Effect of improved home ventilation on asthma control and house dust mite allergen levels

Wright, G.R.; Howieson, Stirling; McSharry, Charles; McMahon, Alex D.; Chaudhuri, Rekha; Thompson, J.R.; Donnelly, Iona; Brooks, Richard; Lawson, Alan; Jolly, Lisa; McAlpine, Lawrence G.; King, Eva-Maria; Chapman, Martin D.; Wood, Stuart F; Thomson, Neil C.

doi:10.1111/j.1398-9995.2009.02098.x

Cited by 55 publications

(51 citation statements)

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“…Aspergillus/Penicillium and Cladosporium were the most frequent fungi identified, 507 which corresponds to other studies (Flannigan et al, 2011 Cladosporium, which is an abundant outdoor fungus (Flannigan et al, 2011 properties (Verdier et al, 2014), as well as temperature and moisture levels 558 (Johansson et al, 2013), which modifies the growth of different hydrophilic and 559 xerophilic fungi (Flannigan et al, 2011 Tracking allergenic fungi with monoclonal antibodies 25 in a previous study (Wright et al, 2009 questionnaires to obtain demographic, health and behavioural data, which may 587 reduce bias when compared to self-reported questionnaires, although both methods…”

supporting

confidence: 53%

“…This with water leaks for example (Gent et al, 2002). Only a subset of these organisms 542 infiltrating the indoor environment are capable of finding suitable growth conditions , 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 Tracking allergenic fungi with monoclonal antibodies 24 which will lead to the re-suspension of spores and hyphae should surfaces become 544 contaminated with fungi (Adams et al, 2013 and physical properties (Verdier et al, 2014), as well as temperature and moisture 548 levels (Johansson et al, 2013), which modifies the growth of different hydrophilic and 549 xerophilic fungi (Flannigan et al, 2011 in a previous study (Wright et al, 2009 …”

mentioning

confidence: 99%

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Identifying risk factors for exposure to culturable allergenic moulds in energy efficient homes by using highly specific monoclonal antibodies

Sharpe

Cocq

Nikolaou

et al. 2016

Environmental Research

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confidence: 53%

mentioning

confidence: 99%

Identifying risk factors for exposure to culturable allergenic moulds in energy efficient homes by using highly specific monoclonal antibodies

Sharpe

Cocq

Nikolaou

et al. 2016

Environmental Research

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“…10 A recent randomised controlled trial (RCT) of home ventilation demonstrated an improvement in evening peak flow readings in adults, and concluded that there may be some merit in considering ventilation in the bedrooms of children with asthma. 11 In short, empirical evidence that investment in housing benefits health is promising but limited. [12][13][14][15][16][17] This randomised controlled trial aimed to strengthen this evidence by evaluating the effectiveness and cost-effectiveness of installing ventilation systems, and improving central heating if necessary, in the homes of children with moderate or severe asthma.…”

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confidence: 99%

Enhancing ventilation in homes of children with asthma: pragmatic randomised controlled trial

et al. 2011

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BackgroundFew robust studies have tested whether enhancing housing also improves health. AimTo evaluate the effectiveness of installing ventilation systems, and central heating where necessary, in the homes of children with moderate or severe asthma. Design and settingPragmatic randomised controlled trial (RCT) in homes within Wrexham County Borough, Wales, UK. MethodA pragmatic RCT was carried out, of a tailored package of housing improvements providing adequate ventilation and temperature, following inspection by a housing officer. One hundred and ninety-two children with asthma aged 5 to 14 years, identified from general practice registers, were randomised to receive this package, either immediately or a year after recruitment. At baseline, and after 4 and 12 months, parents reported their child's asthma-specific and generic quality of life, and days off school. ResultsThe package improved parent-reported asthmaspecific quality of life significantly at both 4 and 12 months. At 12 months, this showed an adjusted mean difference between groups of 7.1 points (95% confidence interval [CI] = 2.8 to 11.4, P = 0.001): a moderate standardised effect size of 0.42. The generic quality-of-life scale showed reported physical problems were significantly reduced at 4 months, but not quite at 12 months, when the mean difference was 4.5 (95% CI = -0.2 to 9.1, P = 0.061). The improvement in psychosocial quality of life at 12 months was not significant, with a mean difference of 2.2 (95% CI = -1.9 to 6.4, P = 0.292). Parent-reported school attendance improved, but not significantly. ConclusionThis novel and pragmatic trial, with integrated economic evaluation, found that tailored improvement of the housing of children with moderate to severe asthma significantly increases parent-reported asthma-related quality of life and reduces physical problems. Collaborative housing initiatives have potential to improve health.

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“…Nevertheless, there is some evidence that improving home ventilation and heating may be beneficial in managing childhood asthma. 3,4 In the only comprehensive published study of the economics of housing modification to improve health, Chapman et al used costbenefit analysis alongside a randomised trial to show that retrofitting houses in New Zealand with insulation yielded benefits worth up to twice the cost. 5 More than one in 10 children between the ages of 5 and 14 years in the UK has asthma, and it is the most common longterm medical condition in children.…”

Section: Introductionmentioning

confidence: 99%

Enhancing ventilation in homes of children with asthma: cost-effectiveness study alongside randomised controlled trial

et al. 2011

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BackgroundThere has been little rigorous economic analysis of the relationship between asthma and improved housing. AimTo evaluate the cost-effectiveness of installing ventilation systems, and central heating if necessary, in homes of children with 'moderate' or 'severe' asthma. Design and settingAn incremental cost-effectiveness analysis alongside a pragmatic randomised controlled trial of a tailored package of housing modifications designed to improve ventilation and household heating in homes within Wrexham County Borough, Wales, UK. MethodA total of 177 children aged between 5 and 14 years, identified from general practice registers, were studied. Parents reported on the quality of life of their children over a 12-month period. General practices reported on healthservice resources used by those children, and their asthma-related prescriptions, over the same period. ResultsThe tailored package shifted 17% of children in the intervention group from 'severe' to 'moderate' asthma, compared with a 3% shift in the control group. The mean cost of these modifications was £1718 per child treated or £12 300 per child shifted from 'severe' to 'moderate'. Healthcare costs over 12 months following randomisation did not differ significantly between intervention and control groups. Bootstrapping gave an incremental cost-effectiveness ratio (ICER) of £234 per point improvement on the 100-point PedsQL ™ asthma-specific scale, with 95% confidence interval (CI) = £140 to £590. The ICER fell to £165 (95% CI = £84 to £424) for children with 'severe' asthma. ConclusionThis novel and pragmatic trial, with integrated economic evaluation, reported that tailored improvement of the housing of children with moderate to severe asthma is likely to be a costeffective use of public resources. This is a rare example of evidence for collaboration between local government and the NHS.

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Effect of improved home ventilation on asthma control and house dust mite allergen levels

Abstract: The addition of MHRV to house dust mite eradication strategies did not achieve a reduction in mite allergen levels, but did improve evening PEF.

Cited by 55 publications

References 27 publications

Identifying risk factors for exposure to culturable allergenic moulds in energy efficient homes by using highly specific monoclonal antibodies

Identifying risk factors for exposure to culturable allergenic moulds in energy efficient homes by using highly specific monoclonal antibodies

Enhancing ventilation in homes of children with asthma: pragmatic randomised controlled trial

Enhancing ventilation in homes of children with asthma: cost-effectiveness study alongside randomised controlled trial

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