1.47
1.22
symptoms to dust*
11.69
8.23
rainy season**
14.56
15.56
age
1.71
1.52
sex*
6.01
3.92
u
X!
r
u
3
d
ant
moth
8
3
O
JZ
1
u
0.99
1.54
0.26
0.11
0.15
1.14
0.17
0.05
1.70
0.07
2.94
0.01
1.88
0.03
0.42
0.80
0.14
0.10
2.25
0.33
0.95
0.35
0.65
0.11
0.62
0.42
2.50
0.75
0.33
0.19
0.12
0.55
1.00
0.09
0.09
1.60
0.41
0.17
0.71
0.66
2.09
0.10
0.71
0.72
0.64
6.25
5.10
1.70
0.10
2.13
8.86
4.46
7.26
3.25
3.81
1.21
1.02
1.48
0.81
1.84
6.22
5.17
0.91
1.12
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6
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X
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2
1.06
0.54
1.60
0.45
0.74
0.94
1.34
0.34
1.06
1.21
0.53
0.05
0.01
1.49
0.05
0.31
1.76
0.93
0.37
1.39
0.39
1.39
1.10
0.52
3.30
0.14
0.61
0.61
0.13
1.85
0.43
0.19
2.31
0.09
5.47
0.22
2.18
1.19
1.17
2.07
0.29
0.20
0.49
2.25
0.20
4.93
4.32
0.15
0.82
3.02
1.28
1.53
2.70
0.24
1.75
2.09
1.42
1.71
1.74
1.18
6.37
3.63
3.99
2.34
1.08
Figure 6-2. Correlation matrix for pest allergies by structural and demographic
variables. All values are "t" values (t-test) except when indicated by an asterisk
(*), which represents a Chi-sguare value with 1 degree of freedom, or when indicated
by a double asterisk (**), which reporesents a Chi-suare value with 2 degrees of
freedom. Significant correlations at the 0.10 level were accepted and are w
highlighted. £

i)
a
age of home
Vi-
0
u
0
s.
«
u
a
a,
a
0.11
P D. pteronyssinus
8
wealth
0.10
0.45
concrete walls*
0.07
0.04
% of finished ceiling
0.06
0.09
# indoor water taps
0.59
0.67
indoor shower*
0.11
0.04
indoor toilet*
0.35
0.16
# rooms
0.12
0.48
# rooms with carpet
0.14
0.23
symptoms to dust*
0.001
0.004
rainy season**
0.002
0.001
age
0.09
0.13
sex*
0.01
0.05
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0.92
0.17
0.88
0.52
0.43
0.89
0.92
0.03
0.74
0.34
0.73
0.52
0.92
0.54
0.52
0.11
0.39
0.57
0.67
0.73
0.46
0.32
0.77
0.77
0.11
0.68
0.86
0.48
0.51
0.04
0.92
0.48
0.47
0.52
0.01
0.02
0.19
0.75
0.15
0.01
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mouse
4-i
2
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0.59
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0.65
0.46
0.35
0.18
0.73
0.29
0.23
0.53
0.82
0.92
0.22
0.83
0.76
0.08
0.35
0.71
0.17
0.70
0.17
0.27
0.61
0.003
0.71
0.44
0.43
0.72
0.17
0.51
0.67
0.13
0.77
0.02
0.82
0.04
0.24
0.24
0.04
0.77
0.84
0.63
0.03
0.84
0.03
0.04
0.70
0.37
0.08
0.91
0.66
0.32
0.83
0.19
0.04
0.16
0.09
0.08
0.24
0.01
0.06
0.05
0.13
0.30
Figure 6-3. P-values for pest allergies by structural and demographic variables.
All values are "t" values (t-test) except when indicated by an asterisk (*), which
represents a Chi-sguare value with 1 degree of freedom, or when indicated by a double
asterisk (**), which reporesents a Chi-suare value with 2 degrees of freedom.
Significant correlations at the 0.10 level were accepted and are highlighted.
ui

Q
u
0
\
u
B
Q.
Q
D. pteronyssinus
D. farinae
+J
%
moth
house fly
cockroach
shellfish
mosquito
cricket
mouse
D. pter. &/or D. farinae
X
X
D. pteronysslnus
-
X
D. farinae
—
73.4
X
(<.ooi)
ant
16.1
23.7
13.2
X
(<.001)
(<.001)
(<.001)
moth
14.0
12.3
16.8
0.7
X
(<.ooi)
(<.001)
(<.001)
(.002)
house fly
8.30
0.5
12.7
14.0
10.4
X
(.004)
(.002)
(<.ooi)
(<.001)
(<.ooi)
cockroach
8.70
7.2
10.6
18.6
12.5
18.4
X
(.003)
(.007)
(.001)
(<.ooi)
(<.001)
(<.ooi)
shellfish
12.7
15.6
8.7
34.2
30.1
18.0
26.6
X
(<.001)
(<.001)
(.003)
(<•001)
(<.ooi)
(<.ooi)
(<.ooi)
mosquito
7.6
5.4
6.0
10.6
10.8
25.2
28.0
34.6
X
(.006)
(.02)
(02)
(.001)
(.001)
(<.001)
(<.001)
(<.001)
cricket
15.5
14.2
21.0
21.0
25.0
20.6
10.1
34.6
0.7
X
(<.ooi)
(<.ooi)
(<.001)
(<.001)
(<.ooi)
(<.ooi)
(<.ooi)
(<.ooi)
(.002)
mouse
4.1
1.32
4.0
0.15
4.5
0.005
0.14
5.14
2.1
4.6
X
(.04)
(.25)
(.05)
(.70)
(.03)
(.94)
(71)
(.02)
(.15)
(.03)
rat
0.187
0.74
0.02
0.13
1.9
1.84
1.10
12.7
0.6
2.7
1.9
(.67)
(39)
(.89)
(.72)
(.17)
(.17)
(29)
(<.001)
(.002)
(.10)
(17)
*->
e
x
Figure 6-4. Correlation matrix for positive skin tests, indicating the
interrelationship between each of the extracts. All values represent a Chi-square
test with 1 degree of freedom.
u>
o

