Home and allergic characteristics of children with asthma in seven US urban communities and design of an environmental intervention: The Inner-City Asthma Study
Home and allergic characteristics of children with asthma in seven US urban communities and design of an environmental intervention: The Inner-City Asthma Study
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DOI：
10.1289/ehp.02110939
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发表时间：
2002-09-01
影响因子：
10.4
通讯作者：
Stout, JW
中科院分区：
文献类型：
--
作者：
Crain, EF;Walter, M;Stout, JW
大多数已发表的环境修复干预措施针对的是单一过敏原，并采用了要求较高的策略；很少在哮喘负担过重的市中心儿童家中进行。我们的目标是：a）描述全国范围内患有中重度哮喘的市中心儿童样本的过敏原敏感性、环境烟草烟雾（ETS）暴露情况以及家庭环境特征；b）制定并实施一项多层面、以家庭为基础的综合干预措施，以减少家庭过敏原和ETS，该措施针对这些儿童的特定致敏和暴露情况量身定制。进行了过敏原皮肤试验和家庭评估，以确定ETS的存在以及已知与室内过敏原水平升高相关的因素。根据已发表的修复技术，设计了一种家庭环境干预措施，该措施分为多个模块，每个模块针对五种特定过敏原组或ETS中的一种。在美国七个城市社区的994名过敏儿童中，937名成功完成了基线访谈和家庭过敏原调查并被纳入研究。超过50%的儿童对三种或更多过敏原组的皮肤试验呈阳性。58%的家庭报告有蟑螂，55%的儿童卧室铺有满铺地毯，48%的家庭有吸烟者，40%的家庭有老鼠，28%的家庭有毛茸茸的宠物。超过60%的参与家庭接受了四个或更多模块，并且所有模块中有94% - 98%得以完成。我们得出结论，大多数患有中重度哮喘的市中心儿童对多种室内过敏原敏感，并且已知与哮喘严重程度相关的环境因素在他们的家中普遍存在。为市中心哮喘研究制定的干预措施采用了公认的方法来解决一系列过敏原和ETS暴露问题，同时确保干预措施针对这些儿童的特定致敏情况和家庭特征量身定制。
Most published environmental remediation interventions have been directed at single allergens and have employed demanding strategies; few have been performed in the homes of inner-city children disproportionately burdened by asthma. Our objective was a) to describe the allergen sensitivities, environmental tobacco smoke (ETS) exposure, and home environmental characteristics of a national sample of inner-city children with moderate to severe asthma and b) to develop and implement a multifaceted, home-based comprehensive intervention to reduce home allergens and ETS, tailored to the specific sensitization and exposure profiles of those children. Allergen skin testing and a home evaluation were performed to determine the presence of ETS and factors known to be associated with increased indoor allergen levels. Based on published remediation techniques, a home environmental intervention, organized into modules, each addressing one of five specific allergen groups or ETS, was designed. Of 994 allergic children from seven U.S. urban communities, 937 successfully completed baseline interviews and home allergen surveys and were enrolled. More than 50% of children had positive skin tests to three or more allergen groups. Cockroaches were reported in 58% of homes, wall-to-wall carpeting in the child's bedroom in 55%, a smoker in 48%, mice or rats in 40%, and furry pets in 28%. More than 60% of enrolled families received four or more modules, and between 94% and 98% of all modules were completed. We conclude that most inner-city children with moderate to severe asthma are sensitized to multiple indoor allergens and that environmental factors known to be associated with asthma severity are commonly present in their homes. The intervention developed for the Inner-City Asthma Study employs accepted methods to address an array of allergens and ETS exposure while ensuring that the intervention is tailored to the specific sensitization profiles and home characteristics of these children.