A program that targets allergens and tobacco smoke in the home resulted in fewer asthma symptoms in children participating in the intervention than in those who were not, according to a new study sponsored by the National Institutes of Health (NIH) in seven metropolitan areas nationwide.
Children taking part in the intervention had 21 fewer days of asthma symptoms over the one-year course of intervention.
The study—co-funded by the National Institute of Allergy and Infectious Diseases (NIAID) and the National Institute of Environmental Health Sciences (NIEHS), two NIH Institutes—appears in the September 9th issue of The New England Journal of Medicine.
“The burden that childhood asthma places on our society is enormous,” says Anthony S. Fauci, M.D., director of NIAID. “For the millions of children living with asthma, this important research demonstrates that taking practical steps can achieve long-term benefits in the form of better quality of life, fewer emergency room visits and lower healthcare costs.”
“These study results are exciting because they show that changes made in the home environment can produce a reduction in symptoms comparable to that achieved with asthma inhalers,” notes Kenneth Olden, Ph.D., director of NIEHS.
Asthma, a chronic lung disease characterized by coughing, wheezing and difficulty breathing, affects roughly 20 million Americans. Children who live in the inner city—in particular African-American and Hispanic children—suffer disproportionately from the disease. Increased asthma symptoms in this population may stem from exposure to high levels of multiple indoor allergens and tobacco smoke.
More than 900 children ages 5 to 11 with moderate to severe asthma participated in the study. Each participant had to be allergic to at least one common indoor environmental allergen, such as cockroach allergen or house dust mite allergen. The children, most of whom were African American or Hispanic, lived in low-income sections of seven major metropolitan areas—the Bronx, Boston, Chicago, Dallas, Manhattan, Seattle/Tacoma and Tucson. Once accepted into the study, they were randomly assigned to either the intervention group or a control group.
Based on the child’s sensitivity to the selected indoor allergens and evidence of exposures at home to known asthma triggers, investigators designed an individualized environmental intervention, carried out by the child’s mother or another caretaker. The intervention focused on educating the family about ways to reduce or eliminate all allergens to which the child was allergic, as well as to reduce exposure to tobacco smoke, and motivating them to pursue these steps. The investigators developed separate interventions tailored to tobacco smoke and to the following allergens—house dust mite, cockroach, pet, rodent and mold.