357
Discussion
Symptomatology
It is difficult to determine at what point in time
asthma began to increase in Barbados. From 1951-1955,
"respiratory disease" accounted for 18.0% of all infant
deaths in Barbados, second only to "congenital debility" at
20.2% (Lowenthal 1957). At that time, the high rate of
respiratory-related death was attributed to "overcrowding"
and "poorly ventilated homes" (Lowenthal 1957). In a
discussion regarding causes for the increasing incidence of
asthma in Barbados, the Acting Chief Medical Officer
suggested that one possibility is not an increase in cases
so much as the likelihood of improved or more uniform
diagnostic procedures among physicians. Furthermore, less
reliance on home remedies and greater reliance on the formal
medical sector, may result in accelerating treatment
(Ferdinand, personal communication). However, she did
concede that, empirically-speaking, more children with
asthma are seen in the casualty clinic than 20 years ago,
when she recalls that the majority of cases were adults
(Ferdinand, personal communication).
The general consensus among Barbadian parents is that a
headcold is a direct result of "getting your head wet" or
"catching a chill" in the night air or in the rain.
Similarly, the onset of asthma is linked with this

phenomenon. One informant in St. Andrew was asked why he
thought asthma was increasing so much in Barbados:
358
I'll tell ya why. It's because parents do not watch
the children the way they use to. Use to be the
children come home from school, they take off they
uniforms, and do homework, under the parent's
supervision. Nowadays, the children come home from
school, they stay outside and play, with they uniforms
on, no one to watch them. They stay out even when it
start to get dark. They leave the clothes on even if
they wet. No supervision. This is the problem. They
gettin' sick...
When parents were asked to list all stimulants that
might elicit an asthmatic attack in the child, the most
common responses were, equally, "housecleaning/dusting" and
"spraying insecticides" (N=112, 66.7%), two factors highly
related to the theme of this study. A large proportion of
responses was related to having a cold, moisture and
coolness. In fact, the second-most common response was
"when it's humid" (N=95, 56.5%) and not far behind this
response was "when the child catches a cold" (N=71, 42.3%).
It can be inferred that, because the common belief is that
an individual "catches a cold" because he/she is wet or has
"a chill," "catching a cold" is also related to moisture
and/or temperature. A number of miscellaneous stimulants
were reported; most are in keeping with notoriously common
allergenic stimulants worldwide, such as certain foods
(28.6%), perfumes (4.8%), pollens (3.6%) and grasses (3.0%).
Yet other individual responses indicated that contact with

359
or exposure to moisture and cool temperatures was important
stimulants.
Additional correlations with moisture and asthmatic
attacks are evident in responses to the question: "When is
your child most likely to have an asthmatic attack?" Table
6-5 illustrates that the most important time periods for
developing asthmatic symptoms are nighttime (N=lll, 66.1%)
and the rainy season (N=91, 54.2%). The response that
attacks happen most frequently during the night bears
significance for several reasons. First, it corresponds to
the traditional belief that "night winds" are deleterious to
health, and asthma, being a result of such "cold" illnesses
(referring to the traditional humoral theory of medicine) as
a headcold or respiratory sickness, could expectedly be
worsened by exposure to such an element. Second, night
temperatures do drop—although the significance of the
decrease in temperature is relative by temperate clime
standards—by as much as 6° Celsius in the winter months (as
low as 25° Celsius, but rarely lower). Bronchial
hyperactivity to irritating stimuli in the asthmatic is a
well-known phenomenon, and cold air is a common irritant
(Kaliner et al. 1987). The third—and perhaps most
important implication in regards to the study—is the fact
that, during the night, the asthmatic spends the most
concentrated time out of a 24-hour period in the domestic

360
Table 6-4. Frequency distribution of stimulants
responsible for an asthmatic attack (N=168).
Stimulant
Frequency
Percent
Housecleaning/dusting
112
66.7
Spraying insecticides
♦When it's very humid
After vacuuming/sweeping the
112
66.7
95
56.5
floors/furniture
82
48.8
When it's dusty/dry outside
75
44.6
After strenuous exercise
74
44.0
Catches a head-/chest-cold
71
42.3
‘when it's cold
59
35.1
After eating certain foods
48
28.6
When it's very hot/sun exposure
39
23.2
Perfumes
8
4.8
When the fruit trees blossom
6
3.6
Smoke/burning trash
6
3.6
Change in emotions
6
3.6
Detergents/soaps/powders
6
3.6
Certain plants/grasses
Dust from marl/sawdust/
5
3.0
construction
3
1.8
Using a sponge/sponge pillows
2
1.2
Stuffed animals
When the cane arrow is out
2
1.2
(November, December)
1
0.6
Too many houseplants
*Goes out into the cold without
1
0.6
a hat
1
0.6
*Sea mist
*When there's standing water
1
0.6
around the house
‘Takes a shower too late in
1
0.6
the evening
1
0.6
‘Gets wet
1
0.6
Breathing felt-tip markers
1
0.6
Exposure to fresh paint
1
0.6
Breathing hair chemicals
1
0.6
Chalk
1
0.6
Taking aspirin
1
0.6
Exposure to nylon
1
0.6
Wax crayons
1
0.6
Denotes moisture- and temperature-related stimulants.

361
environment, particularly in and around high-moisture areas
of the house (e.g., toilet, shower, kitchen) and for a
prolonged period within the confines of a bedroom mattress
(potentially infested with housedust mites); these factors
are those for which there are possibly a number of household
pest allergens.
Referring to attendances to the A&E Department, as
reported in Chapter Two, the "rainy season" response
reflects the peak number of visits in the very rainy months
of October and November, which is reflective of the time of
the year when relative humidity is at its highest.
Table 6-5. Time period when child reportedly is most
likely to experience an asthmatic attack.
Time period
Frequency
Percent
Annual periods:
rainy season
91
54.2
dry season
16
9.5
In a 24-hour period:
morning
27
16.1
afternoon
17
10.1
night
111
66.1
Other:
school season
7
4.2
temperature changes
7
4.2
cane season (January-May)
4
2.4
after returning from a
visit in another locale
4
2.4
after a cold
2
1.2
during summer vacation
2
1.2
when trees are blossoming
2
1.2
after moving to a new
development
1
0.6

362
Individual Allergens
The spatial and temporal distribution of house dust
mites in Barbados was discussed in depth in Chapter Five.
Generally speaking, D^_ pteronvssinus was the predominant
species, found in all homes tested, and densities were
proportionately associated with a concrete structure.
Children living in concrete homes, older homes, homes with
indoor showers, and homes with finished ceilings—or, homes
with features associated with excessive indoor moisture and
decreased ventilation—were more likely to involve children
with hypersensitivity to D^_ pteronvssinus than children
living in homes without these features. Some associations
between densities and structural variables were not found in
the entomological survey, and, as previously suggested, the
small sample size in the entomological survey may have
precluded elucidating associations with some of these
structural variables.
The surprising findings are those associated with D.
farinae. The entomological survey indicated that D^_ farinae
densities were much lower than D_j_ pteronvssinus—by 1/1000—
and found in fewer homes. Nearly the same proportion of
asthmatics who tested positive to D^_ pteronvssinus (77.4%)
tested positive to D^_ farinae (74.4%), and being allergic to
one species was highly correlated to being allergic to the
other (X2=73.4; 1 df, p<<0.001). In addition,
hypersensitivity to D^_ farinae was associated (at the 0.10

