Customised Programme Reduces Asthma Symptoms in Inner-City Children
Posted on: Saturday, 16 October 2004, 06:00 CDT
Customised programme reduces asthma symptoms in inner-city children Morgan W et al. Results of a home-based environmental intervention in urban children with asthma - The Inner City Asthma Study. New England Journal of Medicine 2004; 351, 11:1068-1080
An intervention programme targeting allergens and tobacco smoke in the home has resulted in fewer asthma symptoms in children participating in the intervention than in those who were not.
More than 900 children aged five to 11 with moderate to severe asthma living in low-income sections of seven metropolitan areas in America participated in the Inner City Asthma Study, an initiative comprising seven asthma study centres across the country. Each participant had to be allergic to at least one common indoor environmental allergen, such as cockroach allergen or house dust mite allergen.
Based on the child's sensitivity to the selected indoor allergens and evidence of exposures at home to known asthma triggers, an individualised environmental intervention was carried out by the child's mother or caretaker. This focused on educating the family about ways to reduce or eliminate all allergens to which the child was allergic, as well as reducing exposure to tobacco smoke. In addition, families were given specific allergen-reducing measures, such as allergen-impermeable covers for children's bedding and air purifiers with HEPA (high efficiency particulate air) filters, to be placed in key locations within their homes, including the children's bedrooms. Throughout the year-long study and the one-year follow- up, researchers closely monitored all participants' asthma symptoms and home allergen levels.
It was found that children who participated in the intervention had significantly fewer asthma symptoms compared with those in the control group: an average of 21 fewer days of symptoms in the first year and an average of 16 fewer days during the second, or follow- up year.
The benefits of the intervention occurred rapidly, with significant reductions in symptoms just two months after the study began. Furthermore, the researchers noted a direct correlation between allergen levels and asthma symptoms for the children in the intervention group: the greater the drop in cockroach or house clust mite allergen levels, the greater the reduction in asthma symptoms, suggesting that the allergy-reducing measures made the difference.
Children with asthma are usually sensitive to more than one allergen, say the researchers. By taking a multi-faceted, home- based approach, this study demonstrates the promising results families can achieve when they incorporate the recommended practices of allergen reduction into their everyday lives
Copyright TG Scott & Son Ltd. Oct 2004
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