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REDUCTION IN ASTHMA MORBIDITY IN CHILDREN AS A RESULT OF HOME REMEDIATION AIMED AT MOISTURE SOURCES
Citation:
KERCSMER, C. M., D. G. DEARBORN, M. SCHLUCHTER, L. XUE, L. KIRCHNER, J. SOBOLEWSKI, S. J. GREENBERG, AND S. J. VESPER. REDUCTION IN ASTHMA MORBIDITY IN CHILDREN AS A RESULT OF HOME REMEDIATION AIMED AT MOISTURE SOURCES. ENVIRONMENTAL HEALTH PERSPECTIVES. National Institute of Environmental Health Sciences (NIEHS), Research Triangle Park, NC, 114(8):1574-1580, (2006).
Impact/Purpose:
1. Develop and publish a standard method or guidance document for QPCR analysis of microorganisms in environmental samples (air and water filtrates and dust).a standard method or guidance document for QPCR analysis of microorganisms in environmental samples (air and water filtrates and dust). Publication will involve a consensus standards organization. 2. Use QPCR methods to monitor childhood exposures to mold as a part of field studies, in order to establish whether a relationship exists between molds encountered in indoor environments and asthma-related health problems.
Description:
Objective: Home dampness, presence of mold and allergens have been associated with asthma morbidity. We examined changes in asthma morbidity in children as a result of home remediation aimed at moisture sources.
Design: Prospective, randomized controlled trial.
Participants: Symptomatic, asthmatic children (n=62), aged 2-17 years, living in a home with indoor mold.
Measurements: All participants received an asthma intervention including an action plan, education, and individualized problem solving. The remediation group received household repairs including reduction of water infiltration, removal of water damaged building materials, and HVAC alterations. The control group received only home cleaning information. We measured total and allergen-specific serum IgE, peripheral blood eosinophil counts, and urinary cotinine. Environmental dust samples were analyzed for dust mite, cockroach, rodent urinary protein, endotoxin and fungi. Follow-up period was for one year.
Results: Children in both groups showed improvement in asthma symptomatic days during the pre-remediation portion of the study. The remediation group had a significant decrease in symptom days (p=0.003, as randomized; p= 0.004, intent to treat) following remodeling while these parameters in the control group did not significantly change. In the post-remediation period, the remediation group had a lower rate of exacerbations compared to control asthmatics (1/29 vs. 11/33, respectively, p=0. 003, as-treated; 28.1% and 10.0% respectively, p=.11, intent to treat)
Conclusion: Construction remediation aimed at the root cause of moisture sources and combined with a medical/ behavioral intervention significantly reduces symptom days and health care utilization for asthmatic children who live in homes with a documented mold problem.