363
level) with living in a concrete home. This peculiar
association between incidence of allergy to the two species
and the independent variables with which they are both
associated is highly suggestive of cross-reactivity.
Ants, like other Hymenoptera superfamilies (e.g., bees,
wasps, hornets and yellowjackets), are capable of eliciting
some of the most serious anaphylactic reactions. Despite
the more than 10,000 different species of ants, only ants of
the genus Poqonomvrmex and Solenopsis have been implicated
in anaphylactic reactions in the U.S. (Stablein & Lockey
1986).
The relatively high frequency of allergies to ants in
the Barbados sample was consistent with the literature
(Barnard 1973; Harwood & James 1979). Reflective of the
associations between frequently seeing ants in the home and
structural and socioeconomic variables—or lack there of—
allergy to ants was not highly correlated to any of the
structural variables.
The international incidence of cockroach allergy varies
tremendously; in the Dominican Republic, only 15% of atopies
tested positive to a cockroach mix by skin testing (Brenner
et al. 1991), Marchand (1966) found 52% hypersensitivity
among asthmatics in Puerto Rico, and the incidence has been
reported to be as high as 69% among asthmatic children in
the U.S. (Kang & Chang 1985). Certainly an important
element in evaluating the difference in the incidence of

364
allergy to cockroaches in the tropics versus temperate
regions is the difference in predominant species, and
subsequently different behavioral patterns associated with
the spatial distribution of the pest. The smaller German
cockroach—and to a lesser degree, the oriental—are the
most common species in temperate climes, while the larger
Periolaneta species are predominant in the tropics.
Although each of these species are classified as "domestic
pest species," their behavior is markedly different.
The German cockroach is an indoor breeder, preferring a
humid environment with an average temperature of 70°F/21°C
(Koehler et al. 1987). It is tolerant of crowded
conditions, and a population within a given unit/home can be
quite large; in a North Central Florida study, the median
number of cockroaches found in each apartment exceeded
13,000 (Koehler et al. 1987). Although the American and, to
a lesser extent, the Australian, cockroaches are also
considered to be domiciliary species, they are less
dependent on the indoor environment than are the German and
oriental cockroaches, and are somewhat "peridomestic" in
their behavior. They are primarily outdoor breeders—
particularly in the tropics—and are abundant in out¬
buildings, dumps and wood piles, cracks and crevices in
coral rock, and even palm trees (Cornwell 1968). Therefore,
their indoor densities are significantly less than are
densities of German cockroaches. When German and American

365
cockroach populations are present at the same time, the
Germans usually outnumber the Americans; ratios of 99.7%
German to 0.2% Australian have been reported in three Texas
cities, and ratios of 90% German to 1% Australian were
reported in North Carolina buildings (Ebeling 1975).
An incidence of 36.8% cockroach positive skin tests, as
found in the Barbados study, is higher than that found in
the Dominican Republic (Brenner et al. 1991), but lower than
what was reported in Puerto Rico (Marchand 1966) and lower
than overall incidences in temperate climes (Schulaner 1970;
Kang & Sulit 1978; Kang & Chang 1985). What is surprising
in the Barbados study is the absence of correlations between
certain housing factors and the presence of allergy to
cockroaches. The relationship between housing and cockroach
allergy in the Dominican Republic has been presented
elsewhere in this thesis; it was concluded in that study
that the better-built homes provided better habitats for
cockroaches, and subsequently, children living in those
homes were more likely to suffer from cockroach allergy than
were children living in poorer homes (Brenner et al. 1991).
Yet no such correlations could be found among the Barbados
population.
Frequency of cockroach sightings also was unrelated to
any sociodemographic or structural variables, and it was
suggested in Chapter Five that this factor possibly was due
to the overall pervasiveness of cockroaches throughout the

366
island, therefore precluding the importance of microhabitat
features. The same can be said for the skin test results.
However, another explanation—similar to what was proposed
in Chapter Five—is that certain features of the
microhabitat in Barbadian homes, important for cockroach
infestations, were not included in the methodology of the
study.
The correlation between age and cockroach allergy is
difficult to explain and is, quite possibly, an accidental
relationship, as nowhere in the literature could similar
relationships be found. Children are expectedly exposed to
the same domestic environment from infancy to adolescence,
so an increase in exposure at home is not expected, at least
not in the general sense (possible exceptions include moving
to a new home, upgrading the home). One possibility is
exposure outside of the home; for example, cockroaches are
sighted frequently in commercial areas such as supermarkets.
Indeed, places where goods are imported are typically the
only locales where German cockroaches (Blattella germánica)
can be found in Barbados. Cornwell (1976) reported on
tropical infestations of both German and American
cockroaches in the marketplace and supermarkets. It may be
that older children visiting supermarkets or the like, or
who are increasingly consuming goods from the supermarket
that are contaminated by cockroaches (e.g., canned
beverages, snack food), are increasingly exposed to ingested

367
allergens; elsewhere, hypersensitivity secondary to ingested
arthropod allergens has been discussed (Bernton & Brown
1967). However, this hypothesis is difficult to defend
because children who were not allergic to cockroaches were
only slightly younger (mean=9.30 years) than children who
tested positive (mean=10.32).
Crickets are best classified as "occasional household
pests," and typically migrate indoors when grasses—their
natural food supply—dry and/or become scarce (Ebeling
1975). They are also attracted to light. Field crickets
(genus Gryllus) do not successfully maintain populations
indoors as do House crickets (genus Acheta). Acheta species
deposit their eggs in crevices and other dark places in the
home, attracted by the warmth of the domestic environment,
and sometimes destroying clothing, synthetic fabrics and
carpeting (Ebeling 1975).
The relationship between hypersensitivity to cricket
and household density may be secondary to the warm, moist
environment created by greater numbers of people in a
confined area, a phenomenon described by Hansen (1984), and
the provision of food sources, such as clothing. An
association between age and cricket allergy, as well as more
boys with cricket allergy, may, as in the case of cockroach
allergy, represent behavioral factors. However, as with the
cockroach, there was little difference in the mean age of

368
the children who tested positive to cricket (mean=10.34
years) and those who tested negative (mean=9.36).
Insects under the order Lepidoptera are particularly
allergenic; of 53 different arthropod species, (Wirtz 1980)
found that the predominant sources of allergic reactions
were different species of Lepidoptera (an incidence of
67.0%). In Japan, more than 50% of asthmatics exhibited
hypersensitivity to silkworm, butterfly, and moth allergen
(Kino & Oshima 1978). The most important allergenic
component in Lepidoptera is believed to be the wing scales
(Wirtz 1980).
In the Barbados study, hypersensitivity to the moth
extract was not related to any of the independent variables;
again, possibly due to the pervasiveness of the insect;
moths were the tenth-most frequently seen pest out of 37
pests, and were cited as "usually/always" around the house
by 44.6% of the subsample that answered the pest-related
questions (Chapter Five).
House flies depend on warm, moist materials for laying
their eggs, including animal excrement, decaying fruits and
vegetables, garbage, and contaminated soil (Ebeling 1975).
The fact that many Barbadians—including those in the urban
sector—keep fowl and stock around the house supports the
fact that flies were frequently listed as one of the most
common household pests by informants in the study.

