Susan Eick

Investigation of different approaches to reduce allergens in asthmatic children's homes - The Breath of Fresh Air Project, Cornwall, United Kingdom.

During 2001 to 2004, a study was conducted to assess the indoor environmental and health impact of installing allergen-reducing interventions in the homes of asthmatic children. Based on the results of a pilot study, to determine an intervention that would provide improved symptom scores and a reduction in house dust mite allergen (Der p 1), mechanical ventilation and heat recovery (MVHR) systems were installed in 16 homes. Environmental and respiratory health assessments were conducted before and after the installation of the MVHR systems. The results indicated that the installation of MVHR systems reduced Der p 1 concentrations in living room carpets and mattresses. There were significant reductions in symptom scores for breathlessness during exercise, wheezing, and coughing during the day and night. Although, there was not a parallel control group for the main study, the lack of change in the pilot study control group (who did not receive an intervention), indicated that the changes in symptom scores were in part to do with the intervention. Larger scale trials are needed to determine the efficacy of MVHR systems in homes to improve indoor air quality and reduce asthma symptoms.

Costs of the police service and mental healthcare pathways experienced by individuals with enduring mental health needs

Background Substantial policy, communication and operational gaps exist between mental health services and the police for individuals with enduring mental health needs. Aims To map and cost pathways through mental health and police services, and to model the cost impact of implementing key policy recommendations. Method Within a case-linkage study, we estimated 1-year individual-level healthcare and policing costs. Using decision modelling, we then estimated the potential impact on costs of three recommended service enhancements: street triage, Mental Health Act assessments for all Section 136 detainees and outreach custody link workers. Results Under current care, average 1-year mental health and police costs were £10 812 and £4552 per individual respectively (n = 55). The cost per police incident was £522. Models suggested that each service enhancement would alter per incident costs by between −8% and +6%. Conclusions Recommended enhancements to care pathways only marginally increase individual-level costs.

Designing a simple tool kit and protocol for the investigation of the indoor environment in homes

Monitoring indoor environments can be complicated, time consuming and expensive. The objective of this study was to pinpoint indoor environmental variables that are essential for providing an assessment of the condition of the indoor environment in homes. The Statistical Package for Social Statistics was used to conduct principal component analysis on data from three existing housing and health studies - two UK studies using 38 (n 124 homes) and 49 (n 88 homes) variables and one Swedish study using 104 (n 60 homes) variables. The analyses highlighted 18 components, which represented the variables from all three studies. The 18 components were further reduced to 14 because of considerations of expense and time. The 14 components were: temperature; humidity; dampness; number of people; number of pets; dust mites; airborne microbes; plant related microbes; carbon dioxide (CO2); volatile organic compounds; particles; weather data; ventilation; and information about the dwelling. These components form the basis for an indoor assessment that can be used in environmental studies of people’s homes by non-environmental scientists.

Is England's Warm Front Programme Going to Improve the Country's Health?

There have been a number of initiatives in the UK to increase the energy efficiency of homes by offering improvements to thermal performance through grant schemes. Although the outcomes of these schemes are often linked to health, inherent problems in these schemes mean that is unlikely that there will be any measurable health outcomes.