Good reason to clean house? Home-based interventions reduce the toll of pediatric asthma

It's time to learn your airborne allergens! Home-based environmental interventions can improve the health of inner-city children who suffer moderate or severe asthma, according to the National Institute of Allergy and Infectious Diseases (NIAID) of the National Institutes of Health. Findings of research on a study group of children 5 to 11 years old-sponsored by NIAID and the National Institute of Environmental Health Sciences (NIEHS) and published in the November issue of the Journal of Allergy and Clinical Immunology-show that home-based environmental intervention decreases allergen levels in the home and reduce the severity of asthma symptoms. As for the cost of such a program, the data show that, first, the price tag would be substantially lower if these interventions were implemented in a community setting and, second, they are as cost-effective as many drug interventions.

Six major classes of allergen trigger asthma symptoms: dust mites, cockroaches, pet dander, rodents, passive smoking, and mold. All were targets of the study. Environmental interventions were tailored to each child's sensitivity to the selected allergens and evidence of exposure to these asthma triggers.

Researchers conducted educational home visits that included specific measures for reducing or eliminating allergen levels inside the home. The result was a significant improvement in health status and an overall reduction in the use of medical resources among asthmatic children. Specifically, children in homes that received the intervention had 19% fewer unscheduled medical visits, a 13% reduction in the use of an albuterol inhaler, and on average, 38 more symptom-free days over the course of the study than subjects in the control group.

"While the interventions were clearly effective in reducing asthma symptoms, we wanted to know whether the measures were cost-effective," said Meyer Kattan, MD, a pediatric pulmonologist with the Mount Sinai School of Medicine in New York City and lead author of the study.

The study was part of the larger Inner-City Asthma Study and comprised more than 900 children with moderate or severe asthma. Most were African-American or Hispanic and live in low-income sections of seven urban areas-the Bronx in New York City, Boston, Chicago, Dallas, Manhattan, Seattle-Tacoma, and Tucson. Each child selected for the intervention was allergic to at least one common indoor allergen.