369
Although little attention has been focused on allergy
to flies in the scientific literature (Ebeling 1975; Bellas
1983; Baldo & Panzani 1988), their sheer number in both
urban and agricultural settings implies that they may be of
great antigenic importance. Hypersensitivity to the fly
extract was just slightly less than that to moth, and it was
the fifth-most common allergy overall. The association
between fly allergy and not having a finished ceiling
suggests a greater ease of access into the home (due to the
open space between the wall and rafters) and, subsequently,
greater numbers of flies in the home.
Of all the biting insects, mosquitoes are perhaps the
most common worldwide, and yet, systemic allergic reactions
to mosquitoes appear to be quite rare (Hoffman 1986),
although localized allergic reactions due to the injected
oral secretions during a blood meal have been described
(Harwood & James 1979). Wirtz (1980) reported a number of
occupational-related allergies (entomological workers) to
mosquitoes; similarly to Lepidoptera, the wing scales were
implicated as the main source of the allergen.
The only association between mosquito allergies and
architecture was, similarly to flies, related to ease of
access into the dwelling (unfinished ceiling).
Shellfish were included in the skin test battery,
despite the fact that they are not typically consumed by the
average Barbadian. Shellfish in Barbados are prohibitively

370
expensive and are consumed much more commonly in restaurants
and tourist resorts than by the locals. Nevertheless, as
arthropods, shellfish have been implicated as significant
allergens to asthmatics (Baldo & Panzani 1988). For the
study population, the only significant demographic
associations with shellfish allergy were for older children
and more boys than girls. The fact that allergy to
shellfish (34.7%) was more common than allergy to the common
mosquito (31.1%) once again suggests the phenomenon of
cross-reactivity.
Another possible explanation for the incidence of
allergy to shellfish, despite the probable low rate or •
absence of consumption, is chronic exposure via inhalation.
It is possible that living near the sea and/or play activity
near fishing piers and markets increases the likelihood of
inhaling aerosolized components of shellfish. It can be
postulated that there might be a difference in the degree of
exposure to such allergens, depending on which side of the
island an asthmatic lives (tradewind variation).
Hypersensitivity to the two rodents was the least-
common of all the skin tests. Rodents had been included in
the battery because they are reportedly common in Barbadian
homes (Chapter Five) and are referred to in the literature
(Wirtz 1980; Longbottom & Austwick 1987; Price & Longbottom
1987), although studies have been based primarily on
laboratory workers. Nevertheless, if one of the most common

371
means for acquiring leptospirosis is via indirect contact
with rat urine, it was hypothesized that indirect contact
with allergens in the urine might be a real hazard to
Barbadian asthmatics.
Allergy to the two rodent extracts were inconsistent
regarding correlations to the structural variables, and for
the findings in the entomological survey (Chapter Five),
whereby allergy to rodents—especially mice—was correlated
to living in poorer homes. But according to the skin test
results, mice appear to have an affinity for homes with
carpet. No explanations can be offered for this factor.
Additionally, while hypersensitivity to rodents is
associated with living in a home with few bedrooms and few
indoor water taps, the fact that it was also correlated to
having an indoor toilet suggests that the number of children
reacting to the rat were too few to derive real conclusions.
Allergy to several of the pests was correlated to age
of the child, although all but one of the correlations (the
shellfish) were significant only at the 0.10 level ("one or
both" house dust mite species, cockroach, cricket, and
mouse). The importance of duration of exposure has been
presented (Wirtz 1980; Brenner et al. 1990); the more
frequent the contact with an allergen, the more likely that
contact will result in hypersensitivity. The problem is
compounded by the presence of "generic" allergens that are
common to different species, whereas the development of

372
allergy to one pest predisposes an individual to develop
allergies to other pests. Consequently, older children are
more likely to have come into contact and may even
experienced prolonged contact with a given allergen, that
subsequently renders them hypersensitive to other pest
allergens, to which they have not necessarily been exposed.
The relationship between hypersensitivity to a given
pest allergen and gender is more difficult to explain;
similar findings have not been presented in the literature.
In the Barbados sample, more boys than girls responded to
the extracts of house dust mites, ant, shellfish, mosquito,
and cricket. Although the literature supports the finding
that boys are more likely to develop asthma than are girls,
the Barbados sample was almost equally divided between
asthmatic boys and girls; subsequently, this finding is not
related to the makeup of the sample. Certainly a
possibility is a genetic predisposition for boys to respond
to arboallergens more than for girls. Another possibility
is behavior (e.g., play, daily routine) that is different
between boys and girls, and subjects more boys than girls to
certain allergens (duration of exposure). Worth (1962)
found that, not only did Chinese children demonstrate higher
incidences of atopic dermatitis than did Japanese and
Caucasian children, but the incidence was higher for Chinese
boys than for girls. Worth suggested the following; "An
extrinsic physical agent—probably a food—preferentially

373
offered to Chinese boys in affluent families is the most
likely explanation of these statistically significant
discrepancies" (1962, p.31).
Cross-Reactivity
Studies aimed at identifying the specific allergenic
proteins in arthropods have indicated that some of the
antigenic determinants are shared by different arthropods
(O'Neil et al. 1985; Baldo & Panzani 1988; Solomon & Mathews
1988; Helm et al. 1990). Research on house dust mites found
that at least one of four major allergens was shared by D.
pteronvssinus and D^_ farinae (Solomon & Mathews 1988) .
Similarly there is increasing evidence of cross¬
reactivity among cockroach species. The introduction of the
Asian cockroach (Blattella asahinai Mizukubo) into Florida
has provided the opportunity for testing cross-reactivity
among patients not previously exposed to the Asian
cockroach, but who are known allergies to other species of
cockroaches. Pooled serum IgE from a Chicago sample
recognized proteins from Asian, German (Blattella germánica
(L.)), oriental (Blatta orientalis (L.)) and American
(Periplaneta americana (L.)) cockroaches (Helm et al. 1990).
Further studies with the Chicago serum pool have revealed
cross-reactivity to Blattella vaga (from the arid Southwest)
and Blattella lituricollis (from rural Hawaii) (Brenner &
Helm, personal communication).

374
Cross-reactivity among various families and even orders
of insects also has been reported. Baldo & Panzani (1988)
found hypersensitivity to five different orders of insects
in an Australian study. Preliminary data suggests shared
proteins between cockroaches and sowbugs (Brenner, personal
communication). In another study, cross-reactivity was
implicated in such diverse arthropods as house dust mites,
cockroaches, crabs, shrimp and crawfish (O'Neil et al.
1985). While little specific evidence of cross reactivity
with hymenoptera venom and biting insect saliva exists, it
has been noted that many atopies who react seriously to
insect bites have a history of serious reactions to
Hymenoptera venom (Hoffman 1986). In the Barbados sample,
hypersensitivity to the ant extract was highly correlated to
hypersensitivity to the mosquito extract (X2=10.6; 1 df,
p=0.001).
Summary
In summary, the biomedical testing confirms the extreme
importance of house dust mites in allergy disease among
Barbadian asthmatics; among all household pests tested,
hypersensitivity to the house dust mite was overwhelmingly
the most common, affecting more than three-quarters of the
sample. These findings support those from a study in
Barbados 20 years ago, and are consistent with international
findings. Sociodemographic, architectural, and
symptomatological variables support the concept that allergy

375
to house dust mites is positively correlated to
modernization of the domestic environment, and is
particularly pronounced in the rainy season.
Incidence of allergy to other pests that are reportedly
not common in homes (e.g., moths, crickets) and for which
previous contact is unlikely (shellfish) suggests a
substantial degree of cross-reactivity and/or extreme
allergenicity of these species. For those pests in which
allergy was demonstrated, the general lack of association
between allergy and structural variables implies widespread
infestations regardless of development of housing (e.g.,
cockroaches, ants); this feature was described in Chapter
Five. The generally low incidence of allergy to the two
rodents suggests that arthropods are much more serious
domestic allergens than mammals, despite similar degrees of
exposure.
Notes
1. Hollister Stier, Division of Miles Laboratories Inc.,
Elkhart, IN. 46515.

