Effect of indoor environmental interventions in the home on asthma in children and adolescents: A systematic review.

IF 3.1 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Respiratory medicine Pub Date : 2025-10-01 Epub Date: 2025-08-06 DOI:10.1016/j.rmed.2025.108299

Nina Viskum Hogaard, Torben Sigsgaard, Lone Agertoft, Susanne Halken, Sune Rubak

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引用次数: 0

Abstract

Background: Asthma is the most frequent chronic respiratory disease in childhood. Children spend much time indoors and are therefore exposed to many indoor allergens and pollutants for several hours during day and night. Many different measures have been investigated in an attempt to reduce the different indoor asthma triggers. The objective of this review was to evaluate the effect on asthma in children and adolescents of home environmental interventions.

Methods: A systematic review was conducted by searching five electronic databases and including randomised controlled trials studying the effect of environmental interventions, not aimed at tobacco smoke and smoke alone, on childhood allergic asthma. Data were extracted using a predefined template and quality of the evidence assessed using Cochrane risk-of-bias tool and the GRADE approach.

Results: We identified 13,124 studies and included 54 of which 24 intervened on house dust mites, 3 on pet allergen, 4 on pest allergen, 17 on indoor air quality and 6 were multifaceted interventions. There was a high degree of heterogeneity, and only three studies of high quality. A significant effect was found in two high quality studies on mattress covers, four (1 high, 1 moderate, 2 very low quality) studies on nocturnal, temperature-controlled laminar airflow and low evidence for effect of multifaceted interventions. Apart from this no clear effects of other interventions were found.

Conclusion: Multifaceted interventions, nocturnal laminar air flow and mitigating HDM exposure by mite-impermeable mattress covers are promising interventions. Future studies should use relevant asthma outcome measures and a rigorous study design based on experience from former studies.

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家庭室内环境干预对儿童和青少年哮喘的影响：一项系统综述。

背景：哮喘是儿童最常见的慢性呼吸系统疾病。儿童在室内的时间很长，因此在白天和晚上的几个小时内都暴露在许多室内过敏原和污染物中。已经研究了许多不同的措施，试图减少不同的室内哮喘诱因。本综述的目的是评估家庭环境干预对儿童和青少年哮喘的影响。方法：通过检索5个电子数据库进行系统综述，包括研究环境干预（不针对烟草烟雾或仅针对烟雾）对儿童过敏性哮喘影响的随机对照试验。使用预定义模板提取数据，并使用Cochrane偏倚风险工具和GRADE方法评估证据质量。结果：我们共纳入了13124项研究，其中54项涉及室内尘螨，3项涉及宠物过敏原，4项涉及害虫过敏原，17项涉及室内空气质量，6项涉及多方面干预。有高度的异质性，只有三个研究是高质量的。两项关于床垫套的高质量研究，四项（1项高质量，1项中等质量，2项非常低质量）关于夜间温控层流的研究发现了显著的效果，而多方面干预的效果证据较少。除此之外，没有发现其他干预措施的明显效果。结论：多方面的干预措施，夜间层流空气流动和通过防螨床垫套减轻HDM暴露是有希望的干预措施。未来的研究应使用相关的哮喘结局指标，并根据以往的研究经验进行严格的研究设计。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Respiratory medicine 医学-呼吸系统

CiteScore

7.50

自引率

0.00%

发文量

199

审稿时长

38 days

期刊介绍： Respiratory Medicine is an internationally-renowned journal devoted to the rapid publication of clinically-relevant respiratory medicine research. It combines cutting-edge original research with state-of-the-art reviews dealing with all aspects of respiratory diseases and therapeutic interventions. Topics include adult and paediatric medicine, epidemiology, immunology and cell biology, physiology, occupational disorders, and the role of allergens and pollutants. Respiratory Medicine is increasingly the journal of choice for publication of phased trial work, commenting on effectiveness, dosage and methods of action.