Reduction in Asthma Morbidity in Children as a Result of Home Remediation Aimed at Moisture Sources - (EHP paper from October 2006 issue)

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Reduction in Asthma Morbidity in Children as a Result of Home

Remediation Aimed at Moisture Sources

Environmental Health Perspectives Volume 114, Number 10, October 2006

Carolyn M. Kercsmar, Dorr G. Dearborn, Mark Schluchter,Lintong Xue,

H. Lester Kirchner, Sobolewski, Stuart J. Greenberg, J.

Vesper and Terry Allan

PDF Version:

http://www.ehponline.org/members/2006/8742/8742.pdf

Abstract

Objective: Home dampness and the 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: In this prospective, randomized controlled trial, symptomatic,

asthmatic children (n = 62) , 2–17 years of age, living in a home with

indoor mold, received an asthma intervention including an action plan,

education, and individualized problem solving. The remediation group

also received household repairs, including reduction of water

infiltration, removal of water-damaged building materials, and

heating/ventilation/air-conditioning alterations. The control group

received only home cleaning information. We measured children's total

and allergen-specific serum immunoglobulin E, peripheral blood

eosinophil counts, and urinary cotinine. Environmental dust samples

were analyzed for dust mite, cockroach, rodent urinary protein,

endotoxin, and fungi. The follow-up period was 1 year.

Results: Children in both groups showed improvement in asthma

symptomatic days during the preremediation 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) after remodeling,

whereas these parameters in the control group did not significantly

change. In the postremediation period, the remediation group had a

lower rate of exacerbations compared with control asthmatics (as

treated: 1 of 29 vs. 11 of 33, respectively, p = 0. 003 ; intent to

treat: 28.1% and 10.0%, respectively, p = 0.11) .

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 use for asthmatic

children who live in homes with a documented mold problem.

Key words: asthma, children, damp housing, home remediation, indoor

mold. Environ Health Perspect 114: 1574–1580 (2006) .

doi:10.1289/ehp.8742 available via http://dx.doi.org/ [Online 25 April

2006]