Panayiotis Kouis, Emmanouil Galanakis, Eleni Michaelidou, Paraskevi Kinni, Antonis Michanikou, Constantinos Pitsios, Julietta Perez, Souzana Achilleos, Nicos Middleton, Pinelopi Anagnostopoulou, Helen Dimitriou, Efstathios Revvas, Gerasimos Stamatelatos, Haris Zacharatos, Chrysanthos Savvides, Emily Vasiliadou, Nikos Kalivitis, Andreas Chrysanthou, Filippos Tymvios, Stefania I Papatheodorou, Petros Koutrakis, Panayiotis K Yiallouros
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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).</p><p><strong>Results: </strong>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). 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引用次数: 0
摘要
导言：人为和/或沙漠沙尘造成的颗粒物（PM）浓度升高与哮喘儿童发病率增加有关：利用减少接触方法减轻沙漠沙尘暴对健康的影响随机对照试验评估了减少接触建议（包括室内空气过滤）对塞浦路斯和希腊沙漠沙尘暴高发季节儿童哮喘控制的影响：患有哮喘的小学生被随机分为三个平行组：(a) 无干预组（对照组）；(b) 户外干预组（早期警报通知，建议在沙漠沙尘暴期间待在室内并限制户外体育活动）；(c) 综合干预组（与(b)组相同，同时在儿童家中和学校教室使用高效微粒空气过滤器进行室内空气净化）。哮喘症状控制情况通过儿童哮喘控制测试（c-ACT）、肺活量测定（1 秒内用力呼气容积（FEV1）、用力肺活量（FVC））和呼出一氧化氮分数（FeNO）进行评估：在2019年和2021年期间，共对182名哮喘儿童（平均年龄=9.5岁，SD=1.63）进行了评估。经过三个月的随访，与对照组相比，联合干预组的 c-ACT 有显著改善（β=2.63，95% CI 0.72 至 4.54，p=0.007），特应性儿童的改善幅度更大（β=3.56，95% CI 0.04 至 7.07，p=0.047）。同样，与对照组相比，联合干预措施显著改善了预测 FEV1%（β=4.26，95% CI 0.54 至 7.99，p=0.025）、对任何哮喘药物的需求和非计划就诊率，但 FVC% 和 FeNO 没有改善：结论：建议在可吸入颗粒物污染严重的地区减少接触并使用室内空气滤清，可改善哮喘儿童的症状控制和肺功能：NCT03503812。
Improved childhood asthma control after exposure reduction interventions for desert dust and anthropogenic air pollution: the MEDEA randomised controlled trial.
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.
期刊介绍：
Thorax stands as one of the premier respiratory medicine journals globally, featuring clinical and experimental research articles spanning respiratory medicine, pediatrics, immunology, pharmacology, pathology, and surgery. The journal's mission is to publish noteworthy advancements in scientific understanding that are poised to influence clinical practice significantly. This encompasses articles delving into basic and translational mechanisms applicable to clinical material, covering areas such as cell and molecular biology, genetics, epidemiology, and immunology.
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