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Effect of mattress and pillow encasings on children with asthma and house dust mite allergy

      Abstract

      Background: House dust mite (HDM) allergy is a frequent cause of allergic asthma in children. Reduction of exposure seems to be the most logical way to treat these patients. Objective: Our aim was to investigate whether mattress and pillow encasings resulted in an effective long-term control of HDM allergen levels, thereby reducing the need for asthma medication in children with asthma and HDM allergy. Methods: In a prospective, double-blind, placebo-controlled study 60 children (age range, 6-15 years) with asthma and HDM allergy were randomized to active (allergy control) or placebo mattress and pillow encasings. After a 2-week baseline period, follow-up was performed every 3 months for 1 year. During the entire study period, the dose of inhaled steroids was tapered off to the lowest effective dose according to well-defined criteria. Results: Fifty-two patients completed the trial, and 5 were excluded, leaving data from 47 children (26 in the active treatment group and 21 in the placebo group) for analysis. A significant perennial reduction in HDM allergen concentrations was seen only for the active treatment group. Also, a significant decrease in the dose of inhaled steroids (mean, 408 to 227 μg/d; P < .001) was found for the active treatment group only, with significant differences between groups after 9 and 12 months. After 1 year, the dose of inhaled steroids was reduced by at least 50% in significantly more children in the active treatment group than in the placebo group (73% vs 24%, P < .01). Conclusion: Encasing of mattresses and pillows resulted in a significant long-term reduction in HDM allergen concentrations in mattresses and in the need for inhaled steroids in children with asthma and HDM allergy. (J Allergy Clin Immunol 2003;111:169-76.)

      Keywords

      Abbreviations:

      HDM (House dust mite), SPT (Skin prick test)
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      References

        • Peat JK
        • Tovey E
        • Toelle BG
        • Haby MM
        • Gray EJ
        • Mahmic A
        • et al.
        House dust mite allergens. A major risk factor for childhood asthma in Australia.
        Am J Respir Crit Care Med. 1996; 153: 141-146
        • Silvestri M
        • Oddera S
        • Rossi GA
        • Crimi P
        Sensitization to airborne allergens in children with respiratory symptoms.
        Ann Allergy Asthma Immunol. 1996; 76: 239-244
        • Boulet LP
        • Turcotte H
        • Laprise C
        • Lavertu C
        • Bedard PM
        • Lavoie A
        • et al.
        Comparative degree and type of sensitization to common indoor and outdoor allergens in subjects with allergic rhinitis and/or asthma.
        Clin Exp Allergy. 1997; 27: 52-59
        • Host A
        • Halken S
        The role of allergy in childhood asthma.
        Allergy. 2000; 55: 600-608
        • Wickman M
        • Nordvall SL
        • Pershagen G
        • Sundell J
        • Schwartz B
        House dust mite sensitization in children and residential characteristics in a temperate region.
        J Allergy Clin Immunol. 1991; 88: 89-95
        • Huss K
        • Adkinson Jr, NF
        • Eggleston PA
        • Dawson C
        • Van Natta ML
        • Hamilton RG
        House dust mite and cockroach exposure are strong risk factors for positive allergy skin test responses in the Childhood Asthma Management Program.
        J Allergy Clin Immunol. 2001; 107: 48-54
        • Vervloet D
        • Charpin D
        • Haddi E
        • N’guyen A
        • Birnbaum J
        • Soler M
        • et al.
        Medication requirements and house dust mite exposure in mite-sensitive asthmatics.
        Allergy. 1991; 46: 554-558
        • Sporik R
        • Platts-Mills TA
        • Cogswell JJ
        Exposure to house dust mite allergen of children admitted to hospital with asthma.
        Clin Exp Allergy. 1993; 23: 740-746
        • Owen S
        • Morganstern M
        • Hepworth J
        • Woodcock A
        Control of house dust mite antigen in bedding.
        Lancet. 1990; 335: 396-397
        • Ehnert B
        • Lau-Schadendorf S
        • Weber A
        • Buettner P
        • Schou C
        • Wahn U
        Reducing domestic exposure to dust mite allergen reduces bronchial hyperreactivity in sensitive children with asthma.
        J Allergy Clin Immunol. 1992; 90: 135-138
        • Weeks J
        • Oliver J
        • Birmingham K
        • Crewes A
        • Carswell F
        A combined approach to reduce mite allergen in the bedroom.
        Clin Exp Allergy. 1995; 25: 1179-1183
        • Carswell F
        • Oliver J
        • Weeks J
        Do mite avoidance measures affect mite and cat airborne allergens?.
        Clin Exp Allergy. 1999; 29: 193-200
        • Frederick JM
        • Warner JO
        • Jessop WJ
        • Enander I
        • Warner JA
        Effect of a bed covering system in children with asthma and house dust mite hypersensitivity.
        Eur Respir J. 1997; 10: 361-366
        • Shapiro GG
        • Wighton TG
        • Chinn T
        • Zuckrman J
        • Eliassen AH
        • Picciano JF
        • et al.
        House dust mite avoidance for children with asthma in homes of low-income families.
        J Allergy Clin Immunol. 1999; 103: 1069-1074
        • Cloosterman SG
        • Schermer TR
        • Bijl-Hofland ID
        • van der HS
        • Brunekreef B
        • Van Den Elshout FJ
        • et al.
        Effects of house dust mite avoidance measures on Der p 1 concentrations and clinical condition of mild adult house dust mite-allergic asthmatic patients, using no inhaled steroids.
        Clin Exp Allergy. 1999; 29: 1336-1346
        • Jirapongsananuruk O
        • Malainual N
        • Sangsupawanich P
        • Aungathiputt V
        • Vichyanond P
        Partial mattress encasing significantly reduces house dust mite antigen on bed sheet surface: a controlled trial.
        Ann Allergy Asthma Immunol. 2000; 84: 305-310
        • Vanlaar CH
        • Peat JK
        • Marks GB
        • Rimmer J
        • Tovey ER
        Domestic control of house dust mite allergen in children's beds.
        J Allergy Clin Immunol. 2000; 105: 1130-1133
        • Matthys H
        • Knoch M
        • Eltschka R
        A new aerosol device for bronchial provocation tests.
        Respiration. 1993; 60: 343-350
        • Custovic A
        • Woodcock A
        Clinical effects of allergen avoidance.
        Clin Rev Allergy Immunol. 2000; 18: 397-419
        • Tovey E
        • Marks G
        Methods and effectiveness of environmental control.
        J Allergy Clin Immunol. 1999; 103: 179-191
        • Arlian LG
        • Platts-Mills TA
        The biology of dust mites and the remediation of mite allergens in allergic disease.
        J Allergy Clin Immunol. 2001; 107: S406-S413
        • Gotzsche PC
        • Hammarquist C
        • Burr M
        House dust mite control measures in the management of asthma: meta-analysis.
        BMJ. 1998; 317: 1105-1110