CHAPTER 7
SUMMARY AND IMPLICATIONS FOR FUTURE STUDIES
Asthma as a Disease of Modernization:
Concurrence with the Theoretical Construct
Review of the Findings
A review of modernizing the domestic environment in a
tropical, developing country, an entomological survey
focusing on household pests, and biomedical testing for
hypersensitivity to common arboallergens and other household
pest allergens, all suggest that allergy fits into the
theoretical construct of the epidemiological transition_
Therefore, the null hypothesis of this thesis has been
rejected; modernization of the home does influence the
incidence of asthma, by promoting a favorable environment
for arboallergens responsible for hypersensitivity.
An initial review of the etiology of human allergy
indicated that type I hypersensitivity—or rather, its
mediating factor, IgE—appears to have played a beneficial
role in minimizing severe morbidity in early humankind, by
curtailing the establishment of large worm populations in
the human host. However, the transition of human society
into state-level modes of production changed the
macroenvironment not only at the infrastructural level, but
epidemiologically as well, by means of subjecting large
376

377
populations to a new host of diseases. The continuing
development of medical science and technology drastically
reduced the incidence of many acute, high-mortality
diseases; yet negative changes in lifestyle (e.g., diet,
activity) and exposure to foreign chemicals, proteins, and
other materials, contributed to the rise in chronic disease.
One of those chronic diseases—although realized at times in
an acute condition (anaphylactic reaction)—is asthma.
Asthma was selected as a disease for study because of
its alarming increase internationally and the apparent
interrelatedness of genetics and behavior. Barbados was
chosen as a site of research because of a seemingly
exponential increase in the incidence of asthma over the
last decade. The focus of hypersensitivity to household
pests was selected because of the well-known allergenicity
of various household pests and previous studies that have
indicated a relationship between the development of the
domestic environment and household pest infestations.
The first step in this study was to qualify the concept
of "modernization" of the domestic environment. This was
achieved by reviewing the sociohistorical evolution of the
Barbadian home. The review highlighted a unique phenomenon:
There is a disproportionate level of home ownership compared
to land ownership in Barbados, primarily due to the
socioeconomical history of the island, in which early land
distribution patterns, based on a sugar economy, dictated a

378
social stratification pattern that would persist until the
decline of the industry from which it emerged. In short,
early success in large-scale sugar production mandated a
large-scale labor force, but the small size of the island,
coupled with a low rate of absenteeism, restricted the
distribution of land, and resulted in a majority population
of landless proletariats. The landlessness of the majority
was epitomized by a house form that was moveable, and that
precluded the integration of permanent materials and
amenities such as plumbing, thereby limiting improvements in
standard of living.
Consequently, owning one's house spot became an
aspiration of many, and one that was best exemplified by the
use of concrete in the structure because concrete is
permanent, and a concrete house cannot be moved. A trend
was observed in the asthma study; having a concrete home was
related to owning the land, and when people speculate on
their "dream house", it typically is a house made of
concrete. Other reasons for preferring a concrete home
include sturdiness (e.g., fire resistent, resistance to
climatic elements and termites) and low-maintenance. Yet
the prohibitive cost of building a concrete home instead of
a wood home mandates piecemeal construction. Construction
by the lay person may result in minimizing or negating
altogether certain architectural principles that would
preclude excessive moisture in the home (relative humidity)

379
and maximize ventilation. Specifically, the data indicated
that a number of elements known to affect humidity and
ventilation are part of the modernization process, and
include: The use of concrete, the installation of indoor
toilets and showers in the back of the house (the region of
poor airflow), the installation of more indoor water taps,
crawl spaces, and finished ceilings (lowering the height of
the ceiling and creating a dead air space).
The entomological survey revealed a host of pests that
are common in Barbadian homes. However, at least one of
those species present in all homes tested—the house dust
mite, JDj. pteronvssinus—thrives best in concrete homes,
probably because of the moisture generated and/or the
creation of a microhabitat that is favorable over a wood
home. Other pests also are very common (e.g., Periplaneta
spp. cockroaches, mosquitoes, house flies) and are
potentially widespread arboallergens throughout the home.
There were no apparent differences in pest distribution on
the island, with few exceptions; flies were a particular
problem in homes with livestock, and mosquitoes were less of
a problem to residents on the windward coast. German
cockroaches were found only in urban and semi-urban homes.
The differences of rainfall on the island did not affect
house dust mite densities or frequency of sightings of other
pests; it has been proposed that the overall humidity level

380
on the island precludes differences in spatial distribution
of household pests.
Skin tests confirmed the importance of the house dust
mite as a serious allergen; 77.4% of the children tested
were skin test positive to D^. pteronvssinus. and nearly as
many (74.4%) were allergic to a separate species, D.
farinae. which was much less prevalent. The high incidence
of hypersensitivity to farinae illustrates the importance
of cross-reactivity in insect allergy and implicates the
role of other arthropods that are less common in the home,
or even absent (e.g., shellfish).
Most importantly, hypersensitivity to EK pteronvssinus
was significantly correlated to living in a concrete home.
This correlation supports findings in the entomological
survey: House dust mite allergens are more prevalent in
concrete homes than wood homes.
Hypersensitivity to other pests was less common; some
of those pests tested were those reportedly uncommon in
Bajan homes (e.g., moths, crickets), others were pervasively
present in all homes (according to ethnographic information
and entomological trapping), and one of the allergens,
shellfish, was an allergen for which previous contact was
unlikely. The absence of interrelatedness between
hypersensitivity to these allergens and structural variables
implies that, either the appropriate microhabitats
(harboring the arboallergens) were not considered, or there

