Article Text
Abstract
Introduction Elevated particulate matter (PM) concentrations of anthropogenic and/or desert dust origin are associated with increased morbidity among children with asthma.
Objective The Mitigating the Health Effects of Desert Dust Storms Using Exposure-Reduction Approaches randomised controlled trial assessed the impact of exposure reduction recommendations, including indoor air filtration, on childhood asthma control during high desert dust storms (DDS) season in Cyprus and Greece.
Design, participants, interventions and setting Primary school children with asthma were randomised into three parallel groups: (a) no intervention (controls); (b) outdoor intervention (early alerts notifications, recommendations to stay indoors and limit outdoor physical activity during DDS) and (c) combined intervention (same as (b) combined with indoor air purification with high efficiency particulate air filters in children’s homes and school classrooms. Asthma symptom control was assessed using the childhood Asthma Control Test (c-ACT), spirometry (forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC)) and fractional exhaled nitric oxide (FeNO).
Results In total, 182 children with asthma (age; mean=9.5, SD=1.63) were evaluated during 2019 and 2021. After three follow-up months, the combined intervention group demonstrated a significant improvement in c-ACT in comparison to controls (β=2.63, 95% CI 0.72 to 4.54, p=0.007), which was more profound among atopic children (β=3.56, 95% CI 0.04 to 7.07, p=0.047). Similarly, FEV1% predicted (β=4.26, 95% CI 0.54 to 7.99, p=0.025), the need for any asthma medication and unscheduled clinician visits, but not FVC% and FeNO, were significantly improved in the combined intervention compared with controls.
Conclusion Recommendations to reduce exposure and use of indoor air filtration in areas with high PM pollution may improve symptom control and lung function in children with asthma.
Trial registration number NCT03503812.
- paediatric asthma
Data availability statement
Data are available on reasonable request.
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Data availability statement
Data are available on reasonable request.
Footnotes
Contributors PKouis: project administration, methodology, investigation, software, data curation, visualisation, formal analysis, writing—original draft preparation; EG: methodology, writing—review and editing, supervision; EM: investigation, data curation, writing—review and editing; PKinni: investigation, data curation, software, visualisation, writing—review and editing; AM: investigation, methodology, software, data curation, writing—review and editing; CP: investigation, methodology, data collection, JP: investigation, software, data curation; SA: investigation, data curation, writing—review and editing; NM: methodology, data curation, formal analysis, writing—review and editing; PA: data curation, software, visualisation, writing—review and editing; HD: Project administration, data curation, writing—review and editing; ER: software, writing—review and editing; GS: software, writing—review and editing; HZ: software, data duration, writing—review and editing; CS: investigation, resources, methodology, data curation, writing—review and editing; EV: investigation, resources, project administration, data curation, writing—review and editing; NK: investigation, resources, methodology, data curation, writing—review and editing; AC: investigation, resources, data curation, writing—review and editing; FT: investigation, resources, data curation, writing—review and editing; SIP: methodology, formal analysis, writing—review and editing; PKoutrakis: conceptualisation, methodology, formal analysis, writing—review and editing; PY: conceptualisation, methodology, formal analysis, writing—original draft preparation, funding acquisition, supervision. PY (content guarantor) accepts full responsibility for the finished work and/or the conduct of the study, had access to the data, and controlled the decision to publish.
Funding The study was financed by the European Union LIFE Project MEDEA (LIFE16 CCA/CY/000041).
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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