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Asthma Control Research Cuts Doctors Visits By More Than Two Thirds
November 12, 2001Asthma sufferers made two-thirds fewer visits to their doctor's for help with their condition and significantly reduced their prescription drug use, after taking part in a four-year research programme designed by the University of Strathclyde to make their homes healthier.
Architects and engineers from the University's Department of Architecture and Building Science in association with experts in immunology, public health and respiratory medicine, started their research into ways to stop Britain's asthma pandemic after growing evidence pointed to a link between dust-mites and the illness. Researchers realised that as houses become warmer and damper, and water vapour levels increase, they become perfect environments for house dust mites to live and breed in carpets, soft furnishings and bedding.
The researchers strategy to dry out houses in winter using the drier air to inhibit dust mite activity meant that recolonisation each summer was slower. But rather than limiting themselves to looking at ways of reducing dust mite levels as other, earlier research projects have done, they focussed on getting rid of dust-mite droppings and their associated allergens.
Dust-mite droppings are known to contain ten active allergenic proteins - and an average dust-mite will excrete 60 times its own body weight in droppings during its lifetime. Cutting the dust-mite population is paramout - and the Strathclyde research achieved this by steam cleaning the carpets, providing new bedding and increasing ventilation rates to inhibit re-colonisation. Extracting warm moist air and replacing it with pre-warmed dry fresh air inhibits dust mite activity as fallen-off human skin scales become indigestible to the dust-mites who starve and die.
The World Health Organisation suggests a safety threshold of 2 micro-grams of allergenic protein per gram of house dust. Once above this level the amount of allergens in the droppings is likely to sensitise residents and trigger asthma. If that threshold reaches 10 micro grams per gram of house dust, there is an increased risk of severe allergic reactions.
The homes of 68 asthmatics in North Lanarkshire were studied - 45 dwellings in all. At the start of the Strathclyde project tests showed that:
* 78% of beds contained allergens above the WHO recommended level, with 56% above the upper threshold of 10 micro grams;
* more than 75% of bedroom carpets and beds contained allergens above the WHO recommended threshold, with 50% having concentrations above the upper threshold. One household had allergen levels more than 60 times greater than the upper threshold.
Half the homes were fitted with the mechanical heat recovery ventilation fans, had their carpets steam cleaned and were given new bedding in order to get rid of reduce the number of house-mites and make the environment drier and less appealing to the house dust mites. This active group was then compared with two control groups who did not receive a full range of measures.
Readings of temperature and humidity levels were taken automatically in each house every hour, while the level of allergens was measured every three months. Nine months after the intervention measures were put in place, only two out of the 28 dwellings in the active group were found to have allergen levels above the allergen safety threshold.
Patient's health records were studied over a four year period (2 years before and two years after the interventions) and the measures appear to have significantly reduced both the number of GP consultations and the quantity of prescription drugs inhaled. The group of patients who received all the measures reported by questionnaire that the air quality in their home was much improved and that their asthma had reduced in severity.
A second research phase is now at an advanced planning stage and will involve much more detailed clinical monitoring by a team of respiratory physicians from Glasgow University.
Stirling Howieson, Director of Strathclyde University's Centre for Environmental Design and Research, who led the work, said: "We had a hunch that Britain's soaring rates of asthma are linked to infestations of house-mites and their associated allergens - which in turn rely on warm, humid conditions in the home. This research project supports this view that our domestic environment plays a crucial role in the increasing incidence of asthma.
"As importantly our work shows that, with an investment of around £500 , most homes could become healthy places to live rather than triggering chronic ill-health. This in turn could quickly bring significant savings to the NHS - and a huge improvement to quality of life for asthmatics."
European Commission, Research Directorate
Dust-mite droppings are known to contain ten active allergenic proteins - and an average dust-mite will excrete 60 times its own body weight in droppings during its lifetime. Cutting the dust-mite population is paramout - and the Strathclyde research achieved this by steam cleaning the carpets, providing new bedding and increasing ventilation rates to inhibit re-colonisation. Extracting warm moist air and replacing it with pre-warmed dry fresh air inhibits dust mite activity as fallen-off human skin scales become indigestible to the dust-mites who starve and die.