381
was a substantial degree of cross-reactivity in the sample
population, or both. The low incidence of hypersensitivity
to the two rodents suggests minimal contact with rodent-
borne allergens and illustrates the overwhelming importance
of arboallergens over most other types of indoor allergens,
at least in the Barbadian setting.
Modelling the Variables
Having identified key variables in predicting the
modernization of housing, and subsequently, the development
of a microhabitat favorable to one of the most important
arboallergens, the house dust mite, the variables were
modeled using the SAS logistic procedure (SAS Institute
1988). Equations of the models are presented in Figure 7-1.
A sociohistorical perspective of land ownership was
presented in Chapter Three, and data from Chapter Four
supported the review. When the independent variables were
modeled, a pattern is observed: Owning one's house, plus a
relative degree of wealth, plus living outside of the heavy
urban sector, are predictive for owning the house spot
(model correct 67.2% of the time).
As presented, once a household owns the land, the
family is more likely to integrate concrete into the
dwelling, or build a new concrete structure altogether.
From that point, and/or in the interim, a number of
moisture-related elements are added to the structure. Using
the logistic procedure, a pattern emerged: Living in a

382
concrete structure could be predicted by having a concrete
foundation, having a number of indoor water taps, and having
a greater number of rooms than homes that were wood (model
correct 79.1% of the time). Furthermore, a personal profile
was modeled: Informants who lived in a concrete home had
fewer family members living in the structure, owned the
house spot, and were more likely to be legally married, than
informants living in wood homes (model correct 55.9% of the
time).
Various indoor elements responsible for high, indoor
relative humidity were discussed in Chapter Three. Almost
all of these elements were characteristic of concrete homes
in Barbados. According to Hansen (1984), cooking with a gas
stove and dish-washing are two of the most significant
contributors of moisture in the house; it is important to
note that gas is the predominant stove-type in Barbados.
Another important moisture source is showering, which
produces 0.23 liters of moisture per day in a 1200 square
foot home (Barbadian homes are much smaller than this). In
the ethnographic survey, it was noted that shower stalls
were often covered with mold and fungi (personal
observation). This is probably because they are typically
situated in the back of the house and have very small
windows placed on one wall only; these factors result in
poor air flow and subsequently high relative humidity. When
modeled, having an indoor shower was dependent on having

383
concrete walls and a significant number of indoor water taps
(model correct 89.3% of the time).
The allergens that elicited the greatest number of
responses were the house dust mites, IK. pteronvssinus and D.
farinae. The former was found in all homes in which
densities were surveyed, and densities were highest in
concrete homes (see Chapter Five). In Chapter Five, the
ecology of the house dust mite was discussed, and it was
noted that house dust mites thrive in warm, humid
environments.
When hypersensitivity to D^_ pteronvssinus was modeled,
it was found that both living in a concrete home and having
an indoor shower were predictive for demonstrating
hypersensitivity to D^_ pteronvssinus (model correct 69.6% of
the time). An even stronger relationship was established
for hypersensitivity to D^_ pteronvssinus and/or D^_ farinae:
Allergy to one or both species was predicted by complaining
of symptoms worsening during housecleaning and dusting,
symptoms being worse during the rainy season, and living in
a concrete house (model correct 72.6% of the time).

Intercept
8.13 +
Intercept
6.02
Intercept
0.48
-3.06
owns the
house (=2)
X +1 -0.08 X
jr wealth (0-45)/
-1.28
concrete
oundation (=3
>
-0.71
number indoor^
water taps^
0.39
household
density
>
Intercept
6.89
Intercept
0.20
-0.69
owns the
land (=2)
-3.24
concrete
structure (=2
+ rural
-0.19
number
of rooms
<
X
own the land (=2)
(model correct 67.2%)
d°°J> 4
\ + legally \ = f
f ¡married [=4\/r
concrete structure
(model correct 79.1%)
concrete structure
(model correct 55.9%
-1.75
"t number indoor
water taps
™”0'.TEr~
concrete
structure (
-0.43
indoor
shower (=2)
><
- f -
indoor shower
(model correct 89.3%)
pter. positive
(model correct 69.6%)
D
Intercept
4.35
-1.45
symptoms during^ -f-
dusting (=2) jr
—rrm v
symptoms during +
rainy season (=2J/^
-0.92
concrete =:
structure (=2)/^
f Positive to D. pter. ¡
&/or D.farinae
(model correct 72.6%)
Figure 7-1. Modelling the variables: A summary. Coefficient is displayed above the
variable; ranges for values are in parentheses. Dependent variables are in form log
(p/l-p) (Analysis of Maximum Likelihood Estimates, SAS Inst., 1988).
384

385
Implications for Community- and Household-Level Management
of Pests
Previous studies in tropical, developing countries
indicate that community education and participation are
crucial in the success of eradication of and preventive
programs against disease-causing vectors (schistosomiasis.
Webbe & Jordan 1982; dengue. Armada & Figueredo 1986; yellow
fever and dengue. Le Maitre 1990). Armada and Figueredo
(1986) noted that, during the Cuban dengue epidemic, health
education aimed at stressing the importance of basic
sanitation was believed to have been the most important
element responsible for the program's success.
Essential to the success or failure of control programs
is the dissemination of information to the householders so
that projects may be implemented to their fullest (LeVeen &
Willey 1983). For example, a poor understanding of the
purpose and benefit of ultra-low volume spraying against
Aedes aegypti mosquitoes was evident in the Barbados sample,
in that several informants admitted to "shutting up" the
house when they heard the trucks coming, because of "the bad
odor" from the insecticide. In contrast, the importance of
community education and participation at the household level
is evident in the anti-leptospirosis campaign in Barbados.
More than 93% of the sample correctly identified the vector
for leptospirosis, but only 75% identified the vector for
dengue; this fact is alarming given the pervasiveness of the
mosquito versus the rat and the greater length of time that

386
dengue has been a disease of concern in Barbados (compared
to leptospirosis). Moreover, nearly all of the informants
could identify one or several means for controlling rodents
and subsequently leptospirosis, whereas a much smaller
proportion (35%) were able to identify means for controlling
the mosquito.
LeVeen and Willey warn that, regarding successful pest
control in the domestic setting, management must be viewed
as beneficial to the homeowner, because residents "pursue
pest management to achieve certain general goals" (1983,
p.24), vis a vis protecting one's property (e.g., against
termites), preventing disease (e.g., the management of
rodents), and maintaining "aesthetic values" (e.g., an
extreme dislike for certain pests, and not wanting them in
the vicinity of the home). Ethnographic data from the
Barbados sample suggested that aesthetic properties were
perhaps more important than the perception of a pest as a
threat to health; wanting to destroy a pest was more highly
correlated to being "disgusted" by that pest than perceiving
the pest as "harmful." Also, larger pests (rats, large
centipedes, Blaberus spp. cockroaches)—pests that were less
frequently sighted in and around the home—evoked a greater
level of disgust and desire to kill than the smaller, more
frequently-seen pests.
All of these factors suggest that, in designing a
control strategy, particularly for small, common pests—such

