Does a multifaceted environmental intervention alter the effect of asthma among inner-city children?

Abstract Rationale To reduce asthma symptoms in 5-12 year old children through a multifaceted environmental/educational intervention. Methods Changes in indoor allergen levels and asthma severity scores (summary score of symptoms, activity limitations, medication use, hospitalization and emergency department [ED] use) were compared over 14 months between an intervention and delayed intervention ("control") groups in a prospective, randomized field trial. Intervention group households had dust mite covers put on the child's sleeping surfaces, received a professional house cleaning, had roach bait and trays placed appropriately along with instructions in their monitoring, and received customized information about common allergens avoidance. Results Of 981 eligible subjects presenting to the ED, 410 (42%) were enrolled; 161 (40%) completed baseline activities and were randomized: 84 to intervention and 77 to control. At study's end, control children compared to baseline had a 163% increase in dust mite levels, while the intervention group levels were stable. There was no change in the overall asthma severity scores, however, relative to baseline, the median functional severity score (FSS) component declined more in the intervention (33% versus 20%) than the control group. The median FSS for the intervention group showed a 25% improvement compared to the control group (p Conclusions Dust mite allergen levels did not increase for the intervention group and the FSS indicated improvement without changing the overall asthma severity score. The interventions probably contributed to improvements in the allergenic environment and the function of the children.