The World Health Organisation suggests a safety threshold of 2 micro-grams of allergenic protein per gram of house dust. Once above this level the amount of allergens in the droppings is likely to sensitise residents and trigger asthma. If that threshold reaches 10 micro grams per gram of house dust, there is an increased risk of severe allergic reactions.
The homes of 68 asthmatics in North Lanarkshire were studied - 45 dwellings in all. At the start of the Strathclyde project tests showed that:
* 78% of beds contained allergens above the WHO recommended level, with 56% above the upper threshold of 10 micro grams;
* more than 75% of bedroom carpets and beds contained allergens above the WHO recommended threshold, with 50% having concentrations above the upper threshold. One household had allergen levels more than 60 times greater than the upper threshold.
Half the homes were fitted with the mechanical heat recovery ventilation fans, had their carpets steam cleaned and were given new bedding in order to get rid of reduce the number of house-mites and make the environment drier and less appealing to the house dust mites. This active group was then compared with two control groups who did not receive a full range of measures.
Readings of temperature and humidity levels were taken automatically in each house every hour, while the level of allergens was measured every three months. Nine months after the intervention measures were put in place, only two out of the 28 dwellings in the active group were found to have allergen levels above the allergen safety threshold.
Patient's health records were studied over a four year period (2 years before and two years after the interventions) and the measures appear to have significantly reduced both the number of GP consultations and the quantity of prescription drugs inhaled. The group of patients who received all the measures reported by questionnaire that the air quality in their home was much improved and that their asthma had reduced in severity.
A second research phase is now at an advanced planning stage and will involve much more detailed clinical monitoring by a team of respiratory physicians from Glasgow University.
Stirling Howieson, Director of Strathclyde University's Centre for Environmental Design and Research, who led the work, said: "We had a hunch that Britain's soaring rates of asthma are linked to infestations of house-mites and their associated allergens - which in turn rely on warm, humid conditions in the home. This research project supports this view that our domestic environment plays a crucial role in the increasing incidence of asthma.
"As importantly our work shows that, with an investment of around £500 , most homes could become healthy places to live rather than triggering chronic ill-health. This in turn could quickly bring significant savings to the NHS - and a huge improvement to quality of life for asthmatics."
European Commission, Research Directorate
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Women can usually keep using the same asthma drugs they were using before they got pregnant. Budesonide sprays are the best studied and can be regarded as safe.
Study shows school-based program enables children and adolescents to better manage chronic disease
A new study has found that a school-based asthma education program conducted in the Oakland, California school district was shown to reduce symptoms and increase the number of days that children who suffered from asthma were able to go to school.
Pregnant women with asthma can be more confident about some medicines
Women can usually keep using the same asthma drugs they were using before they got pregnant. Budesonide sprays are the best studied and can be regarded as safe.
Fall babies: Born to wheeze?
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Hospital visits for respiratory illnesses spiked during Southern California wildfires
Raging wildfires that engulfed Southern California earlier this decade not only destroyed neighborhoods laying in their path, they also caused significant health problems for many who lived outside the fires' reach.
The miseries of allergies just may help prevent some cancers, study finds
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Is ineffective esophageal motility associated with gastropharyngeal reflux disease?
IEM is associated with an increased acid clearance times in the distal esophagus. Gastropharyngeal reflux causes supraesophageal manifestations such as globus, chronic cough, hoarseness, asthma, chronic sinusitis, or other otorhinolaryngologic diseases.
Flu vaccination rates lag for at-risk adolescents
Influenza vaccination rates for adolescents who suffer from asthma and other illnesses are still far too low, according to a recent study.
Tweens and teens double use of diabetes drugs
America's tweens and teens more than doubled their use of type 2 diabetes medications between 2002 and 2005, with girls between 10 and 14 years of age showing a 166 percent increase. One likely cause: Obesity, which is closely associated with type 2 diabetes.
Researchers Apply Systems Biology and Glycomics to Study Human Inflammatory Diseases
An innovative systems biology approach to understanding the carbohydrate structures in cells is leading to new ways to understand how inflammatory illnesses and cardiovascular disease develop in humans. The work was described in two recent publications by University at Buffalo chemical engineers.
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