387
as the house dust mite—a thorough investigation regarding
the negative perceptions of that pest must be implemented
prior to designing a control strategy, and the findings from
that study must be capitalized and integrated into the
strategy. For example, the author recommends that, because
asthma has become an island-wide concern (and quite possibly
affects at least one extended family member or acquaintance
of every household in the island), the life-threatening
potential of household pests (e.g., the house dust mite)
should be emphasized. In addition, emphasis should be
placed on the very negative characteristics of pests such as
the house dust mite (e.g., a pest that feeds on human skin
scales, a pest that is present in one's bed).
Implications for Patient Education
In keeping with the theme presented by LeVeen and
Willey (1983), control strategies for highly allergenic
pests should be presented to the asthmatic and her/his
family as a means to prevent disease. Studies have
demonstrated that the degree of exposure to Per p I in
infancy increases the risk of asthma in childhood (Sporik et
al. 1990). Others have indicated that a significant
reduction of densities in the home can improve symptoms and
even reverse bronchial hyperactivity (Pollart et al. 1987).
Such information should be presented to the parent of an
asthmatic child as a stimulus to control all pests—even

388
microscopic or rarely seen pests—in the domestic
environment.
In the Barbados study, both "house dust" and "spraying
insecticides" reportedly elicited asthma-related symptoms
more frequently than any of the other stimuli, for 66.7% of
the children. These two points should be central in the
direction of patient education, by: (1) Explaining that the
house dust mite is the major component in house dust in
general, and therefore illustrates the danger of house dust
to the asthmatic child; and (2) alternative modes of pest
prevention (e.g., screens, food containment) should replace
the heavy reliance on chemical control.
In developed countries, there exists an almost standard
protocol presented to asthmatics and their families for
minimizing house dust and house dust mites. This includes
frequent vacuuming, preferably with water trap/double-filter
vacuums, air filters in climate control devices,
dehumidifiers, and acaricides (Pollart et al. 1987; National
Asthma Education Program 1991). A recent study indicated
that the use of computer-aided education was effective in
reducing allergen levels of house dust mites (Huss et al.
1992). While these methods of control can be very effective
in reducing densities of house dust mites, a number of
constraints in the tropical, developing setting preclude
their use.

389
Financial constraints
Despite the U.N. classification of Barbados as a "more
developed" nation, the standard of living in Barbados is
modest compared to developed countries, and most of the
above recommendations are restricted to the highest
socioeconomic strata. It was discovered in the asthma study
that, although more than half of the householders had carpet
in the home (N=103), most residents did not own a vacuum-
cleaner. However, a common practice for cleaning carpets
and upholstered furniture is to remove the objects from
inside the home and clean them outside, allowing them to dry
in the sun. Unknowingly, residents are destroying most of
the fungi and mites in this process. Explaining this added
benefit to their behavior—killing the elements that wreak
havoc on the asthmatic—may encourage them to increase the
frequency of this behavior, thereby reducing the density of
aeroallergens in the home. This is obviously a very
inexpensive means for environmental control.
Financial constraints preclude the use of items other
than vacuum cleaners in Barbados. The most affordable
chemical control for pests is over-the-counter insecticides,
most of which are designed to kill flying and crawling
insects, and none of which contain acaracides. Just over a
third of the asthma study respondents had ever used
professional pest control, and 62% of those respondents had
only used it one time; therefore, it is apparent that this

390
service is restricted to the wealthy Barbadians. Also,
relatively inexpensive items in developed countries, such as
plastic mattress and pillow coverings, can be prohibitively
expensive or even unavailable in a developing country.
Structural constraints
Any of the usual recommendations involving climate
control are irrelevant in the Barbadian setting; as
previously explained, indoor climate control is nonexistent
in even the wealthy Barbadian homes and is limited to
businesses and tourist hotels and apartments. A
dehumidifier, even if affordable, would be futile in a
structure constantly open to the outdoors. Perhaps another
solution might be the increased use of electrical fans—
particularly ceiling fans—for the circulation of indoor air
and subsequently the lowering of indoor relative humidity.
Education of ideal habitats for allergens such as the house
dust mite, molds, and fungi (e.g., shower and toilet stalls
with poor ventilation), and the importance or aerating these
spaces (e.g., via fans, larger windows) may function to
further reduce indoor relative humidity where it is most
critical.
Although nearly 85% of the informants recognized
cockroaches as "indoor pests", the most common perception as
to why cockroaches were attracted to the indoors was related
to food; none of the informants acknowledged the importance
of indoor water sources as attractants to cockroaches, even

391
though they were most commonly sighted in and around the
kitchen, toilet, and shower stall (personal observation).
Public education regarding the importance of eliminating
rodent habitats to prevent leptospirosis has been
implemented and, impressively, cited by nearly 85% of the
sample population, the reduction and/or elimination of other
pest habitats should also be encouraged. Knowledge of the
importance of plumbing as an attractant to cockroaches may
promote stringent housecleaning in these areas of the home,
and in turn, reduce the level of molds, fungi, and other
allergens.
The addition of concrete in the home, which in turn
leads to the addition of concrete foundations, increasing
numbers of indoor water sources, and a host of other
moisture-related and decreased ventilatory principles, has
been examined in the Barbadian setting. Built under ideal
conditions, these features are not necessarily deleterious;
however, as presented, many Barbadians are financially
restricted from the use of building contractors, or the
systematic construction of their homes. This results in
building practices that promote excessive moisture
accumulation, including wicking (e.g., absence of a moisture
barrier, wet soil, construction during the rainy season),
and the placement of high-moisture sources in poorly-
ventilated regions of the home (e.g., toilet and shower
stalls in the back of the house).

392
Data presented in Chapter Four illustrate that
residents do not care for screens, although the style of
window they are adopting is appropriate for screens.
Screens in the windows would at least reduce the volume of
dust collecting inside the home. Education as to the source
of aeroallergens—many from the outdoors—may encourage
clients to incorporate screens in the structure of their
home.
Environmental constraints
It has been demonstrated that the overall daily
relative humidity level in Barbados are far greater than the
highest annual levels in temperate climes, where most
studies have taken place. This factor compounds
modernization features that promote the production of pest-
related allergens, by providing the optimal macroenvironment
for almost every pest discussed thus far. Educating
asthmatics and their families as to the important role of
relative humidity in the worsening of symptoms can reduce
the level of disease in the rainy season. Providing
information regarding various moisture sources (e.g., wet
concrete, poor drainage of water around the house,
collection of water in crawl spaces) may promote behavior
that would, ultimately, reduce the indoor relative humidity
level.

393
Ideological constraints
A repeated theme throughout this dissertation has been
the integration of concrete in the Bajan home, and the
historical and sociological basis for this integration—
social status. This feature must be recognized as not
simply a fad, or even a trend, but the real direction of
contemporary housing in Barbados. The benefits of concrete
housing over wood probably outweigh the health-related costs
outlined in this work for the majority of the population,
considering the greater durability of concrete against
tropical storms and pests, the availability of concrete
versus the absence of timber on the island, and lower
overall maintenance of concrete versus wood (e.g., wood
rot) .
The example of screens in windows—or a lack thereof—
is both a structural and ideological constraint. Referring
again to Chapter Four, most of the reasons for not using
screens in the windows were purely aesthetic. Similarly,
other structural features of the home, described as
promoting a warm, moist, low airflow indoor environment,
reflect a trend based on emulation to homes in developed
countries (in very different climates), commercial
availability and, in general, visual appeal. Recognition of
the ideological importance of this transition in housing
must be integrated into the planning and development of a
preventive strategy.

