Randomized Trial of Interventions to Improve Childhood Asthma in Homes with Wood-burning Stoves.
Randomized Trial of Interventions to Improve Childhood Asthma in Homes with Wood-burning Stoves.
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DOI：
10.1289/ehp849
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发表时间：
2017-09-13
影响因子：
10.4
通讯作者：
Ward TJ
中科院分区：
文献类型：
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作者：
Noonan CW;Semmens EO;Smith P;Harrar SW;Montrose L;Weiler E;McNamara M;Ward TJ
为住宅供暖而燃烧生物质造成的家庭空气污染对弱势群体产生不利影响。改善哮喘儿童家中室内空气质量的随机对照试验有限，并且没有在使用木材取暖的家庭中进行过此类研究。我们的目的是检验这样一个假设，即家庭层面的干预措施，特别是改进技术的木材燃烧器具或空气过滤装置，将改善健康措施，特别是儿童哮喘生活质量问卷（PAQLQ）评分，相对于安慰剂，在家庭中使用木材燃烧炉灶的哮喘儿童中。一项三臂安慰剂对照的随机试验在哮喘儿童中使用烧木材的炉子进行。多项干预前和干预后数据包括PAQLQ（主要结局）、呼气峰流量（PEF）监测、昼夜峰流量变异性（dPFV，气道高反应性指标）和室内颗粒物（PM）。与安慰剂相比，空气过滤器和柴炉干预都没有改善生活质量。在次要结局中，与安慰剂相比，dPFV显示使用空气过滤的变异性降低4.1个百分点。空气过滤器干预显示，67%（95%CI：50%至77%）减少在室内，但没有观察到与改进技术的柴炉干预的变化。在患有哮喘和长期暴露于木材烟雾的儿童中，改善室内空气质量的空气过滤器干预并不影响生活质量。意向治疗分析显示次要指标dPFV有所改善。ClincialTrials.gov NCT 00807183。https://doi.org/10.1289/EHP849
Household air pollution due to biomass combustion for residential heating adversely affects vulnerable populations. Randomized controlled trials to improve indoor air quality in homes of children with asthma are limited, and no such studies have been conducted in homes using wood for heating. Our aims were to test the hypothesis that household-level interventions, specifically improved-technology wood-burning appliances or air-filtration devices, would improve health measures, in particular Pediatric Asthma Quality of Life Questionnaire (PAQLQ) scores, relative to placebo, among children living with asthma in homes with wood-burning stoves. A three-arm placebo-controlled randomized trial was conducted in homes with wood-burning stoves among children with asthma. Multiple preintervention and postintervention data included PAQLQ (primary outcome), peak expiratory flow (PEF) monitoring, diurnal peak flow variability (dPFV, an indicator of airway hyperreactivity) and indoor particulate matter (PM) . Relative to placebo, neither the air filter nor the woodstove intervention showed improvement in quality-of-life measures. Among the secondary outcomes, dPFV showed a 4.1 percentage point decrease in variability [ to ] for air-filtration use in comparison with placebo. The air-filter intervention showed a 67% (95% CI: 50% to 77%) reduction in indoor , but no change was observed with the improved-technology woodstove intervention. Among children with asthma and chronic exposure to woodsmoke, an air-filter intervention that improved indoor air quality did not affect quality-of-life measures. Intent-to-treat analysis did show an improvement in the secondary measure of dPFV. ClincialTrials.gov NCT00807183. https://doi.org/10.1289/EHP849