The Science Journal of the American Association for Respiratory Care

2002 OPEN FORUM Abstracts

EFFECTIVE EDUCATION BY RESPIRATORY THERAPISTS CAN REDUCE INDOOR ENVIRONMENTAL ASTHMA TRIGGERS

Timothy R. Myers BS, RRT, Thomas Kallstrom, RRT, FAARC & the Multicenter Indoor Environment Study Group for the American Respiratory Care Foundation, American Association for Respiratory Care & the Environmental Protection Agencies Indoor Division. Dallas, Tx & Washington D.C.

Introduction. The home environment is one of the crucial components of any comprehensive asthma management program. The ultimate goal in environmental control is eradication of the offending trigger source, or at the very least a reduction in exposure to irritants. The primary objective of this pilot project was to identify and attempt to reduce indoor environmental triggers (by 25%) through a respiratory therapy-driven intervention.

Methods. Multicenter study of children aged 1-18 years admitted to the hospital or visiting the emergency department (ED) for an asthma exacerbation were eligible for the study. Study centers were located in 3 regions of the U.S., the South, Midwest and Northwest. Centers were located in metropolitan, inner-city neighborhoods. Study participants had a history of asthma or reactive airways disease. Patients and/or their parents were questioned regarding the child?s exposure to indoor asthma triggers such as dust mites, pests, pets, molds, etc?. After completing a questionnaire, an intervention was implemented by respiratory therapists to educate and suggest mechanisms to reduce or eliminate triggers. Upon discharge, families were contacted initially at 7-10 days after discharge and again at 2 and 4 months to assess for behaviour changes that either reduced or eliminated indoor asthma triggers.

Results. A multicenter educational intervention with 437 study participants. The majority of patients were black males (61.1% and 58.1% respectively). The table below represents overall percentages of potential triggers (by category) reported to be present in study participants? homes. A specific breakdown found the following triggers present in study participants? homes (overall percentages). Dust mites exposure as a potential trigger was the most prevalent source overall (stuffed animals=68%, absence of dust-proof casings =52%, bedroom or TV room carpeting =70%). Almost 41% of children in this study were exposed to second-hand cigarette smoke. In the two Southern study sites, over 50% of the study participants were exposed to second-hand smoke. The most prevalent pet trigger reported in the home was a family dog (23% overall). The two most prevalent pests sources as triggers were mice and cockroaches (10% and 9%). However in the two Southern study sites, the presence of cockroaches were more prevalent than the overall study average (27%). Unemptied refrigerator drip pans (27%) were the most frequently reported potential trigger source for molds and mildews. For the category of fumes, a natural gas stove was the most frequently reported source as a potential trigger (53%). Post intervention contact made by respiratory herapists found a decrease in study rentention with each phone call (68%, 49%, 47%).

Trigger Category Overall Percentage Trigger Category Overall Percentage
Second-hand Smoke 25.3% Pests 6.5%
Pets 8.8% Molds & Mildew 25.1%
Dust Mites 44.2% Fumes 27.7%

Conclusions. For the 4-month duration of this multicenter, pilot study by respiratory therapist, 38% of the children had home interventions or behavior modifications that led to the reduced potential or complete elimination of potential indoor triggers of asthma.

OF-02-031

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