Home environmental intervention in inner-city asthma: a randomized controlled clinical trial

Eggleston, Peyton A.; Butz, Arlene; Rańd, Cynthia S.; Curtin-Brosnan, Jean; Kanchanaraksa, Sukon; Swartz, Lee; Breysse, Patrick N.; Buckley, Timothy J.; Diette, Gregory B.; Merriman, Barry; Krishnan, Jerry A.

doi:10.1016/s1081-1206(10)61012-5

Cited by 186 publications

(200 citation statements)

References 31 publications

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“…Multifaceted allergen and irritant avoidance measures were found to inconstantly reduce asthma symptoms in a group of children living in poverty areas who were often inadequately treated (1440)(1441)(1442)(1443). No effect on rhinitis was reported.…”

Section: Inhalant-allergen Avoidancementioning

confidence: 94%

Allergic Rhinitis and its Impact on Asthma (ARIA) 2008*

Bousquet¹,

Khaltaev²,

Cruz³

et al. 2008

Allergy

3,749

1,753

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Section: Inhalant-allergen Avoidancementioning

confidence: 94%

Allergic Rhinitis and its Impact on Asthma (ARIA) 2008*

Bousquet¹,

Khaltaev²,

Cruz³

et al. 2008

Allergy

3,749

1,753

View full text Add to dashboard Cite

“…[9][10][11][12][13][14][15] Few have significantly reduced ED utilization. This leads us to ask: are there reasons for asthma-related ED use that prior interventions have not addressed?…”

mentioning

confidence: 99%

“No Other Choice”: Reasons for Emergency Department Utilization Among Urban Adults With Acute Asthma

Lawson

Carroll

Gonzalez

et al. 2014

Academic Emergency Medicine

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Objectives: Asthma is considered "ambulatory care-sensitive," yet emergency department (ED) visits remain common. Few studies have examined how ED asthma patients choose their sites of urgent care. The authors explored reasons for asthma-related ED use among adults.Methods: From May to September 2012, semistructured qualitative interviews were conducted with a convenience sample of patients visiting a high-volume urban ED for asthma. A piloted interview guide was used; it had open-ended questions derived from clinical experience and a focus group of asthmatic adults who frequently use the ED for care. Interviews were conducted until theme saturation was reached. Interview transcripts and field notes were entered into NVivo 10 and double-coded, using an iterative process to identify patterns of responses, ensure reliability, examine discrepancies, and achieve consensus through content analysis.

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“…In a multifaceted trial to reduce indoor pollutants that included portable HEPA air cleaners, Morgan et al 28 reported a 13.6% reduction in the number of unscheduled visits attributable to asthma and a significant reduction in asthma symptoms. In a trial of multiple environmental interventions that included HEPA air cleaners, Eggleston et al 29 reported a significant improvement in asthma symptoms but no difference in unscheduled asthma visits according to group assignment. In a trial to reduce exposures to indoor asthma triggers among inner-city children that did not include portable air cleaners, Krieger et al 41 reported a 15% reduction in unscheduled asthma visits but no significant improvement in asthma symptoms.…”

Section: Discussionmentioning

confidence: 99%

“…Other trials incorporated HEPA air cleaners to reduce environmental triggers among children with asthma, but it was not possible to quantify the specific contribution of the air cleaners because the studies involved multiple environmental interventions. 28,29 We speculated that children with asthma who were exposed to SHS would particularly benefit by using air cleaners. The purpose of this double-blind, randomized trial was to test the efficacy of HEPA air cleaners in reducing unscheduled asthma visits, asthma symptoms, and SHS exposure among children with asthma.…”

mentioning

confidence: 99%

Effects of HEPA Air Cleaners on Unscheduled Asthma Visits and Asthma Symptoms for Children Exposed to Secondhand Tobacco Smoke

2010

PEDIATRICS

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WHAT'S KNOWN ON THIS SUBJECT:Exposure to secondhand smoke (SHS) is associated with asthma exacerbations in children. Anticipatory guidance has failed to reduce SHS in controlled trials. It is not known whether high-efficiency, particlearresting (HEPA) air cleaners can reduce SHS or improve asthma symptoms in children. WHAT THIS STUDY ADDS:HEPA air cleaners led to reductions in unscheduled asthma visits and fine airborne particle levels but not asthma symptoms or cotinine levels. HEPA air cleaners may be useful as part of a multifaceted strategy to reduce asthma morbidity among children. abstract OBJECTIVE:The goal was to test the effects of high-efficiency, particulatearresting (HEPA) air cleaners on unscheduled asthma visits and symptoms among children with asthma exposed to secondhand smoke. METHODS:We enrolled 225 eligible children who were 6 to 12 years of age, had physician-diagnosed asthma, and were exposed to Ն5 cigarettes per day. We conducted a double-blind, randomized trial. Children were assigned randomly to receive 2 active or inactive HEPA air cleaners. RESULTS:Of 225 enrolled children, 110 (49%) were assigned to the intervention group and 115 (51%) to the control group; 215 (95%) completed the trial. During the trial, there were 42 fewer unscheduled asthma visits among children in the intervention group (18.5% [95% confidence interval: 1.25%-82.75%]; P ϭ .043), compared with those in the control group, after adjustment for baseline differences. There was a significant difference in the reductions of levels of particles of Ͼ0.3 m according to group assignment; there was a 25% reduction in particle levels in the intervention group, compared with a 5% reduction in the control group (P ϭ .026). There were no significant differences in parent-reported asthma symptoms, exhaled nitric-oxide levels, air nicotine levels, or cotinine levels according to group assignment. CONCLUSIONS:These results hold promise for using HEPA air cleaners as part of a multifaceted strategy to reduce asthma morbidity, but further research is necessary before they can be recommended routinely for the medical management of asthma.

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Home environmental intervention in inner-city asthma: a randomized controlled clinical trial

Cited by 186 publications

References 31 publications

Allergic Rhinitis and its Impact on Asthma (ARIA) 2008*

Allergic Rhinitis and its Impact on Asthma (ARIA) 2008*

“No Other Choice”: Reasons for Emergency Department Utilization Among Urban Adults With Acute Asthma

Effects of HEPA Air Cleaners on Unscheduled Asthma Visits and Asthma Symptoms for Children Exposed to Secondhand Tobacco Smoke

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