L. Gard

The impact of home cleaning on quality of life for homes with asthmatic children

Treatment with common household bleach containing hypochlorite destroys dust mites and denatures protein allergens. The purpose of this study was to determine if home use of hypochlorite products results in lowered exposure to bacteria, fungi, and protein allergens and improved quality of life (QOL) for asthmatic persons in the home. Asthmatic and nonasthmatic households containing at least three persons (between 2 and 17 years of age) were recruited. Households were supplied one of three sets of cleaning products (regular products, some containing hypochlorite; regular products plus three additional products with dilute hypochlorite; control, no products). Participants were supplied with cleaning instructions and asthma education. The control group was instructed to clean as usual. Participants completed general health and QOL questionnaires. Asthmatic participants completed an additional asthma QOL questionnaire. Families participated in the study for 8 weeks and completed the full set of questions every 2 weeks. Homes were visited at the beginning of the study and twice thereafter at monthly intervals. Samples evaluated were surface bacteria, viable and nonviable airborne spores, and dust antigen content. Reductions in surface bacteria, airborne fungal spores, and dust antigen levels were achieved. Significant improvement in general health parameters was seen for the asthmatic product groups over the control group. Significant improvement in general QOL and asthma-specific QOL was seen in the asthmatic group. Emphasis on cleaning and cleaning education combined with hypochlorite-based cleaning supplies resulted in significantly improved QOL for families with asthmatic children.

Low-cost interventions improve indoor air quality and children's health.

Intervention in the home environment to reduce asthma triggers theoretically improves health outcomes for asthmatic children. Practical benefit from application of these interventions has proven difficult. This single-blind study tested the effectiveness of simple low-cost home interventions in improving health scores of children with asthma. Families with at least one asthmatic child were recruited. Initial health examination, health, and home assessments were conducted and targeted interventions were implemented. Interventions included dehumidification, air filtration, furnace servicing, and high-efficiency furnace filters. When present, gross fungal contamination was remediated. Asthma education was provided along with education in healthy home practices. Follow-up assessments were conducted after 6 months. Health surveys were completed at enrollment and follow-up. This study enrolled 219 children with asthma. Home inspections and interventions were conducted in 181 homes and 83 families completed all phases. Reduction in asthma and allergy-related health scores was shown in follow-up health surveys. Health improvements were significant for cough when heating, ventilation, and air conditioning (HVAC) service and dehumidification were used. Breathing problems were significantly improved for dehumidification, HVAC service, and room air cleaners. Total dust allergen load was reduced for the dehumidification group (p < 0.05). Mold spore counts were reduced one order of magnitude in 25% of the homes. Indoor spore counts adjusted for outdoor spore levels were reduced overall (p < 0.01). Simple low-cost interventions directed to producing cleaner indoor air coupled with healthy home education improve the indoor air quality and health in asthmatic children.

Comparison of allergens collected from furnace filters and vacuum floor dust

The ideal determinant of allergen exposure would be knowing the specific types and amounts of allergen material deposited in the airways during any period.1 Because this is impractical, proxies for exposure determination have been used. In homes with forced-air heating ventilation and air conditioning, all air is passed through the system approximately once every hour.2 The filter in that system should collect a representative sample of airborne allergens. We previously reported that dust from high-efficiency furnace filters (FFs) contains substantial amounts of aeroallergen.3 In the present report, we describe the relation of FF allergens to allergen levels obtained from floor dust. We hypothesized that measuring allergens in FFs would provide a different assessment of exposure than floor or bedroom dust collection. FQT12 1-inch disposable FFs were provided by Allergy Zone (Louisville, Kentucky). Antibodies and immunoassay standards were obtained from Indoor Biotechnologies (Chantilly, Virginia) and Greer Laboratories (Lenoir, North Carolina). Assays followed protocols described previously.3,4 Human subject aspects were approved by the institutional review board of the Children’s Mercy Hospital (Kansas City, Missouri). The collection of dust from FFs, HEPA vacuums (HVs), and children’s bedroom floors (CRs) has been described previously.3,5 Briefly, dust was removed from the HV or vacuumed from the CR or the FF using a HEPA unit with an x-cell-100 filter (Midwest Filtration, Cincinnati, Ohio). Levels of Der f 1 and Der p 1 are presented as the sum of dust mite allergens. Results are displayed as nanograms per gram of dust. Descriptive and comparative statistics were generated using SPSS software (IBM Corporation. Armonk, New York). Correlation coefficients were by the Spearman rank correlation equation performed in SPSS. Demographics for homes in this study have been previously reported.3,5 All had forced-air heating ventilation and air conditioning systems. For this dataset, 54 homes were included in the FF data; 47 of those homes also had determination of allergen levels in dust taken from the HV, and 35 homes had allergen data from all 3 types of dust collected. Reasons for missing data points varied from insufficient quantity of dust collected to hurried appointments because of occupant requirements.