394
Implications for Further Research
Due to financial and time constraints, only the
potential aeroallergens of the house dust mite were
quantified and examined spatially and temporally within the
home. The pervasiveness of house dust mites in the
entomological sample reflect the high incidence of
hypersensitivity to their allergens. Entomological
sightings and ethnographic data suggest that other pests—
particularly cockroaches, house flies, and mosquitoes—are
also pervasive pests, common in all Barbadian homes,
regardless of socioeconomic status and, in most cases,
regardless of house-type at the macro-level. Nevertheless,
the incidence of allergy to these pests was relatively low,
compared to the house dust mite. One explanation is of
course the predominance of house dust mites compared to most
other allergens in the home (Buchanan & Jones 1972; Kang &
Sulit 1978; Dowse et al. 1985; Massicot & Cohen 1986;
National Asthma Education Program 1991). Another
possibility is that other arthropods are less allergenic
than house dust mites. However, an additional explanation
is the suitability of a particular house-type as an ideal
microhabitat for aeroallergens of other pests; it is
possible that many homes, for reasons not identified in the
current study, do not support the presence of large numbers
of arboallergens because of structural and/or behavioral
factors. This issue deserves further investigation.

395
Another factor not considered in the entomological
survey was the seasonal difference in pests other than the
house dust mite; again, because these pest populations were
not quantified, it was not possible to state with certainty
temporal variations in population levels. However, perhaps
in the tropical setting, pests favor the domestic
environment more at certain periods than others; this too,
requires additional research. For example, due to an
unlimited supply of moisture at the macro-level, perhaps
cockroach infestations are greater during the dry season.
Lowenthal (1957) noted that flies were most common when cane
fields were being fertilized, between July and October.
Perhaps heavy fly populations and, subsequently, large
densities of aeroallergens from flies, are a particular
problem for those households in the agricultural sector, but
not for the urban sector. Temporal distribution patterns of
arboallergens are important to the design of preventative
protocols (e.g., avoidance measures to take in the home, and
when).
There is a definite seasonal pattern in the worsening
of asthmatic symptoms and attendances to the A&E Department
in Barbados. Data revealed that there was no significant
difference in temporal distribution of house dust mites, and
most informants did not cite significant differences in the
frequency of household pest sightings according to weather.
It is possible that other indoor allergens, such as molds

396
and fungi (which thrive in moist environments), are
significant aeroallergens in the morbidity of asthma during
the rainy season.
The deleterious elements related to concrete housing
must be identified, potential behavioral and structural
modifications must be focused upon, and a plan to implement
these modifications should be designed and conducted. The
objective of this project was to identify those elements—
this has been met. Findings suggest the importance for a
longitudinal study, analyzing the effects of behavior
modification directed at reducing the level of arboallergens
in the home, thereby reducing the risk of exposure to
allergenic substances. The Barbadian environment presents
with features quite different than those seen in temperate
locales, necessitating a preventative protocol designed
specifically for that population. Clearly, chemical pest
control is a reactive means of control; preventative means
are required to tackle the increasing incidence of asthma in
developing countries.
In summary, the ramifications of these findings are
crucial to Barbadians and, for that matter, any atopic
individual residing in a tropical environment undergoing
urbanization and modernization. The house dust mite
continues to pose a threat to asthmatics, and there is no
evidence to support a possible reduction in the source of
that allergen in the last two decades. In general, the

397
extreme allergenicity of arthropods and the potential for
cross-reactivity, coupled with the already favorable macro¬
habitat (temperature, humidity, density of homan
populations) and the ever-improving micro-habitat (such as
moisture in the home, synthetic fibers, reduced ventilation)
will certainly continue to play a role in the increasing
prevalence of asthma among tropical inhabitants.

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BIOGRAPHICAL SKETCH
Kathleen Carole Barnes was born in Akron, Ohio, October
27, 1960, and spent most of her childhood in Danville, VA. In
1979 she entered James Madison University, Harrisonburg, VA,
as a music major, and studied the flute for three years,
before transferring to the Medical College of Virginia in
Richmond, where she completed her B.S.N. in 1984. She worked
for two years at the MCV Hospitals in maternal-child health,
before entering the University of Florida, Gainesville, in
pursuit of her Ph.D. in biocultural anthropology. During her
graduate studies, she worked part-time in maternal-child
health nursing at Shands Teaching Hospital, taught a part-time
nursing course at the Santa Fe Community College, and
functioned as a graduate assistant at the Medical and
Veterinary Entomology Research Laboratory, USDA/ARS. During
the summer of 1988, Barnes conducted a pilot study on allergy
in the Dominican Republic, where she studied Spanish. During
her studies in Barbados, she traveled much of the Eastern
Caribbean. Her areas of specialization are vector-borne
disease, allergy, and Caribbean health issues. For leisure,
she enjoys scuba diving, music, and photography. After
graduating she will begin a postdoctorate position in the
Department of Medicine at Johns Hopkins University, Baltimore.
422

I certify that I have read this study and that in my
opinion it conforms to acceptable standards of scholarly
presentation and is fully adequate, in scope and quality, as
a dissertation for the degree of Doctor of Philosophy.
>rald Murray',
Associate
Anthropology
Chair
rofessor
of
I certify that I have read this study and that in my
opinion it conforms to acceptable standards of scholarly
presentation and is fully adequate, in scope and quality, as
a dissertation for the degree of Doctor of Philosophy.
¿¡/6,6 AmaLi
George Armelagos, *
Professor of Anthropology
I certify that I have read this study and that in my
opinion it conforms to acceptable standards of scholarly
presentation and is fully adequate, in scope and quality, as
a dissertation for the degree of Doctor of Philosophy.
CA WVclIfiL-
Linda Wolfe
Associate Professor of
Anthropology
I certify that I have read this study and that in my
opinion it conforms to acceptable standards of scholarly
presentation and is fully adequate, in scope and quality, as
a dissertation for the degree of Doctor of Philosophy.
Jit
Leslie Sue Lieberman,
Associate Professor
Anthropology
of
I certify that I have read this study and that in my
opinion it conforms to acceptable standards of scholarly
presentation and is fully adequate, in scope and quality, as
a dissertation for the degree of Doctor of Philosophy.
Entomology and Nematology

I certify that I have read this study and that in my
opinion it conforms to acceptable standards of scholarly
presentation and is fully adequate, in scope and quality, as
a dissertation for the degree of Doctor of Philosophy.
Richard Patterson,
Professor of Entomology
Nematology
and
This dissertation was submitted to the Graduate Faculty
of the Department of Anthropology in the College of Liberal
Arts and Sciences and to the Graduate School and was accepted
as partial fulfillment of the requirements for the degree of
Doctor of Philosophy.
December, 1992

UNIVERSITY OF FLORIDA
3 1262 07332 017 7




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