Families can help relieve asthma symptoms in children by making simple changes at home. Researchers from the University of Arizona College of Medicine found that children who live in the inner city suffer an excess burden of illness and even die due to asthma. But by making a difference in the indoor environment, people can improve the health of children suffering from asthma. Such steps include using pillow covers that are impermeable to dust mites, and air purifiers to get rid of tobacco smoke, mold and cat or dog allergens. In their study, investigators used a multifaceted approach for 937 children, aged 5 to 11 years, with atopic or allergic asthma. The children were from inner-city areas in seven major cities across the US and were randomly assigned to an intervention group or a control group for comparison purposes. The children in the study group received up to seven home visits during the 12-month intervention period, during which their caretakers were taught how to create an environmentally safe sleeping zone, by using mattress, pillow and box spring covers that were impermeable to allergens. The intervention was also tailored to each child, as some caretakers were given specially equipped vacuum cleaners and air purifiers while others were given professional pest control to eliminate cockroach allergen. Children in the comparison group received four home visits during which their home environment was surveyed and dust allergens were collected. At each follow-up, children in the intervention group reported experiencing asthma symptoms on fewer days during a two-week period than those in the comparison group. This greater reduction in asthma symptoms persisted for 12 months after the intervention period, for a total of two years. Overall, children in the intervention group experienced about 34 fewer days with wheeze during a two-year period than did their peers in the comparison group. Altogether, the indoor environmental changes resulted in nearly 14 per cent fewer unscheduled visits to the emergency department or clinic, 20 per cent fewer days with symptoms, and 21 per cent fewer missed school days per year for children in the intervention group. Researchers emphasize that controlling indoor asthma triggers is not a substitute for standard asthma therapy. Instead, changes to the indoor environment should be done in conjunction with standard treatments. Anti-inflammatory medicine is key in any child with persistent symptoms and it should be continued once the symptoms are under control to prevent their recurrence. The study has, however, shown that creating a safe home environment is also an important part of asthma management.
New England Journal of Medicine,
September 2004